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Rey L, Guyon AJAA, Hildebrandt H, Güsewell A, Horsch A, Nater UM, Jamieson JP, Gomez P. Demand-resource evaluations and post-performance thoughts in classical music students: how they are linked and influenced by music performance anxiety, audience, and time. Front Psychol 2025; 16:1579759. [PMID: 40420993 PMCID: PMC12104281 DOI: 10.3389/fpsyg.2025.1579759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2025] [Accepted: 04/23/2025] [Indexed: 05/28/2025] Open
Abstract
Introduction Musicians' performance experiences range widely, from elation to severe anxiety. In this study, we examined musicians' performance experiences through the lens of the biopsychosocial model of challenge and threat. According to this model, a challenge state arises when perceived resources meet or exceed perceived demands, while a threat state occurs when demands outweigh resources. These states can be quantified using the Demand Resource Evaluation Score (DRES), calculated as the difference between resource and demand evaluations, with higher values indicating a greater challenge-type response. Although post-event processing is a key factor in maintaining social anxiety, research on factors influencing musicians' post-performance thoughts remains limited. Additionally, the link between DRES and post-performance thoughts is unknown. This study aimed to determine (1) how DRES is influenced by the general music performance anxiety (MPA) level, audience presence, and time (pre-performance vs. during-performance); (2) how negative and positive post-performance thoughts are influenced by general MPA level and audience presence; and (3) whether DRES predicts post-performance thoughts. Methods Classical music students (N = 121) with varying levels of MPA performed solo in a private and a public session. We assessed pre-performance and during-performance DRES, and negative and positive post-performance thoughts. Results DRES decreased with increasing general MPA level, was lower in public than private sessions, and declined from pre-performance to during-performance. These effects were qualified by a three-way interaction: the effect of general MPA level was strongest before performing publicly, the audience effect was most pronounced at higher general MPA levels before performing, and the time effect was greatest at lower general MPA levels during public sessions. General MPA level was associated with more negative thoughts and fewer positive thoughts. Audience presence increased only negative thoughts. Higher during-performance DRES predicted fewer negative and more positive thoughts both intraindividually and interindividually, with pre-performance DRES showing similar interindividual effects. Discussion These findings demonstrate the complex interplay of personal and situational factors in shaping musicians' challenge and threat experiences. Moreover, high general MPA levels are associated with a general tendency toward more negative and fewer positive post-performance thoughts. Interventions fostering challenge-oriented appraisals may enhance musicians' post-performance processing, potentially mitigating performance anxiety.
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Affiliation(s)
- Ludovic Rey
- Department of Occupational and Environmental Health, Unisanté, Center for Primary Care and Public Health & University of Lausanne, Lausanne, Switzerland
| | - Amélie J. A. A. Guyon
- Department of Clinical Research, Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Horst Hildebrandt
- Swiss University Center for Music Physiology, Basel University of the Arts, Basel, Switzerland
- Swiss University Center for Music Physiology, Zurich University of the Arts, Zurich, Switzerland
| | - Angelika Güsewell
- HEMU–Haute Ecole de Musique, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatology Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Urs M. Nater
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
- University Research Platform “Stress of Life (SOLE) – Processes and Mechanisms Underlying Everyday Life Stress”, University of Vienna, Vienna, Austria
| | - Jeremy P. Jamieson
- Department of Psychology, University of Rochester, Rochester, NY, United States
| | - Patrick Gomez
- Department of Occupational and Environmental Health, Unisanté, Center for Primary Care and Public Health & University of Lausanne, Lausanne, Switzerland
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Flynn AJ, Yoon KL. Post-event processing in social anxiety: A scoping review. J Anxiety Disord 2025; 109:102947. [PMID: 39622110 DOI: 10.1016/j.janxdis.2024.102947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 10/17/2024] [Accepted: 11/21/2024] [Indexed: 01/13/2025]
Abstract
Graded exposure successfully reduces fear in specific phobias and anxiety disorders, yet social exposure in daily life often fails to mitigate social anxiety. Post-event processing, perseverative, negative, self-referential thinking that occurs following a social-evaluative event, may partly explain inhibited desensitization to social fears. Post-event processing has been studied extensively since its first description by Clark and Wells (1995) and previously reviewed (e.g., Brozovich & Heimberg, 2008; Wong, 2016). However, these reviews are now dated or limited in scope. In the present scoping review, we pay particular attention to contemporary research that addresses unanswered questions raised in past reviews (e.g., Brozovich & Heimberg, 2008), synthesizing existing knowledge. Specifically, we discuss post-event processing's evolving role in cognitive models of social anxiety disorder, its core features, its eliciting situations (e.g., performance vs. social interactions), its relation to other cognitive and affective constructs (e.g., memory, performance appraisal, self-focused attention), and its assessment. Our findings indicate that post-event processing is more frequent after performance situations than social interactions, is related to negative memory biases, is bi-directionally related to worsening performance appraisals, and may be precipitated by self-focused attention. Future research directions include elucidating post-event processing's course, clarifying post-event processing's potential causal role in the development of social anxiety disorder, and identifying factors that underlie post-event processing's deleterious nature.
