How does music performance anxiety relate to other anxiety disorders?

Acknowledgements The authors would like to thank all students and administrative staff of participating music universities. The authors would also like to express their appreciation to Professor Katja Beesdo-Baum and Dr Manfred Nusseck for general support, to Birgit Maicher for programming the basic version of the questionnaires and to Professor Hans-Christian Jabusch for helping to recruit participants as well as for discussions at later stages of the project. Funding The author(s) received no financial support for the research, authorship, and/or publication of this article.Peer reviewedPublisher PD

The role of retrospectively perceived parenting style and adult attachment behaviour in music performance anxiety

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Mental health and well-being from childhood to adulthood: design, methods and results of the 11-year follow-up of the BELLA study

Mental health and well-being are of great interest in health policy and research. Longitudinal surveys are needed to provide solid population-based data. We describe the design and methods of an 11-year follow-up of the German BELLA study in children, adolescents and young adults, and we report on age- and gender-specific courses of general health and well-being, long-term health-related outcomes of mental health problems, and mental health care use. The BELLA study is the module on mental health and well-being within the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Standardised measures were used at each of the five measurement points of the BELLA study. In the 11-year follow-up, young people aged 7–31 years participated (n = 3492). Individual growth modelling, linear regression and descriptive analyses were conducted. Self-reported general health and well-being were both better in younger (vs. older) and in male (vs. female) participants according to the data from all five measurement points. Mental health problems in childhood and adolescence (measured at baseline) predicted impaired health outcomes at 6-year and 11-year follow-ups. Approximately one out of four children with a diagnosed mental disorder was not undergoing mental health treatment. With its 11-year follow-up, the prospective longitudinal BELLA study provides new and solid data on mental health and well-being from childhood to adulthood in Germany, and these data are important for health promotion and prevention practices. These results are consistent with previous findings. Promising future analyses are planned.Peer Reviewe

Mental disorders and the risk for the subsequent first suicide attempt: results of a community study on adolescents and young adults

Adolescents and young adults represent the high-risk group for first onset of both DSM-IV mental disorders and lifetime suicide attempt (SA). Yet few studies have evaluated the temporal association of prior mental disorders and subsequent first SA in a young community sample. We examined (a) such associations using a broad range of specific DSM-IV mental disorders, (b) the risk of experiencing the outcome due to prior comorbidity, and (c) the proportion of SAs that could be attributed to prior disorders. During a 10-year prospective study, data were gathered from 3021 community subjects, 14-24 years of age at baseline. DSM-IV disorders and SA were assessed with the Munich-Composite International Diagnostic Interview. Cox models with time-dependent covariates were used to estimate the temporal associations of prior mental disorders with subsequent first SA. Most prior mental disorders showed elevated risk for subsequent first SA. Highest risks were associated with posttraumatic stress disorder (PTSD), dysthymia, and nicotine dependence. Comorbidity elevated the risk for subsequent first SA, and the more disorders a subject had, the higher the risk for first SA. More than 90% of SAs in the exposed group could be attributed to PTSD, and over 30% of SAs in the total sample could be attributed to specific phobia. Several DSM-IV disorders increase the risk for first SA in adolescents and young adults. Several promising early intervention targets were observed, e.g., specific phobia, nicotine dependence, dysthymia, and whether a young person is burdened with comorbid mental disorders

The Behavior and Mind Health (BeMIND) study: Methods, design and baseline sample characteristics of a cohort study among adolescents and young adults

Objectives: The Behavior and Mind Health (BeMIND) study is a population‐based cohort study of adolescents and young adults from Dresden, Germany. The aim is to investigate psychological and behavioral factors linked to a range of mental disorders and health behaviors and their interaction with social‐environmental and genetic/biologic factors. Methods: A random sample of 14–21 year olds was drawn from the population registry in 2015. The baseline investigation was completed 11/2015–12/2016 (N = 1,180). Assessments include standardized diagnostic interview, cognitive‐affective tasks, questionnaires, biosamples, and ecologic momentary assessment in real life with combined actigraphic/geographic monitoring. In the family study component, parents completed similar assessments and provided information on child's early development. Results: The participation rate (minimum response proportion) was 21.7%; the cooperation rate was 43.4%. Acceptance and completion of study components were high. General health data indicate that more than 80% reported no or only mild impairment due to mental or somatic health problems in the past year; about 20% ever sought treatment for mental health problems or chronic somatic illnesses, respectively. Conclusions: Data from BeMIND baseline and follow‐up investigations will provide novel insights into contributors to health and disease as adolescents grow into adulthood

