Debilitating performance anxiety in musicians and the performance specifier for social anxiety disorder: should we be playing the same tune?

ObjectiveResearch on the experience of performance anxiety (PA) in musicians is often explored through the use of the term music performance anxiety (MPA). Current diagnostic classifications include PA as a specifier for social anxiety disorder (SAD). This inclusion aims to acknowledge a distinct group of individuals who demonstrate the same cluster of symptoms as SAD but in a performance specific context. This present review aims to examine and sythesise these distinct literatures from a cognitive-behavioural perspective.MethodRelevant literature from the cognitive-behavioural perspective of SAD and MPA were identified, compared, and critically reviewed.ResultsDespite a continued focus in the field of clinical psychology on developing diagnostic tools, disorder-specific models, and gold standard treatments for SAD, these advancements are not widely employed when understanding and managing debilitating PA in musicians. This review considers that research investigating debilitating PA in musicians could be examined as a context-specific form of SAD, informed by well-established cognitive-behavioural models and assessment tools, which can aid the development of standardised treatment protocols.ConclusionsCognitive-behavioural models of SAD could aid in our understanding of PA in musicians, especially when considering treatment targets. Limitations for the model's application are also discussed, recognising the complex nature and research already conducted on MPA. What do we already know about this topic: The experience of performance anxiety (PA) in musicians is often referred to using the term music performance anxiety (MPA).Research on social anxiety disorder (SAD) continues to evolve, with the development of cognitive-behavioural models that aid in treatment and conceptualisation.A performance-only specifier has been included in the DSM-5-TR as a specifier for SAD, whilst the term MPA continues to be used when exploring the experience of PA in musicians.What does this topic add: Established cognitive-behavioural models could support our understanding of the development and maintance of PA in musicians. Key models for MPA incorporate components of available cognitive models of SAD, demonstrating shared constructs which may aid in the development of context-specific cognitive-behavioural interventions.Given the development of a performance-only specifier for SAD in DSM-5-TR, the term performance anxiety (PA) may offer a simpler term to characterise the experience of debilitating anxiety surrounding the fear of evaluation despite available skills.Future research is needed support the integration of PA research across fields (i.e. sport, public speaking). This will not negate the complexities of individual performers experiences, rather provide clarity on the shared fear of negative evaluation underlying experienced PA.