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Affiliation(s)
- Aidan J Flynn
- University of Maryland, Baltimore County, Baltimore, USA.
| | - K Lira Yoon
- University of Maryland, Baltimore County, Baltimore, USA
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Ma Y, Li J, Zhang M, Zuo T, Kong L, Yang Y. Relationship between social anxiety and sleep quality in depressed adolescents: the mediating role of internet addiction. Front Psychiatry 2024; 15:1416130. [PMID: 39465053 PMCID: PMC11503650 DOI: 10.3389/fpsyt.2024.1416130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 09/12/2024] [Indexed: 10/29/2024] Open
Abstract
Objective This study investigated the association between social anxiety and sleep quality and further explored the potential mediating role of internet addiction in depressed adolescents. Methods This study included 440 Chinese depressed adolescents (mean age = 15.0 years, SD = 2.0). Participants completed questionnaires, including Social Avoidance and Social Distress Scale, Internet Addiction Test, and Pittsburgh Sleep Quality Index. A structural equation model was used to analyze the association between social anxiety and sleep quality, with internet addiction as a mediator. Gender differences were examined by multi-group analysis. Results Among participants, 61.8% reported poor sleep quality. The sleep quality was significantly different on the level of gender (p = 0.016), education level (p = 0.043), and family history (p = 0.002). Sleep quality was positively associated with social anxiety (p < 0.001) and internet addiction (p < 0.001). Furthermore, internet addiction partially mediated the relationship between social anxiety and sleep quality, and the mediation effect ratio was 16.1% (p < 0.001). Finally, no significant differences were found in this mechanism. Conclusion We concluded that both social anxiety and internet addiction were risk factors for depressed adolescents' poor sleep quality. Social anxiety further affected sleep quality through internet addiction.
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Affiliation(s)
- Yifan Ma
- Department of Child and Adolescent Mental Behavior, Shandong Mental Health Center, Shandong University, Jinan, China
| | - Jingya Li
- Department of Child and Adolescent Mental Behavior, Shandong Mental Health Center, Shandong University, Jinan, China
| | - Meng Zhang
- Department of Child and Adolescent Mental Behavior, Shandong Mental Health Center, Shandong University, Jinan, China
| | - Tiantian Zuo
- Clinical Psychology, The People’s Hospital of Zouping City, Binzhou, China
| | - Linghua Kong
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ying Yang
- Department of Child and Adolescent Mental Behavior, Shandong Mental Health Center, Shandong University, Jinan, China
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Edgar EV, Richards A, Castagna PJ, Bloch MH, Crowley MJ. Post-event rumination and social anxiety: a systematic review and meta-analysis. J Psychiatr Res 2024; 173:87-97. [PMID: 38518572 PMCID: PMC11018455 DOI: 10.1016/j.jpsychires.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/03/2024] [Accepted: 03/12/2024] [Indexed: 03/24/2024]
Abstract
Post-event rumination, the extent to which one engages in persistent, detailed, and negative thinking following social situations, serves as a risk process in the pathophysiology of social anxiety. Although a substantial body of research has assessed post-event rumination and social anxiety, this literature has produced inconsistent results. We conducted a systematic review and meta-analysis to examine whether the magnitude of the association between post-event rumination and social anxiety varied as a function of questionnaire and/or task utilized. We included all studies reporting a correlation between post-event rumination and social anxiety symptomatology. Fisher's z correlation coefficients were calculated through random-effect meta-analyses. Results indicated a moderate association between post-event rumination and social anxiety symptomatology (r = 0.45, p < 0.001, 95%CI [0.40-0.50]). Subgroup meta-analyses indicated that the type of questionnaire used to assess post-event rumination (Q = 44.36, df = 3, p < 0.001) and social anxiety (Q = 26.44, df = 8, p < 0.001), as well as the task conducted prior to assessing post-event rumination (Q = 14.31, df = 2, p < 0.001), influenced the effect size. This study demonstrates a moderate relation between post-event rumination and social anxiety across the anxiety spectrum, illustrating the importance of treatments specifically targeting post-event rumination. Moreover, we highlight the importance of taking care when designing studies to explore relations between post-event rumination and social anxiety.