Social anxiety in adolescents and young adults from the general population: an epidemiological characterization of fear and avoidance in different social situations

Social Anxiety Disorder (SAD) and, more generally, social fears are common in young people. Although avoidance behaviors are known to be an important maintaining factor of social anxiety, little is known about the severity and occurrence of avoidance behaviors in young people from the general population, hampering approaches for early identification and intervention. Symptoms, syndromes, and diagnoses of DSM-5 mental disorders including SAD were assessed in a random population-based sample of 14-21-year-olds (n = 1,180) from Dresden, Germany, in 2015/2016 using a standardized diagnostic interview (DIA-X-5/D-CIDI). An adapted version of the Liebowitz Social Anxiety Scale was used to ascertain the extent of social fears and avoidance. Diagnostic criteria for lifetime SAD were met by n = 82 participants, resulting in a weighted lifetime prevalence of 6.6%. Social anxiety was predominantly reported for test situations and when speaking or performing in front of others. Avoidance was most prevalent in the latter situations. On average, anxiety and avoidance first occurred at ages 11 and 12, respectively, with avoidance occurring in most cases either at about the same age as anxiety or slightly later. In the total sample, lifetime prevalence for most DSM-5 disorders increased with the severity of social anxiety and avoidance. Results underline the need for preventive or early intervention efforts especially regarding test anxiety and fear and avoidance of speaking in front of others. These situations are particularly relevant in youth. Avoidance behaviors may also be discussed as diagnostic marker for early case identification

Specific Traumatic Events Elevate the Risk of a Suicide Attempt in a 10-year Longitudinal Community Study on Adolescents and Young Adults

Traumatic events (TEs) have been associated with suicide attempts (SAs). However, the empirical status of some TEs is inconclusive. This also concerns community adolescents and young adults, known to be a high-risk group for SAs. We examined associations between (a) a range of prior TEs (physical attack, rape/sexual abuse, serious accident, and witnessing somebody else experiencing a TE) and a subsequent SA, and (b) the number of prior TEs and an SA, and (c) we estimated attributable proportions of SAs, in relation to each TE. Over a 10-year period, the Early Developmental Stages of Psychopathology (EDSP) study prospectively assessed community members, aged 14-24 years at baseline. Starting with 3021 subjects, each individual was assessed up to four times. Assessment was based on the Munich-Composite International Diagnostic Interview. Temporal associations were estimated using the Cox model with time-dependent covariates. Attributable proportions were based on the results of the Cox models. All four TEs elevated the risk for a subsequent SA, adjusting for confounders. Highest risk was found for the combined TE rape/sexual abuse. Results showed that 56-90% of SAs could be attributed to TEs in the exposed group; on the population level, attributable proportions ranged between 6.9% and 23.5%. Different TEs have been shown to elevate the risk of an SA in a young community sample. Our results suggest that both health professionals and health policy decision-makers consider specific TEs and the number of prior TEs as risk factors for SAs

Subclinical patterns of disordered eating behaviors in the daily life of adolescents and young adults from the general population.

