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Abstract

Acceptance and commitment therapy (ACT) is a “third wave” behavioral therapy that aims to increase psychological flexibility through mindfulness, acceptance, and behavioral commitment processes. This study explored relations among facets of psychological flexibility, music performance anxiety (MPA), and perceived performance quality to better understand the utility of ACT-based interventions for musicians. Twenty-seven university music students participated in the study, which involved performing a one-to-three-minute prepared musical excerpt of their choice in a mock audition and then completing the study measure, which included the Multidimensional Psychological Flexibility Inventory (MPFI) of Rolffs et al., the Performance Anxiety Inventory (PAI) of Nagel et al., and the Performance vs. Practice Scale (a measure of perceived music performance quality adapted from the work of Farnsworth-Grodd). The results revealed a significant positive relationship between participants’ psychological flexibility and their perceived performance quality (r(25) = .391, p = .022); and a significant inverse relationship between psychological flexibility and MPA (r(25) = −.498, p = .004). One facet of psychological flexibility, cognitive defusion, emerged as a significant predictor of both perceived performance quality and MPA. The findings build on existing evidence demonstrating the suitability of ACT as both a treatment for MPA and a method of performance enhancement for musicians. Additionally, the results provide support for emphasizing cognitive defusion processes within an ACT-for-MPA treatment approach. The study holds particular significance for the population of interest, university music students, who commonly seek specific skills and strategies for enhancing performance outcomes and managing the effects of MPA.

Keywords

Acceptance and commitment therapy music performance anxiety performance psychology psychological flexibility university music students

Music performance anxiety (MPA) is a pervasive mental health concern among both student and professional musicians. Defined as “marked and persistent anxious apprehension related to musical performance” (Kenny, 2011, p. 433), MPA includes a spectrum of cognitive, affective, behavioral, and physiological symptoms that can compromise performance quality and generate feelings of personal and professional distress. Within the past decade, music performance researchers began to explore the suitability of acceptance and commitment therapy (ACT; Hayes et al., 2012) as both a treatment for MPA and as a method of performance enhancement. Grounded in contextual behavioral science, ACT belongs to the movement of “third wave” behavioral therapies that focus on the context and function of how one relates to psychological experiences (Hayes, 2004; Hayes et al., 2006). Unlike traditional behavioral therapy (i.e., first wave) and cognitive-behavioral therapy (i.e., second wave), ACT does not target symptom reduction as the primary outcome of interest. Rather, by emphasizing values, mindfulness, and acceptance principles, ACT aims to change one's relationship to symptoms of distress by increasing psychological flexibility: the ability to contact the present moment with full awareness and engage in values-congruent action, even if doing so elicits psychological discomfort (Harris, 2009).

Within the theoretical framework of ACT, psychological flexibility consists of six interrelated behavioral processes known collectively as the ACT hexaflex. The facets of the hexaflex include the following: (i) acceptance of one's experiences, (ii) cognitive defusion, (iii) self-as-context, (iv) contact with the present moment, (v) identification of values, and (vi) commitment to action consistent with values (Hayes et al., 2006). The first three facets are mindfulness and acceptance processes; the latter three facets are commitment and behavior change processes.¹

Table 1.

Facets of psychological flexibility: The six core processes of ACT.

Facet	Description
Acceptance	“Open up.” Allowing for the presence of aversive private experiences (e.g., unwanted feelings, sensations, urges, and emotions).
Present-moment awareness	“Be here now.” Consciously connecting with the present moment.
Self-as-context	“Pure awareness.” Cultivating a transcendent sense of self (i.e., an “observing self”) that is defined more by context than by the content of one's internal experiences.
Defusion	“Watch your thinking.” Creating separation between the observing self and cognitions (e.g., thoughts, images, memories).
Values	“Know what matters.” Values are chosen qualities of meaning and importance to an individual. Values clarification informs and guides ongoing committed action.
Committed Action	“Do what it takes.” The ability to take effective action guided by values, even if doing so elicits psychological discomfort.