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Affiliation(s)
- Elizabeth V Edgar
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA.
| | - Ashlyn Richards
- Department of Psychology, Sewanee the University of the South, Sewanee, TN, USA
| | - Peter J Castagna
- Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA
| | - Michael H Bloch
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Michael J Crowley
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
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Donohue HE, Modini M, Abbott MJ. Psychological interventions for pre-event and post-event rumination in social anxiety: A systematic review and meta-analysis. J Anxiety Disord 2024; 102:102823. [PMID: 38142483 DOI: 10.1016/j.janxdis.2023.102823] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/04/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
Pre-event and post-event rumination have been consistently identified by cognitive models as important maintaining factors in Social Anxiety Disorder (SAD). This systematic review and meta-analysis aimed to investigate the effectiveness of psychological treatment in reducing pre-event and post-event rumination in adults with social anxiety. A comprehensive literature search identified 26 eligible studies, with 1524 total participants. Psychological treatments demonstrated large significant within-group effect sizes (from pre- to post-treatment) in reducing pre-event rumination (g = 0.86) and post-event rumination (g = 0.83). Subgroups analysed showed CBT to have large significant effect sizes in reducing pre-event rumination (g = 0.97) and post-event rumination (g = 0.85). Interventions that specifically addressed rumination were found to be significantly more effective in reducing pre-event rumination than those that did not (p = .006). Both individual and group treatment formats were equally effective in reducing pre-event rumination and post-event rumination. Meta-regressions revealed that pre-event rumination treatment effects were significantly larger in individuals with higher baseline social anxiety, meanwhile post-event rumination treatment effects were larger for those with higher baseline depression. Overall findings show that pre-event and post-event rumination are effectively reduced through psychological treatment, and clinical implications for the enhancement of evidence-based treatment protocols are discussed.
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Affiliation(s)
| | - Matthew Modini
- School of Psychology, The University of Sydney, Australia; Concord Centre for Mental Health, Sydney Local Health District, Australia
| | - Maree J Abbott
- School of Psychology, The University of Sydney, Australia.
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Massad R, Hertz-Palmor N, Schneier FR, Lazarov A. Development and initial validation of the Visual Social Anxiety Scale (VSAS): Could a picture be worth a thousand words? J Anxiety Disord 2022; 89:102589. [PMID: 35689849 DOI: 10.1016/j.janxdis.2022.102589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 03/13/2022] [Accepted: 05/31/2022] [Indexed: 11/19/2022]
Abstract
Accurate assessment is crucial for determining appropriate therapeutic interventions for social anxiety and conducting sound clinical research. While self-report measures of social anxiety are widely used in both research and clinical settings, they have several drawbacks inherent to their textual nature. Here, we describe the development and initial validation of the Visual Social Anxiety Scale (VSAS), a novel picture-based self-report measure of social anxiety, based on the well-established widely-used Liebowitz Social Anxiety Scale (LSAS). Specifically, the 24 items of the LSAS were used as the basis for social situations to be included in the VSAS. First, pictures to serve as VSAS items were selected using a rigorous two-phase process (four pilot studies; n = 225). Next, reliability (internal consistency, test-retest) and validity (convergent, discriminant) were explored with new participants (n = 304) who completed the VSAS and a battery of additional self-report questionnaires, delivered in a random order. The VSAS was completed again a month later (n = 260/304). The VSAS showed high internal consistency and test-retest reliability, and good convergent and discriminant validities. VSAS correlations with convergent measures were significantly greater than its correlations with discriminant measures. Thus, the VSAS shows initial promise as a novel picture-based self-report measure of social anxiety.
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Affiliation(s)
- Raz Massad
- School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel
| | | | - Franklin R Schneier
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Irving Medical Center, NY, USA
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel.
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