BACKGROUND Disordered eating behaviors (DEBs), a risk factor for the development of eating disorders (EDs), are prevalent in young people and different DEBs frequently co-occur. Previous studies on DEB-patterns have largely used traditional retrospective questionnaires to assess DEBs. In addition, most previous studies did not specifically exclude individuals with clinical EDs, which limits current knowledge concerning purely subclinical patterns of DEBs. In the present study, we aimed to explore phenotypes and group sizes of subclinical patterns of DEBs reported in everyday life via smartphone-based ecological momentary assessment (EMA) in adolescents and young adults from the general population without lifetime EDs. In secondary analyses, we further aimed to investigate whether DEB-patterns would be associated with additional previously identified risk factors for ED-development. METHODS EMA was conducted in a community sample of 14-21-year-olds from Dresden, Germany, over four days for up to eight times a day and covered engagement in four DEBs: skipping eating, restrained eating, eating large amounts of food, and loss-of-control eating. Data were analyzed from N = 966 individuals without lifetime EDs with an EMA compliance rate of at least 50% (81.9% of the total sample; average compliance: 84.6%). Latent profile analyses were performed to identify subclinical patterns of DEBs, stratified by sex. Associations between symptomatic profiles and ED-risk factors were tested via regression analyses. RESULTS Based on theoretical deliberations, statistical indices, interpretability, and parsimony, a three-profile solution, namely no DEBs, high-mixed DEBs, and low-mixed DEBs, was selected for both sexes. Both symptomatic profiles in both sexes were associated with more unfavorable manifestations in additional ED risk factors compared to the no DEBs profile, with the highest number of associations being observed in the female high-mixed profile. CONCLUSIONS The present findings suggest that problematic manifestations of DEBs in young people may occur even in the absence of an ED diagnosis and that they are associated with additional risk factors for EDs, warranting increased efforts in targeted prevention, early identification and intervention in order to counteract symptom progression

Music performance anxiety and its anxiety correlates

Music performance anxiety (MPA) is considered a social anxiety disorder (SAD). Recent conceptualisations, however, challenge existing MPA definitions, distinguishing MPA from SAD. In this study, we aim to provide a systematic analysis of MPA interdependencies to other anxiety disorders through graphical modeling and cluster analysis. Participants were 82 music students (M(age)=23.5 years, SD=3.4; 69.5% women) with the majority being vocal (30.5%), string (24.4%) or piano (19.5%) students. MPA was measured using the German version of the Kenny Music Performance Anxiety Inventory (K-MPAI). All participants were tested for anxiety-related symptoms using the disorder-specific anxiety measures of the DSM-5, including agoraphobia (AG), generalised anxiety disorder (GAD), panic disorder (PD), separation anxiety disorder (SEP), specific phobia (SP), social anxiety disorder (SAD) and illness anxiety disorder (ILL). We found no evidence of MPA being primarily connected to SAD, finding GAD acted as a full mediator between MPA and any other anxiety type. Our graphical model remained unchanged considering severe cases of MPA only (K-MPAI≥105). By means of cluster analysis, we identified two participant sub-groups of differing anxiety profiles. Participants with pathological anxiety consistently showed more severe MPA. Our findings suggest that GAD is the strongest predictor for MPA amongst all major DSM-5 anxiety types

How does music performance anxiety relate to other anxiety disorders?

Music performance anxiety (MPA) is considered a social anxiety disorder (SAD). Recent conceptualisations, however, challenge existing MPA definitions, distinguishing MPA from SAD. In this study, we aim to provide a systematic analysis of MPA interdependencies to other anxiety disorders through graphical modelling and cluster analysis. Participants were 82 music students (Mage=23.5 years, SD=3.4; 69.5% women) with the majority being vocal (30.5%), string (24.4%) or piano (19.5%) students. MPA was measured using the German version of the Kenny Music Performance Anxiety Inventory (K-MPAI). All participants were tested for anxiety-related symptoms using the disorder-specific anxiety measures of the DSM-5, including agoraphobia (AG), generalised anxiety disorder (GAD), panic disorder (PD), separation anxiety disorder (SEP), specific phobia (SP), social anxiety disorder (SAD) and illness anxiety disorder (ILL). We found no evidence of MPA being primarily connected to SAD, finding GAD acted as a full mediator between MPA and any other anxiety type. Our graphical model remained unchanged considering severe cases of MPA only (K-MPAI≥105). By means of cluster analysis, we identified two participant sub-groups of differing anxiety profiles. Participants with pathological anxiety consistently showed more severe MPA. Our findings suggest that GAD is the strongest predictor for MPA amongst all major DSM-5 anxiety types