Note. Descriptions of core processes are adapted from ACT Made Simple (Harris, 2009).

Psychological flexibility is correlated with numerous positive outcomes, such as increased well-being (Wersebe et al., 2018); increased social skills (Herbert et al., 2018); and performance enhancement across the domains of public speaking (Glassman et al., 2016), work (Bond & Bunce, 2003; Bond & Flaxman, 2006) and athletics (Gross et al., 2016; Josefsson et al., 2019). In the ACT-for-MPA research literature, eight studies (including both individual and group treatment modalities) have investigated the efficacy of ACT to treat musicians with significant MPA symptoms (Clarke et al., 2020; Erenius & Wallengren, 2012; Juncos et al., 2014; Juncos et al., 2017; Juncos & Markman, 2016; Mahony et al., 2022; Shaw et al., 2020; Swain & Bodkin-Allen, 2017). These studies found that increases in psychological flexibility led to improvements in performance quality, reduced shame about MPA, and increased confidence. Although symptom reduction was not the targeted outcome, musician participants in these studies also experienced significant reductions in MPA symptoms from pre- to post-treatment and follow-up. While promising, these studies contend with significant limitations, including small sample sizes and lack of control or comparison groups. Additionally, participants across these studies mainly comprised student vocalists, representing a narrow scope of the musician population. Nonetheless, ACT remains a promising intervention for student musicians with MPA. As musicians often seek reductions in MPA to enhance overall performance quality (Kenny, 2009), these findings provide support for examining the relationship between psychological flexibility and performance quality outcomes among musicians, which is the primary focus of the current study.

While previous studies have explored the efficacy of ACT as a treatment for MPA, only one study adequately assessed each facet of the ACT hexaflex pre- and post-treatment; however, in-depth analysis of facet-level changes were prohibited by the study's small sample (Clarke et al., 2020). Thus, in addition to exploring relationships between global psychological flexibility, MPA, and performance quality, the present study seeks to examine individual facets of psychological flexibility as possible predictors of performance outcomes. Exploring these facet-level relationships may provide clinically useful insights for therapists interested in using ACT to treat musicians who experience performance anxiety. Namely, as clinical interventions are often time-limited in nature (especially at settings such as university counseling centers), knowledge of the most salient ACT hexaflex processes for MPA treatment may guide clinicians with assessment and treatment planning.

Purpose of the Present Study

Within the existing literature, relatively few studies have evaluated ACT as an intervention for musicians with MPA, and no studies to date have examined the six facets of psychological flexibility as possible predictors of both MPA and perceived performance quality. The present study sought to investigate relationships between these variables and explore which processes within the ACT hexaflex may predict desired performance outcomes among university music students. Given that collegiate music training is a critical developmental period for musicians and that young musicians commonly request support for managing MPA, the primary researcher designed the present study to provide practical information for music students seeking to enhance their performance experiences.

In the current study, we developed two hypotheses. Hypothesis 1 : There is a positive linear relationship between global psychological flexibility (GPF) and perceived performance quality (PPQ), such that students with higher levels of flexibility report higher quality performance outcomes. Hypothesis 2 : There is a negative linear relationship between GPF and MPA, such that students with higher levels of flexibility report lower levels of performance anxiety. As the theoretical framework of ACT regards symptom reduction (e.g., decreased MPA) as a side benefit of enhancing psychological flexibility, Hypothesis 2 should be regarded secondary to Hypothesis 1. Further, Kenny (2009) recommended that researchers measure performance quality as the dependent variable in studies of music performance anxiety, noting that musicians largely seek improvement in performance quality as the desired treatment outcome.

