Comparison of Perfectionism Between Music and Medical Students and its Association with Anxiety.

OBJECTIVES: Perfection is a central goal for many musicians and health professionals. The present study compared perfectionism between music and medical students to examine whether perfectionism is adaptive or maladaptive and how it evolves during university studies. Furthermore, the association between perfectionism and anxiety was investigated in both populations to determine possible implications for mental and general health. METHODS: 110 music students (61 F, avg age 23.2 yrs) and 281 medical students (209 F, avg age 23.3 yrs) took part in the study. Perfectionism was surveyed using two multidimensional perfectionism scales and anxiety was measured using the State-Trait-Anxiety-Inventory. Subscales and total scores of the perfectionism scales were compared within and between groups and correlated with the anxiety measures. RESULTS: Music and medical students did not differ in their level of perfectionism. However, music students in the early semesters showed significantly (p = 0.009) stronger maladaptive perfectionism (mean 0.3, SD 1.4) than students from more senior semesters (-0.3, 1.7). Musicians from early semesters also scored higher on "parental expectations and criticism" (p = 0.04), showed more "concerns over mistakes and doubts" (p = 0.009), and perfectionism in general (p = 0.01). Analysis of the anxiety measure showed a strong correlation (rs = 0.55) between maladaptive perfectionism and anxiety for the music students. Semester and age had no influence on anxiety. Maladaptive perfectionism and adaptive perfectionism both correlated significantly with anxiety in medical students. CONCLUSION: Music and medical students had similar levels of perfectionism. Medical students maintained a consistent level of perfectionism throughout their studies, while music students were more perfectionistic at the beginning of their education. For both groups, perfectionism was significantly correlated with anxiety.

Focal Dystonia and the Stress Network: The Role of Stress Vulnerability and Adverse Childhood Experiences in the Development of Musician's Dystonia.

Musician's dystonia is often described as a neurological disorder, resulting from reduced inhibition in the basal ganglia and the cerebellum and dysfunctional cortical plasticity. However, several studies over the last decades support the hypothesis that psychological factors play an important role in the aetiology of dystonia, contradicting its classification as "purely neurological". Especially adverse childhood experiences (ACEs) such as neglect, maltreatment, or household dysfunction may influence the sensorimotor system, additionally to the impact they have on psychological traits. They are known to alter limbic networks, such as the amygdala, the hippocampus, and the stress response via the hypothalamus-pituitary-adrenal (HPA) axis and might also affect the cortico-striatal-thalamo-cortical loop that is vital for correct motor movement learning. Especially a higher activity of the basolateral amygdala could be important by increasing the consolidation of dysfunctional motor memories in stressful situations.Therefore, this chapter explores how musician's dystonia might be a result of dysfunctional stress-coping mechanisms, additionally to the already established neurological alterations.

Influence of Adverse Childhood Experiences and Perfectionism on Musician's Dystonia: a Case Control Study.

Background: Musician's dystonia (MD) is a task-specific movement disorder characterized by muscle cramps and impaired voluntary motor-control whilst playing a musical instrument. Recent studies suggest an involvement of adverse childhood experiences (ACEs) in the development of MD. Objectives: By investigating the prevalence of ACEs in MD patients with perfectionism as possible mediating factor this study aims to gain further insights into the etiology of MD. Methods: The Adverse Childhood Experiences Scale (ACE-S), the Childhood Trauma Questionnaire (CTQ) and Frost's Multidimensional Perfectionism Scale (FMPS) were answered by 128 MD patients and 136 healthy musicians. Regression and mediator analyses were conducted to identify relevant predictors of MD and to investigate the role of perfectionism. Results: The CTQ total score (OR: 1.04; 95% CI [1.01, 1.08]) and the sub-score "emotional neglect" (OR: 1.13; 95% CI [1.02, 1.25]) were identified as two predictors of MD. Patients scored significantly higher on the sub-score emotional neglect, but no significant differences were observed for other forms of ACEs. Perfectionism had no mediating function on the association between ACEs and MD. Discussion: Though only slight differences between both groups were found, there is a trend towards higher rates of emotional neglect among dystonic musicians. A possible explanation for the association between musician's dystonia and emotional neglect could be a lower stress resilience in musicians with a history of ACEs, which increases vulnerability to acquire dysfunctional movement patterns.These tendencies should be further investigated in future studies in which the MD and HM groups are more evenly matched in sex and age. Highlights: We investigated the role of Adverse Childhood Experiences in the development of musician's dystonia, comparing a large sample of healthy musicians and dystonia patients. Our findings suggest that experiencing emotional neglect might increase the probability to acquire musician's dystonia. The findings offer new implications for etiology and treatment of dystonia.