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Music Performance AnxietyNCT05735860

The Application of Virtual Reality Exposure Versus Relaxation Training in Music Performance Anxiety

A study testing Virtual Reality Exposure Therapy (VRET) and Progressive Muscle Relaxation (PMR) in people with Music Performance Anxiety, run by Wuerzburg University Hospital at 1 site in Germany.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The aim of the study is to investigate the effect of exposure treatment using virtual reality (VR) in musicians with performance anxiety compared to a relaxation technique on anxiety symptoms and corresponding cardiovascular parameters. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Music Performance Anxiety
What is being tested?
Virtual Reality Exposure Therapy (VRET) and Progressive Muscle Relaxation (PMR)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
46 participants
Where
1 siteGermany
Study dates
11 Jan 2022to 1 Mar 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Music performance anxiety (MPA)
  • Reporting anxiety and/or avoidance of musical performance situations
  • Reporting psychological distress and/or impaired functioning due to the MPA
  • Sufficient knowledge of the German language (to understand questionnaires and the therapy manual)
  • Compliance with the covid-19-regulations for local study appointments
  • Written informed consent

Who cannot join

  • Substance use disorder
  • Physiological contraindications for an exposure therapy (i.e. epilepsy, serious disorder of the cardiovascular system)
  • Psychological contraindications for an exposure therapy (i.e. psychotic disorder, substance dependence, borderline personality disorder, acute suicidality)
  • Use of sedative medication or tranquilizers (i.e. beta-blockers) for the therapy appointments
  • Claustrophobia
  • Blood-injection-injury type phobia
Show all 10Show fewer
  • Instrument not portable, too big or not playable while standing (i.e. piano, drums, harp, double bass)
  • Not able to play the instrument blindfold
  • Current psychotherapy because of the MPA
  • Recent (< 6 months ago) psychotherapy because of the MPA

Trial locations and contacts

1 site in 1 country.

Daniel Bellinger, Dr. med. contact

0931/201-76345

Bellinger_D@ukw.de

Kristin Wehrmann, M. Sc. contact

wehrmann_K2@ukw.de

Germany1 site, 1 recruiting
  • Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital of Wuerzburg

    Würzburg, 97080

    Jürgen Deckert, Prof. Dr. med.

    Recruiting

Other trials in Germany

About this study

Official title: Die Nutzung Virtueller Realität Zur Behandlung Von Auftrittsangst

The aim of the study is to investigate the effect of exposure treatment using virtual reality (VR) in musicians with performance anxiety compared to a relaxation technique on anxiety symptoms and corresponding cardiovascular parameters. The prospective, randomized clinical trial will include 46 musicians with musical performance anxiety (MPA). The experimental group will receive four exposure sessions in VR and the control group will receive four progressive muscle relaxation (PMR) sessions. Anxiety symptoms will be measured using a german version of the Performance Anxiety Questionnaire and a behavioral assessment test (BAT) before, after the treatment, and at 6-month follow-up. The cardiovascular reactivity will be assessed measuring the heart rate variability (HRV) throughout the BAT and the blood pressure before and after the BAT. Furthermore, blood and saliva samples will be collected before and after the BAT to assess endocrine stress parameters and epigenetic markers. The following hypotheses are derived: 1) Significant and lasting reduction of subjective MPA symptoms for the experimental group receiving VRET at T1 (post/ shortly after treatment) and T2 (follow-up/ 6 months after treatment) compared to T0 (pre/ before treatment). 2) Significant better reduction of subjective MPA symptoms for the experimental group receiving VRET compared to the control group receiving PMR at T1 (post/shortly after treatment) and T2 (follow-up/ 6 months after treatment) compared to T0 (pre/ before treatment). 3) The postulated effects in hypotheses 1 and 2 go along with a significantly higher HRV representing less cardiac stress during the BAT in case of a successful reduction of anxiety symptoms at T1 (post/ shortly after treatment) and T2 (follow-up/ 6 months after treatment) compared to T0 (pre/ before treatment).

Being tested
Virtual Reality Exposure Therapy (VRET), Progressive Muscle Relaxation (PMR)

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Virtual Reality Exposure Therapy (VRET)Behavioural

    Four VRET sessions of approx. one hour each session taking place in an individual setting accompanied by a therapist. The participants wear a head-mounted display showing different musical performance scenarios (i.e. audition in a concert hall/ recording studio/ in front of a professional jury/ an audience/ a class of music students) that are selected individually by a previously standardized, graded exposure procedure.

  • Progressive Muscle Relaxation (PMR)Behavioural

    Four PMR sessions of approx. 45min each session taking place in an individual setting accompanied by a therapist. The sessions follow a previously standardized procedure.

Study groups in NCT05735860
Study groupRoleWhat they receive
Virtual Reality Exposure Therapy (VRET)ExperimentalNot described
Receives: Behavioral: Virtual Reality Exposure Therapy (VRET)
Progressive Muscle Relaxation (PMR)Active comparatorNot described
Receives: Behavioral: Progressive Muscle Relaxation (PMR)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. German Version of the Performance Anxiety Questionnaire (Fehm, 2002)

    Measuring subjective MPA symptoms for solo and ensemble performances by assessing the total score for the scale solo performance (0-80) and the total score for the scale ensemble performance (0-80). Higher scores indicate more symptoms of music performance anxiety.

    Measured: Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)

  2. Heart rate variability

    Measuring the cardiac reactivity throughout the BAT in virtual reality

    Measured: Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)

Secondary outcomes (18)
  1. Subjective Units of Distress (SUDs) during the BAT

    Measuring subjective MPA (0-100) in the BAT in virtual reality. Higher scores indicate a higher level of anxiety.

