OBJECTIVE: Vocal fold (VF) nodules are very common laryngeal lesion that affects people, including children as well. However, it has a negative impact on the communication and voice quality which is why it is important to study and measure it. Unfortunately, there may be factors which disturb examining process especially during questionnaire self-assessment. This study aimed to investigate whether public speaking anxiety (stage fright) correlates with scores on the Children\'s Voice Handicap Index-10 (CVHI-10) and to determine if children with VF nodules assess their voice similarly to those without such lesions.
METHODS: Thirty-seven respondents at age 8-12 participated in the study. It was conducted the surveys: Children Voice Handicap Index-10 (CVHI-10), Stage Fright Scale - Children & Youth (SFS-CY), and Neuroticism subscale of the Big Five Questionnaire - Children (BFQ-C-Neu) and endoscopy laryngeal examination. The text describes the reliability analysis, means comparison, and correlation analysis.
RESULTS: The measures used achieved a high level of reliability. There were no statistically significant differences in voice self-assessment scores between groups with and without VF nodules. Significant relationships were found between the CVHI-10 scores and all factors of the SFS-CY.
CONCLUSIONS: The results reveal that children with VF nodules assess their voice similarly to those without laryngeal lesions. Correlation analysis shows significant relationships between voice handicap in self-assessment and stage fright factors. This may explain the lack of differences in CVHI-10 scores among groups; however, further research is needed to clarify this phenomenon.

Musical performance anxiety (MPA) is considered a subtype of social phobia and affects musicians who must face musical exposure in public, potentially severely affecting their emotional stability and significantly impairing the quality of their performance. This research has utilized previous scientific knowledge on the issue and a qualitative approach to musicians\' needs through focus groups in order to design a collective preventive program for MPA that could be implemented within the training curriculum of professional musicians. To evaluate the adequacy of the preventive program \'ConfiDance\', a pilot test was conducted with a sample of 17 professional musicians in training, all post-graduate students in classical music performance. For the pilot test, a quasi-experimental model with a repeated measures methodology (pre-post and one-year follow-up after application) was carried out. The results indicate a significant decrease in MPA after the program implementation, with a notable improvement in effect one year post-application, demonstrating an even greater positive impact over time. These data should be interpreted cautiously due to sample limitations but represent an opportunity for the future implementation of a program that can prevent and treat MPA in music education centers.

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Performance anxiety is a widespread issue that can affect musicians across their education and career. It can develop in musicians from a young age leading to short-term and long-term impacts on not only their performance, but also their wellbeing. There is potentially a significant role that music educators hold in the development of their students and how they handle performance anxiety, though it is not clear how, or how often, teachers support their students in this way. Through a PRISMA-based systematic review, this paper explores what is known about the strategies used by music educators to help manage their students\' performance anxiety. The paper also discusses the role that instrumental/vocal tutors and school classroom teachers might hold in this area. The findings show that music educators are implementing multiple strategies to assist their students with MPA, with the most common being simulated performance, positive outlook, preparation and breathing. It was found that there is a role for teachers to address MPA management with their students. While some students prefer to receive MPA support from experts in the field of psychology, students still expressed a need to have this support come from their teacher. Though many teachers felt a need for additional training for them to help their students cope with MPA, many of the strategies were found to be multifunctional and embedded into the regular teaching practices or teaching styles of the educator. Although these strategies might be implicit rather than explicit, the findings suggest that music educators could represent a valuable source of support for MPA management.

Music performance anxiety (MPA) manifests itself at mental, physiological, and behavioral levels. The present study investigated how the experience of the three levels of symptoms changes over time, and how musicians cope with these temporal changes in MPA symptoms. To this end, we conducted a questionnaire survey in which 38 student musicians freely commented on their experiences of mental and physical changes, as well as their coping strategies for these changes. This was examined during five different time periods around public performance, extending from the beginning of the preparation for a public performance until shortly before the next public performance. The free-text comments obtained from the questionnaire were analyzed thematically and classified into different response themes. We then examined the temporal changes in the frequency of comments on each response theme. We further conducted a semi-structured interview involving eight musicians to explore the responses to the questionnaire in greater detail. We analyzed the contents of the free-text comments obtained from the questionnaire and the interview for each response theme, focusing on the most frequently mentioned sub-themes. The results indicate that musicians started to experience mental MPA symptoms (e.g., negative feelings) as soon as they began to prepare for public performance. To cope with mental symptoms, musicians employed mental strategies such as positive thinking/self-talk and concentration both before and during public performance. The experience of physiological MPA symptoms (e.g., increased heart rate) peaked shortly before public performance and remained throughout performance. To cope with a variety of physiological symptoms, musicians employed physical strategies, especially deep breathing and exercise, shortly before public performance. In contrast, behavioral MPA symptoms (e.g., tremor) were experienced mostly during public performance. Some musicians also reported experiencing the actual impairment of performance quality. To avoid this, musicians employed a variety of practicing techniques (e.g., playing at a slower tempo) during the preparation for public performance and performing techniques (e.g., paying attention to expressions) during public performance. Together, the present findings indicate that mental, physiological, and behavioral symptoms of MPA exhibit differential timelines and that musicians effectively utilize different coping strategies according to the temporal changes in MPA symptoms.