Additionally, we explored which facets of psychological flexibility best predict both PPQ and MPA. Examining whether specific core processes of psychological flexibility (e.g., acceptance, defusion, present-moment awareness) were significant predictors of desired performance outcomes could highlight clinically useful factors to consider in the treatment of MPA. Knowledge of the most pertinent hexaflex facets may be especially valuable within brief intervention efforts in which some processes and skills must be prioritized over others. As the hexaflex processes correlate with skills required for high-level behavioral performance (e.g., the ability to remain grounded in the present moment and continually redirect attention), the exploration of the different facets is motivated by a question of whether some hexaflex processes are more salient than others in the context of music performance. As no theoretical precedent suggests that one core process of psychological flexibility is more predictive than another, these follow-up research questions were exploratory in nature.

Method

Participants

The participants were recruited from a music school at a mid-sized four-year public university located in the southeastern United States. The study included music students of any year of study (i.e., undergraduate through master's level), music degree program (e.g., music performance, music education, music minor), or instrument group (strings, brass, voice, etc.). The final sample for the study included 27 participants, amounting to roughly 10% of the music school population. Sample characteristics, including major, collegiate year, gender, race, and instrument group, are provided in Table 2.

Table 2.

Demographic and musical sample characteristics.

	Total	Percentage
Gender
Female	11	40.7%
Male	16	59.3%
Race/ethnicity
Asian/Asian American/Pacific Islander	3	11.1%
Black/African American	2	7.4%
White/European	22	81.5%
Year of study
1st year	9	33.3%
2nd year	9	33.3%
3rd year	4	14.8%
4th year	1	3.7%
Graduate	4	14.8%
Degree concentration
Music performance	11	40.7%
Music education	9	33.3%
Jazz studies	2	7.4%
Other	5	18.5%
Instrument group
Strings	7	25.9%
Brass	5	18.5%
Woodwind	5	18.5%
Voice	6	22.2%
Piano/percussion	3	11.1%
Unknown	1	3.7%

Procedure

The participants were asked to pre-select 1–3 minutes of musical repertoire and perform their music in front of a research assistant assuming the role of judge in a mock audition format. The participants were informed ahead of time that they would not be receiving evaluative feedback from the judge. Although the lack of evaluative feedback may have limited the level of anxiety elicited in the performance task, the judges were instructed to demonstrate behaviors to simulate the conditions of a typical musical audition (e.g., taking notes during the performance, maintaining a neutral facial expression, and interacting minimally with the performer). Participants were allotted a brief warm-up period and were then escorted to the mock audition room to perform their selected musical excerpt. To create a naturalistic audition experience, participants were encouraged to select repertoire that they deemed to be at least “moderately challenging.” Following the mock audition, participants completed the study measures described below in paper-and-pencil format.

Measures

Psychological Flexibility

Global and subscale psychological flexibility scores were assessed using the 30 items of the Multidimensional Psychological Flexibility Inventory (MPFI; Rolffs et al., 2018) designed to assess the six dimensions of psychological flexibility as illustrated by the ACT hexaflex model: acceptance, present-moment awareness, self-as-context, cognitive defusion, values, and committed action. Participants did not complete the full MPFI instruments, which also include 30 items of inflexibility, as those items were designed to measure constructs that are theoretically distinct from flexibility (Rolffs et al., 2018) and thus beyond the scope of this study. In the present study, the MPFI showed excellent internal reliability for the total scale (α = .94) and acceptable to excellent reliability for the subscales (acceptance, α = .73; present-moment awareness, α = .89; self-as-context, α = .89; cognitive defusion, α = .92; values, α = .91; committed action, α = .89).

Music Performance Anxiety

Music performance anxiety was assessed with the Performance Anxiety Inventory (PAI; Nagel et al., 1989), a 20-item self-report instrument that assesses individual experiences of anxiety in musical performance situations. Adapted from the State-Trait Anxiety Inventory (STAI; Spielberger et al., 1983), the measure assesses cognitive, behavioral, and physiological components of music performance anxiety and captures both state anxiety (anxiety in response to a particular situation) and trait anxiety (general tendency toward anxious response). In the present study, internal reliability for the measure was α = .87.

