Treatment Of Performance Anxiety Research Articles

Choking under Pressure: Degrading Flashforwards Related to Performance Anxiety

Intrusive vivid images of future catastrophe (“flashforwards”) are important in social fears, like performance anxiety. Previous studies in healthy volunteers found that eye movements reduce vividness and emotionality of negative mental images of past events and future–oriented events. This study tested whether eye movements reduce image vividness and emotionality in students with performance anxiety. Participants (N = 29) imagined two feared future events related to performance anxiety during six 24 s blocks per image: one image was accompanied by eye movements, the other was not. Image vividness and emotionality were assessed before and after these blocks. Relative to the eyes stationary condition, eye movements resulted in a significant decrease in image vividness, and a trend was observed for reduced emotionality. The findings add to earlier experimental findings on the benefits of dual-tasks during mental imagery, and suggest that eye movements and related procedures may be helpful in the treatment of performance anxiety.

Symptoms and Significance: Constructivist Contributions to the Treatment of Performance Anxiety

Drawing on the case study of Gabriel, a college student faced with severe performance anxiety, I illustrate the possible approach to case conceptualization and treatment that might be taken by two constructivist schools of psychotherapy—personal construct therapy and coherence therapy. In doing so, I emphasize the distinctive procedures that characterize these classic and contemporary constructivist models, which differentiate them clearly from the orientation to assessment and intervention preferred by many other approaches to cognitive therapy. Finally, I close by noting my own penchant for a personal, integrative style of therapy that finds inspiration in both personal construct and coherence models, as well as a diversity of other constructivist and social constructionist perspectives.

Special Applications of EMDR: Treatment of Performance Anxiety, Sex Offenders, Couples, Families, and Traumatized Groups

This article presents four brief reports that illustrate EMDR’s potential in addressing a range of pathologies and problems. These include traumatized groups, families and couples, sex offenders, and individuals with performance anxiety. Each brief report provides a short summary of the research, highlights current EMDR research, and points out what is needed for future investigations. Preliminary results suggest that the EMDR–integrative group treatment protocol may be an effective means of providing mental health care to large groups of people affected by critical incidents. The report titled “EMDR in Couples and Family Therapy” provides an overview of the field and describes the various ways in which EMDR is being incorporated. The presenting issue with performance anxiety is debilitating evaluation anxiety at the prospect of having to perform some important activity in front of an audience that matters a great deal to the client. Sex offender treatment is enhanced by an effective means of resolving psychological mechanisms that contribute to the dynamics of the offense chain.

Good and Bad Medicine: Whose Definition Will It Be?

Once again, the reliable New York Times provides, at least in part, inspiration for my editorial. On October 17, 2004, an article appeared in the Sunday Arts & Leisure section entitled "Better Playing Through Chemistry," by Blair Tindall. The main thrust of the article was, once again, to air the use of -blocking drugs in the treatment of performance anxiety among musicians.

Short term dynamic psychotherapy goes to Hollywood: the treatment of performance anxiety in cinema.

This article uses characters in popular films to demonstrate the theory and application of short term dynamic psychotherapy (STDP) in the treatment of performance anxiety. The reader is taught to identify affect phobias that are hypothesized to underlie performance anxiety. Similar in function to external phobias, affect phobias or internal phobias involve the avoidance of feelings (e.g., fear about feeling anger, shame about showing grief, pain about closeness), which thwarts adaptive responding and generates numerous behavioral problems. STDP treatment focuses on the restructuring of defenses, conflicted affects, and attachments. The resolution of the affect phobia requires systematic desensitization of affective responses (i.e., exposure and desensitization of underlying conflicted feelings). When patients learn to access adaptive forms of feelings, performance anxiety can often be resolved.

Etiology and treatment of social anxiety: a commentary.

Substantial advances in our understanding of the etiology and treatment of performance anxiety have occurred during the past decade. It has become clear that the development of efficient and effective treatments cannot be divorced from knowledge of the specific form of psychopathology being treated and that treatments must be tailored to this psychopathology. After describing a current model of the etiology of performance anxiety and social phobia, this commentary notes the common factors present across the rich and diverse set of articles in this issue describing treatments from different approaches and different theoretical orientations. To the extent that these common factors are important mechanisms of action, it is possible that the future will introduce more unified and more effective, efficient, and theoretically informed treatment for performance anxiety as well as the potential for preventive techniques.

The assessment and treatment of performance anxiety in musicians

Performance anxiety in musicians may be severe enough to require intervention but has been the subject of relatively little clinical research. The authors' objectives were to describe the results of a comprehensive clinical and laboratory assessment and to perform a double-blind, placebo-controlled study comparing buspirone, cognitive-behavior therapy, and the combination of these treatments for performance anxiety. Ninety-four subjects were recruited by mass media announcements and were seen in a university-based outpatient psychiatric clinic. Assessments were 1) questionnaires for all 94 subjects, 2) diagnostic interview of 50 subjects, and 3) laboratory performance of 34 subjects. Treatment conditions were 1) 6 weeks of buspirone, 2) 6 weeks of placebo, 3) a five-session, group cognitive-behavior therapy program with buspirone, or 4) the cognitive-behavior therapy program with placebo. Treatment outcome measures included subjective anxiety ratings and heart rate measures during a laboratory performance, a questionnaire measure of performance confidence, and a blind rating of musical performance quality. All subjects fulfilled criteria for DSM-III-R social phobia. Of the 15 full-time professional musicians, ten had tried propranolol and three had stopped performing. Most of the subjects had substantial anxiety and heart rate increases during laboratory speech and musical performances. Cognitive-behavior therapy resulted in statistically significant reductions in subjective anxiety, improved quality of musical performance, and improved performance confidence. Buspirone was not an effective treatment. Cognitive-behavior therapy is a viable treatment approach for performance anxiety in musicians.

The Causes and Treatment of Performance Anxiety

Through the use of an experiential approach and method the causes of performance anxiety were discovered. These causes were found in the way the experience of performance anxiety was constituted rather than in the external conditions. The five causal elements present in the experience of performance anxiety were as follows: the perceived presence of significant others, consideration of the possibility of visible failure, the felt need to avoid failure, the uncertainty of the outcome, and the focus on self. Treatment strategies were suggested for dealing with each of these elements. Optimal strategies included focusing on process rather than results, the moment of experience rather than the future, positive approach goals rather than negative avoidance goals, and self-acceptance rather than self-doubt.

Components of Cognitive-Behavioural Treatment for Performance Anxiety

Research in cognitive-behaviour modification (CBM; Meichenbaum, 1978) continues apace, and a particularly important area is the study of the “crucial ingredients” of successful CBM programmes. However, findings reported to date are not unequivocal. For example, in a recent article, Glogower, Fremouw and McCroskey (1978) report that the rehearsal of coping self-statements was a more effective component of cognitive restructuring than imparting insight into unhelpful self-statements in reducing performance anxiety about speaking in a group. A treatment condition which combined both procedures was most successful in general, but was not significantly better than rehearsal alone. The study was well-designed and implemented, and the authors were able to support their conclusions by referring to both self-report and behavioural data. The results directly contrast with those of Thorpe, Amatu, Blakey and Burns (1976), who sought to test similar hypothesis in a similar experiment in Britain. Glogower et al. correctly point out the differences between the studies include the relative youth of subjects, brevity of treatment, and few kinds of coping self-statement used in the Thorpe et al. study. They further indicate that a combination group has fared well in studies other than their own (e.g. Fremouw & Zitter, 1978), but that in the Thorpe et al. study the combination procedure, similar to the instructional rehearsal procedure, was significantly less effective than “insight” on self-report measures.