UNASSIGNED: High heart rate (HR) and restlessness are two important features of music performance anxiety (MPA). In a case report of a cellist suffering from this condition, we showed that HR and restlessness decreased after repeated live performances of the same musical excerpt, thereby positively modulating objective performance criteria and subjective components. Here, we largely replicate these results in a group of 18 string players reporting MPA.
UNASSIGNED: Objective measurement devices included a miniaturized electrocardiogram monitor and three 3-axis accelerometer loggers. Subjective measures included the Multidimensional Mental Health Questionnaire (MDBF) and a customized visual analogue scale (VAS) questionnaire for MPA. Non-artistic performance errors were assessed by music experts using a composite score for technical playing errors (i.e., intonation errors, omission of notes, and bowing noise). Data were collected from each study participant during three brief public solo performances of the same musical excerpt, with each performance occurring before a new audience on the same day.
UNASSIGNED: From the 1st to the 3rd performance, HR, VAS, and playing error scores decreased significantly. MDBF (RU scale) showed a significant increase in calmness from the 1st to the 3rd performance on stage. HR and RU, VAS, and RU, as well as bow acceleration and overall duration of playing correlated significantly across participants and performances.
UNASSIGNED: We conclude that repeated stage exposure significantly reduces HR as well as restlessness and playing errors linked to MPA. Public performances are still successful when HR is significantly higher than during rest periods. These results underscore the importance of stage training to become accustomed to realistic public self-exposure. Musicians - especially students - should consider this component of stage training as an integral part of their practice routine. Therefore, stage training can reduce MPA, promote better live performances and prevent stress-related mental disorders and physical injuries. These result from excessive self-exercise strategies common in musicians experiencing MPA. HR monitoring should be an integral part of evaluating the effectiveness of interventions for better MPA management and efficient performance training.

Propranolol, a non-cardioselective β1,2 blocker, is most commonly recognised for its application in the therapy of various cardiovascular conditions, such as hypertension, coronary artery disease, and tachyarrhythmias. However, due to its ability to cross the blood-brain barrier and affinity towards multiple macromolecules, not only adrenoreceptors, it has also found application in other fields. For example, it is one of the very few medications successfully applied in the treatment of stage fright. This review focuses on the application of propranolol in the treatment of various types of anxiety and stress, with particular reference to stage fright and post-traumatic stress disorder (PTSD). Both mechanisms of action as well as comparison with other therapies are presented. As those indications for propranolol are, in most countries, considered off-label, this review aims to gather information that can be useful while making a decision about the choice of propranolol as a drug in the treatment of those mental conditions.

Stressors induce physiological changes in the brain and periphery that support adaptive defensive responses. The consequences of psychological stress on cognitive functioning are often measured in laboratory settings using experimentally induced stress that leads to mainly negative subjective feelings. There is a need for verification of these studies using real-life stressors that may potentially induce both positive and negative subjective feelings. In an observational study, we investigated real-life stress induced by voluntary stage performance at a large-scale music festival, including 126 participants (60 female, age range = 16-57 years). Our primary measurements involved salivary cortisol, heart rate, blood pressure, and positive and negative affect. In addition, participants completed a 2-back working memory task and a speeded decision-making task. We found that stage performance significantly increased salivary cortisol - with a particularly low number of cortisol non-responders - and heart rate, even when controlling for potential confounding factors, such as sleep, movement, and alcohol use. Interestingly, stage performance significantly decreased negative affect while increasing positive affect. This positively experienced stressor (\"eustressor\") was related to impaired working memory performance: the stronger the increases in cortisol, the slower participants responded to targets. Decision-making, however, was not affected. In conclusion, we show how stressful experiences in real-life can lead to positive affect, but still have a similar negative impact on cognitive functioning. We suggest that future research should focus more on the consequences of real-life stressors, and the consequences of eustress, in order to extend our understanding of the concept of psychological stress.

Music performance anxiety (MPA) is one of the most common disorders among professional musicians, nevertheless, little is known about the disease. With this systematic review, prevalence, risk factors and treatment procedures for MPA were assessed, and for the first time, quality assessments were carried out for all studies using standardized assessment tools. A systematic literature search was conducted via search algorithms in the databases MEDLINE, EMBASE, CINAHL, PsycArticles, PsycInfo and ERIC. Included were case reports, case-control, cohort, cross-sectional and intervention studies examining professional musicians with MPA. For quality assessment, adapted tools of the National Heart, Lung, and Blood Institute were used. A total of 43 studies were included (10 case reports, 21 intervention, 11 cross-sectional, one cohort study). Quality ratings ranged from -11 to 6 out of a maximum of 15/16 points for cross-sectional/cohort studies and -4 to 11 out of 18 points for intervention studies. The prevalence of MPA was between 16.5% and 60%. More women than men were affected and musicians older than 45-50 years reported less MPA than younger musicians. Regarding treatment cognitive behavioural therapy (CBT) and β-blockers were most often researched with beneficial results for CBT. However, studies with adequate control groups for CBT interventions are needed to clarify its efficacy. Studies showed methodological weaknesses, especially in the selection of participants, recording of influencing factors, blinding of interventions, randomization of participants and analysis of comorbidity. Recommendations for further research are made.

Anxiety has long been associated with diminished performance within a number of domains involving evaluative interpersonal interactions, including Sex, Sport, and Stage. Here, we pose three questions: (1) how do these disparate fields approach and understand anxiety and performance; (2) how does the understanding of the issue within one field offer insight to another field; and (3) how could each field benefit from the ideas and strategies used by the others. We begin with a short review of models of anxiety/arousal and performance and then explore definitions, models, presumed underlying physiological processes, and characterizing and influencing factors within each domain separately in a narrative review. This discussion is followed by a synthesis that identifies elements specific to and common across the various domains, with the latter captured in a model of essential characteristics. Concluding remarks note the potential value of promoting increased cross-disciplinary conversation and research, with each domain likely benefiting from the conceptualizations and expert knowledge of the others.