Perceived Performance Quality

Perceived performance quality (PPQ) was measured by asking participants to rate (a) their satisfaction with the performance and (b) their perception of how the performance compared to their “best performance during practice” (Farnsworth-Grodd, 2012, p. 230). To help optimize memory of their performance quality, participants completed the PPQ survey immediately following the mock audition, prior to completing the other measures. Both scales for PPQ were adapted from Farnsworth-Grodd's (2012) inventory for assessing music performance outcomes among collegiate music students. The Performance Satisfaction scale contains two items assessing satisfaction—with the overall performance and with effort—and prompts participants to rank their experience of satisfaction on a scale ranging from 1 (very dissatisfied) to 7 (very satisfied). The Performance versus Practice scale contains 10 items related to varying aspects of musical performance (e.g., tempo, dynamics, articulation). The measure prompts participants to rate the quality of their performance on a scale ranging from 1 (much worse) to 7 (much better) in comparison to their best performance during practice. In the present study, subjective evaluations of performance quality were favored over the use of a third-party evaluator (such as a judge), as participant self-evaluations provide insight into the relative quality of performance at an individual level, whereas third-party evaluations do not capture how the performance compares to the participant's baseline quality level. Furthermore, third-party evaluations are susceptible to problems with inter-rater reliability as evaluations of performance quality can vary greatly between judges. Preliminary analysis revealed questionable internal reliability for the Performance Satisfaction scale (α = .63) and excellent internal reliability for the Performance versus Practice scale (α = .91). In light of this discrepancy, we chose to use the scores for the Performance versus Practice scale as the sole measure of PPQ.

Demographic Information

A demographic survey was included at the end of the measures packet to gather the following information: age, gender, race/ethnicity, and mental health history. Mental health-related questions pertained to any history of a diagnosed anxiety disorder and the prescribed use of anxiolytic medications (including beta blockers). Participants were also prompted to provide musical sample characteristics, including year of study, degree concentration, and instrument type.

Data Analysis

Statistical analyses were performed using Version 27 of the Statistical Package for Social Science (SPSS). Prior to testing hypotheses, influential observations were assessed following the procedures for DFBETA tests as outlined by Cohen et al. (2003), and no extreme scores were detected. A missing value for one participant item was replaced using EM Algorithm and Missing Values Analysis in SPSS. Means, standard deviations, and correlations between study variables were also calculated (see Table 3).

Table 3.

Descriptive statistics and correlations for study variables.

Variable	M	SD	1	2	3	a	b	c	d	e	f
1. PPQ	36.76	10.69	—
2. MPA	47.30	11.02	−.44*	—
3. Global PF	4.11	0.77	.39*	−.50**	—
a. Acceptance	3.63	0.91	.32	−.29	.71**	—
b. Present awareness	4.23	1.01	.21	−.15	.58**	.69**	—
c. Self-as-context	4.33	1.16	.25	−.41*	.82**	.34*	.22	—
d. Defusion	3.23	1.24	.49**	−.59**	.83**	.50**	.30	.65**	—
e. Values	4.60	0.93	.15	−.27	.79**	.38*	.30	.73**	.60**	—
f. Committed action	4.64	1.03	.27	−.48**	.75**	.32	.19	.67**	.58**	.55**	—

*p < .05. **p < .01.

Following preliminary analysis, two simple bivariate regressions were used to test the hypotheses: global psychological flexibility will have (a) a positive linear relationship with perceived performance quality (PPQ) and (b) a negative linear relationship with music performance anxiety (MPA). To deconstruct various predictors of both PPQ and MPA and thereby enhance understanding of the significant relationships, two forward stepwise linear regressions were then conducted using the six subscale scores of the MPFI (i.e., the facets of psychological flexibility, acceptance, present-moment awareness, self-as-context, defusion, values, and committed action). As no existing literature supported a hierarchical precedent for analysis (i.e., no theoretical models indicated that one facet of psychological flexibility would be more predictive of PPQ and MPA than another), stepwise regressions suited the exploratory nature of these analyses. Further, given that facets of psychological flexibility in the MPFI are moderately correlated, stepwise regression allowed for the minimization of multicollinearity. Predictor variables were added based on p values equal to or less than .05.

