Limitations
rigidity, anxiety
VR setup might be not efficient to evoke the psychological and physiological correlates of MPA, which are a prerequisite of successful exposure therapy. With regard to the external circumstances of the SARS-CoV2 pandemic and all their manifold implications the 360° VR exposure material has been created under considerable restrictions and hygiene regulations. By this time now, we do not know how and to which extend the face masks compromise the maximum effect of the virtual environment evoking a high anxiety. All actors shown in the VR videos are wearing face masks making it difficult to impossible for the probands to recognize and differentiate human facial expression with the head mounted display. Emotional expressions of different valences such as surprise, joy, astonishment, rejection, or rigidity which are essential for an interaction of the proband with the VR cannot be generated sufficiently. This could have a positive or negative impact on musician’s performance anxiety. On the one hand, some musicians could experience it as a relief and protective barrier, on the other hand it could be interpreted as a “lack of human feedback” from the audience. However, throughout the course of the pandemic people certainly have gotten used to face masks and have learned to practice more eye and body reading with their interaction partner. Indeed, participants included in the study report current high MPA levels evoked in the present pandemic situation suggesting that exposing the current real life condition in VR will lead to high anxiety levels. Furthermore, the number of spectators was limited due to the social restrictions and spatial distance among themselves within the room or concert hall. A crowded concert hall setting for example, triggering probably the highest anxiety levels for some musicians could not be realized. Only a small audience of 17 up to 21 people was possible to record. Furthermore, the nuances of an audition setting with the authority, rigidity or benevolence of the judges can be shown as just rudimentary. To summarize, it remains unclear at this moment how these technical and social factors are negatively assessed by the probands and to which extent the VR setting is being impaired in its effectiveness. Finally, this exposure-based VR therapeutic setting allows us to work with the musician individually, but not to set individual therapeutic priorities e.g. focus on cognitive, physiological or behavioral symptoms in a recessed way. Musicians might further benefit from additional interventions on an individual level, therefore, further studies should explore the effect of VR therapy 