    Measured: Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)

  2. Social Interaction Anxiety Scale (SIAS)

    Measuring symptoms of social anxiety or distress specifically when talking or meeting others. A higher total score (0-80) indicates more symptoms of social anxiety.

    Measured: Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)

  3. Social Phobia Scale (SPS)

    Measuring symptoms of social phobia specifically in anticipation of or when actually being observed by others and when engaging in activities in the presence of others. A higher total score (0-80) indicates more symptoms of social anxiety.

    Measured: Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)

  4. Beck Depression Inventory (BDI-II)

    Measuring symptoms of depression. A higher total score (0-63) indicates more symptoms of depression.

    Measured: Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)

  5. Beck Anxiety Inventory (BAI)

    Measuring symptoms of anxiety. A higher total score (0-63) indicates more symptoms of anxiety.

    Measured: Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)

  6. Anxiety Sensitivity Index (ASI-3)

    Measuring anxiety sensitivity. A higher total score (0-56) indicates a higher level of anxiety sensitivity.

    Measured: Only one assessment at T0 (pre/ before treatment)

  7. State Trait Anxiety Inventory - Trait (STAI-Trait)

    Measuring trait anxiety. A higher total score (20-80) indicates a higher level of trait anxiety.

    Measured: Only one assessment at T0 (pre/ before treatment)

  8. Childhood Trauma Questionnaire (CTQ)

    Measuring childhood-history of abuse and neglect by assessing the total scores for the scales Emotional Neglect (7-35), Sexual Abuse (5-25), Physical Abuse and Neglect (7-35), and Emotional Abuse (5-25). Higher Scores indicate a higher level of childhood abuse and/or neglect.

    Measured: Only one assessment at T0 (pre/ before treatment)

  9. Immersive Tendencies Questionnaire (ITQ)

    Measuring immersive tendencies. Higher scores on the scales Focus (5-35), Implication (5-25), Emotion (4-28), Joy (3-31) and a higher total score (17-119) indicate a higher level of immersive tendencies.

    Measured: Only one assessment at T0 (pre/ before treatment)

  10. Uncertainty Tolerance Scale (UGTS)

    Measuring uncertainty tolerance. A higher total score (8-48) indicates a higher level of uncertainty tolerance.

    Measured: Only one assessment at T0 (pre/ before treatment)

  11. Positive and Negative Affect Schedule (PANAS)

    Measuring state affect. Higher scores on the scales Positive Affect (10-50) and Negative Affect (10-50) indicate a higher level of positive or negative state affect.

    Measured: Change from before to after (approx. 45min later) the BAT in VR at T0 (pre/ before treatment), T1 (post/ approx. one week after treatment) and T2 (follow-up/ 6 months after treatment)

  12. Blood pressure

    Measuring cardiac stress

    Measured: Change from before to after (approx. 30min later) the BAT in VR at T0, T1 and T2; and changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)

  13. Heart rate

    Measuring cardiac stress

    Measured: Change from before to after (approx. 30min later) the BAT in VR at T0, T1 and T2; and changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)

  14. Salivary cortisol hormone

    Measuring the psychophysiological stress response

    Measured: Change from before to after (approx. 30min later) the BAT in VR at T0, T1 and T2; and changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)

  15. Neuropeptides

    Analysis of neuropeptides with modulating effects on humoral and behavioral stress response, and myocardial as well as autonomic nerve system function, such as Atrial natriuretic Polypeptide (ANP), neuropeptide Y (NPY), Oxytocin (OCT), salivary Alpha-Amylase (sAA).

    Measured: Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)

  16. Epigenetic Targets

    mDNA analysis of the candidate genes related to the endocrine stress reactivity (NR3C1, FKBP5, CRHR1) and DNAm analysis of Norepinephrine Transporter (NET) and Oxytocin Receptor (OXTR) genes due to their implication in the regulation of autonomous function and social anxiety

    Measured: Change from before to after (approx. 30min later) the BAT in VR at T0, T1 and T2; and changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)

  17. Kenny Music Performance Anxiety Inventory-Revised (K-MPAI-R)

    Measuring performance anxiety in musicians. A higher total score (0-240) indicates a higher level of music performance anxiety.

    Measured: Change from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)

  18. Questionnaire on safety- and avoidance behaviors for musicians (Mumm et al., 2020)

    Measuring the use of safety and avoidance behaviors in musicians. A higher total score (0-215) indicates a higher use of safety- and avoidance behaviors to reduce anxiety in performance situations.

    Measured: Change from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Feb 2023
  2. Study start11 Jan 2022
  3. Primary completion1 Mar 2024 (estimated)
  4. Study completion1 Mar 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
randomized controlled / two-arm parallel assignment
Masking
Single blind
Who is masked
Participant
Enrolment
46 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05735860
Sponsor's protocol ID
194/21-sc
Status last verified
Feb 2023
First submitted
14 Dec 2022
Last updated
21 Feb 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Bellinger D, Wehrmann K, Rohde A, Schuppert M, Stork S, Flohr-Jost M, Gall D, Pauli P, Deckert J, Herrmann MJ, Erhardt-Lehmann A. The application of virtual reality exposure versus relaxation training in music performance anxiety: a randomized controlled study. BMC Psychiatry. 2023 Aug 1;23(1):555. doi: 10.1186/s12888-023-05040-z.

    PubMed 37528410

Questions about this trial

What is this clinical trial studying?

A study testing Virtual Reality Exposure Therapy (VRET) and Progressive Muscle Relaxation (PMR) in people with Music Performance Anxiety, run by Wuerzburg University Hospital at 1 site in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 21 Feb 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Daniel Bellinger, Dr. med. (0931/201-76345, Bellinger_D@ukw.de), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

German Version of the Performance Anxiety Questionnaire (Fehm, 2002) (time frame: Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05735860, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Feb 2023.

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