Results

Hypotheses

Hypothesis #1: There is a positive linear relationship between global psychological flexibility (GPF) and perceived performance quality (PPQ). A Pearson correlation coefficient was computed to assess the linear relationship between GPF and PPQ. There was a significant positive correlation between the two variables, r(25) = .391, p = .022, 95% CI [0.08, 1]. Simple linear regression was used to test if GPF significantly predicted PPQ. The fitted regression model was as follows: y = 14.95 + 5.31*(GPF). The overall regression was statistically significant (R²= .15, Adjusted R²= 0.12, F(1, 25) = 4.50, p = .044), with GPF significantly predicting increases in PPQ (β = 5.31, p = .044).

Hypothesis #2: There is a negative linear relationship between global psychological flexibility (GPF) and music performance anxiety (MPA). A Pearson correlation coefficient was computed to assess the linear relationship between GPF and MPA. There was a significant negative correlation between the two variables, r(25) = −.498, p = .004, 95% CI [−1.00, −.208]. Simple linear regression was used to test if GPF significantly predicted levels of MPA. The fitted regression model was as follows: y = 75.97–6.98*(GPF). The overall regression was statistically significant (R²= .25, Adjusted R²= .22, F(1, 25) = 8.24, p = .008), with GPF significantly predicting decreases in MPA (β = −6.98, p = .008).

Exploratory Examination of Predictors of PPQ and MPA

To help mitigate the possible effect of multicollinearity (along with calculating the variance inflation factor-VIP), two stepwise multiple regressions were conducted to identify possible predictors of PPQ and MPA using the six subscale scores of the MPFI (measures of psychological flexibility: acceptance, present-moment awareness, self-as-context, defusion, values, and committed action). Predictor variables were added based on p values equal to or less than .05. Bivariate correlations between each subscale score and the outcome variables are provided in Table 3. The results of the regression indicated that one psychological flexibility facet, cognitive defusion, significantly predicted both PPQ and MPA (see Table 4).

Table 4.

Multiple regressions exploring hexaflex facets as predictors of PPQ and MPA.

Variable	B	t	p
PPQ
Acceptance	.09	.45	.654
Present awareness	. 07	.38	.709
Self-as-context	−.12	−.52	.607
Defusion	.49	2.83	.009**
Values	−.232	−1.07	.297
Committed action	−.018	−.084	.933
MPA
Acceptance	.00	.00	1.000
Present awareness	.03	.17	.864
Self-as-context	−.05	−.23	.819
Defusion	−.59	−3.62	.001**
Values	.14	.67	.509
Committed action	−.21	−1.05	.303

*p < .05. **p < .01.

In the first regression, the defusion score explained 24% of the variance (R²= .24, F(1, 25) = 7.99; 95% CI: [1.15, 7.31], VIP = 1.31) and significantly predicted increases in perceived performance quality (β = .49, p = .009). The effect size of the first regression was medium to large (f²= .319). In the second regression, the defusion score explained 34% of the variance (R²= .34, F(1, 25) = 13.06, 95% CI: [−8.14, −2.23], VIP = 1.51) and significantly predicted decreases in performance anxiety (β = −.59, p = .001). The effect size of the second regression was large (f²= .522).

Discussion

The findings in this study align with the theoretical principles of ACT, which view psychological flexibility as a means of enhancing engagement in values-congruent action. Exploratory analyses indicated that one facet of psychological flexibility, cognitive defusion (hereafter called “defusion”), significantly predicted both increases in PPQ and decreases in MPA. Defusion is conceptualized as the ability to observe or witness one's private experiences (thoughts, images, memories) with a quality of detachment (Harris, 2009). In the context of MPA, defusion can be understood as the ability to disengage from unhelpful thoughts and feelings prior to and during performance. Harris elaborates that, in a state of fusion (the opposite of defusion), a thought can be experienced as the absolute truth, a command to obey, something that requires all of one's attention, or a threat to eliminate as soon as possible. For example, in the context of music performance, fusion can be experienced as becoming preoccupied by MPA-related thoughts, memories, or images (e.g., “I can’t stop shaking. I sound horrible. What if I drop my instrument? Everyone knows I’m the worst.”). Attempts to control or eliminate these fears may then consume the musician's attention, leading to the occurrence of performance errors (e.g., missing an entrance, having a memory slip, miscounting measures). Conversely, defusion allows one to become “less reactive to unwanted internal experiences” by creating separation between the experience and the “observing self” (Juncos & de Paiva e Pona, 2018, p. 5). In other words, defusion allows an individual to witness thoughts without becoming “fused” with the narrative of the anxious mind. One defusion technique requires the participant to preface thoughts with the phrase “I’m having the thought that…,” which encourages separation between the thought itself and the witness to the thought. In a state of defusion, thoughts do not dominate one's attention or chosen behaviors but are regarded simply as a series of words and pictures that are allowed to come and go, enabling the individual to remain present and engaged with the task at hand (Harris, 2009).

One possible explanation for defusion emerging as a significant predictor variable in the present study is that defusion processes correlate more directly with the mental demands of skilled performance than other facets of psychological flexibility. Although facets of psychological flexibility are interconnected and support one another (Harris, 2009; Hayes et al., 2006), the ability to detach from distracting thoughts and feelings may be the most helpful for managing MPA symptoms during performance. This conclusion is supported by the work of Juncos and de Paiva e Pona (2018), who theorize that “by mindfully observing MPA symptoms and defusing from what their minds tell them about their symptoms, a musician becomes more accepting of and less reactive to those symptoms” (p. 8). While the findings suggest that strengthening defusion may be particularly useful for musicians who seek to manage the effects of MPA and enhance their performances, it is possible that other facets of psychological flexibility may assist musicians with performance in ways not explored in the present study. For example, increasing global levels of psychological flexibility may help musicians minimize practice avoidance, which could in turn support higher quality performance outcomes (Osborne et al., 2021). In sum, while ACT for MPA protocols can address all six facets of psychological flexibility over the course of treatment, findings from this study suggest that skills related to defusion may warrant particular emphasis, especially within brief or time-limited interventions in which exercises and treatment goals are prioritized.

Implications for Clinical Practice

The findings of this study are also congruent with existing evidence supporting the use of ACT for the treatment of MPA in university student populations. Results from the present study may be taken into consideration when conducting individual or group therapy with musicians and when designing clinical outreach efforts for music programs. For example, in addition to providing psychoeducation on MPA and performance enhancement, clinicians may consider integrating ACT-based processes (especially experiential defusion exercises) into workshops for university music students and faculty. Prior research suggests that the ACT hexaflex processes are trainable outside of the context of therapy and that music faculty (in addition to mental health professionals) may facilitate the strengthening of psychological flexibility for music students (Clarke et al., 2020). Thus, ACT may offer an accessible means of addressing the needs of young musicians and bolstering the expertise of music faculty relative to other psychological interventions.

Based on personal observations derived from clinical practice, we note that many professional musicians are likely knowledgeable of certain mindfulness-based skills for performance, in part due to the influence of popular sport psychology authors such as Don Greene (2002) and Timothy Gallwey (1974). Mindfulness skills are often utilized in ACT interventions (Hayes et al., 2012). Thus, the integration of ACT-based scientific knowledge and practice may offer some conceptual clarity and provide musicians with concrete exercises and skills that are grounded in an evidence-based treatment approach. Moreover, existing strategies that musicians use to manage MPA—especially those reminiscent of behavioral therapy, such as the use of exposure, performance fear hierarchies, visualization, and grounding skills—may be easily integrated into ACT for MPA protocols. Finally, ACT also emphasizes commitment processes that have been shown to increase musicians’ participation in values-congruent behavior, such as performing in public more regularly or auditioning for solos more often (Juncos & Markmanet, 2016; Shaw et al., 2020).

For ACT clinicians working with musicians, these data contribute a clearer understanding of the relevance of psychological flexibility to the realm of music performance, with cognitive defusion standing out as the most salient hexaflex process to target over the course of treatment. In settings where treatment options are brief or time-limited (such as university counseling centers), clinicians could utilize measurements of psychological flexibility (e.g., the MPFI) as an assessment tool and consider whether strengthening cognitive defusion should be prioritized as a treatment goal. Additionally, ACT provides a conceptual framework for clinicians working with both mild and more severe presentations of MPA. Regardless of symptom severity, clinicians using an ACT-based approach should note that, because symptom reduction is not the goal of therapy, proper assessment of performance-relevant values is a critical process in setting the course of treatment. For example, by clarifying what they find to be most personally meaningful or important about performances, clients might shift their focus to behavior that aligns with performance values, rather than spending energy attempting to control MPA-related symptoms (Juncos & de Paiva e Pona, 2018, p. 10). In their book ACT for Musicians (2022), Juncos and de Paiva e Pona highlight examples of common performance-related values among musicians, such as “being an emotionally expressive performer,” “connecting with the audience,” “practicing and being fully prepared,” and “challenging myself to learn new repertoire” (p.149). Whereas performance goals are concrete and have an endpoint (e.g., winning a competition, earning top marks in a jury examination), values serve as a compass for continuous behavior and are never accomplished. Thus, musicians high in psychological flexibility may be better able to persist in the direction of their values, even when they fall short of achieving specific performance goals. Further, targeting psychological flexibility may also help musicians practice self-compassion in the face of professional setbacks, which are common in the music performance industry (Pecen et al., 2018; Yadavaia et al., 2014).

Limitations and Considerations for Future Research

There are several limitations to consider within the present study. First, the small sample size restricted our ability to control for potential confounding variables (e.g., gender, year in school) or determine if any other meaningful group distinctions existed. Additionally, given that our music student participants were volunteers and not incentivized by compensation, self-selection bias is also possible. Further, the study's correlational design precludes the researchers from drawing any conclusions regarding directionality between variables. As such, an alternative explanation for the findings is that participants who report higher performance quality and lower MPA could be reporting higher psychological flexibility because they have higher levels of self-efficacy with performance outcomes (i.e., lower MPA and/or higher PPQ allows for higher psychological flexibility). However, our findings are consistent with previous experimental research results, such as the studies conducted by Juncos et al. (2014, 2016, 2017), which included self-report evaluations of psychological flexibility, performance quality, and MPA at two time points (pre- and post-treatment) and demonstrated that increases in performance quality and decreases in MPA followed increases in psychological flexibility.

Despite statistical constraints on power due to the small sample size, the strength of cognitive defusion in predicting both increases in PPQ and decreases in MPA suggests that the findings would remain significant with a larger sample. Further, the present study may be regarded as a preliminary project that provides the groundwork for more comprehensive research efforts with the target population. Regarding continued research efforts in this area, future projects should consider including a performance task that may elicit higher levels of anxiety than the mock audition experience of the present study. For example, projects might utilize end-of-semester jury examinations or ensemble auditions, which could potentially produce a more robust sample size and enhance internal validity. Additionally, future research could improve upon the current study by including both subjective evaluations and third-party assessments of music performance quality (e.g., by obtaining juror ratings of performances). Although participants in the current study completed evaluations of their performance immediately following the mock audition, the validity of the PPQ scores is limited by the accuracy of participant memory. Thus, obtaining both subjective and third-party evaluations may allow for more comprehensive assessment of performance outcomes and thereby yield the most valid results.

Finally, the results of the present study may inform the development of future ACT-for-MPA intervention studies with university music students. As there is a dearth of literature comparing ACT to CBT for MPA treatment, future researchers could conduct an intervention study with two treatment groups and assess for changes in perceived performance quality and MPA post-treatment. The scientific literature supports ACT and CBT as equivalently efficacious treatments for reducing symptoms of social anxiety disorder, a diagnosis that shares common core features with MPA (Craske et al., 2014; Herbert et al., 2018; Kocovski et al., 2013; Krafft et al., 2020). While both treatments may be effective for reducing anxiety symptoms, ACT may be clinically advantageous for the treatment of MPA when considering outcome variables of interest, such as behavioral performance. For example, research demonstrates that ACT is more effective than CBT in improving test performance (Brown et al., 2011), observer-rated public speaking skills (Block, 2002; Glassman et al., 2016), and observer-rated social skills (Herbert et al., 2018). Given these findings, a randomized control trial comparing ACT and CBT for the treatment of MPA appears warranted. Such a study could also compare changes in psychological flexibility and include an anxiety-inducing performance task at pre- and post-treatment.

Conclusion

The present study explored relationships between psychological flexibility, perceived performance quality, and music performance anxiety among university music students. The study is the first to explicitly deconstruct the six facets of psychological flexibility to investigate predictors of both perceived performance quality (PPQ) and music performance anxiety (MPA). The results showed a significant positive relationship between psychological flexibility and PPQ and a significant inverse relationship between psychological flexibility and MPA. The findings build on existing evidence demonstrating the suitability of ACT as both a treatment for MPA and a means of performance enhancement for musicians. Following exploratory analysis of the facets of psychological flexibility, cognitive defusion emerged as a significant predictor of both PPQ and MPA. The findings fit with existing knowledge regarding the utility of cognitive defusion in the context of music performance and provide additional support for emphasizing cognitive defusion processes within an ACT-for-MPA treatment approach. Overall, these study findings hold particular significance for the population of interest, university music students, who commonly seek out concrete skills and strategies for enhancing performance outcomes and managing the effects of MPA. Instead of targeting symptom reduction, clinicians working with music students on performance or MPA-related concerns may consider strengthening psychological flexibility as a means of enhancing mindfulness, acceptance-based skills, and values-congruent performance behaviors, thereby promoting higher-quality performance experiences with or without the presence of anxiety.

Footnotes

Action Editor

Graham Welch,University College London,Institute of Education.

Peer Review

Alison Fairley,University of Georgia,Hugh Hodgson School of Music Rebecca Herman,Royal College of Music,Centre for Performance Science.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research or authorship of this article.

Ethical Approval Statement

The Institutional Review Board at the authors’ university approved of the study for human subjects (IRB # UTK IRB-21-06580-XM).

Funding

Funding for open access to this research was provided by University of Tennessee's Open Publishing Support Fund.

ORCID iD

Jacob J. Levy

Data Availability Statement

Data for this study are available at:

(Levy,2024).

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Exploring the Relations among Psychological Flexibility,Music Performance Anxiety,and Perceived Performance Quality with University Music Students

Abstract

Keywords

Purpose of the Present Study

Method

Participants

Procedure

Measures

Psychological Flexibility

Music Performance Anxiety

Perceived Performance Quality

Demographic Information

Data Analysis

Results

Hypotheses

Exploratory Examination of Predictors of PPQ and MPA

Discussion

Implications for Clinical Practice

Limitations and Considerations for Future Research

Conclusion

Footnotes

Action Editor

Peer Review

Declaration of Conflicting Interests

Ethical Approval Statement

Funding

ORCID iD

Data Availability Statement

References