Sample recruitment and selection criteria
borderline personality disorder, phobia, epilepsy, substance dependence, impaired functioning, harpists, comorbid psychiatric, psychotic disorders, disorders of the cardiovascular system, claustrophobia
RECRUITMENT, PHYSICAL DISORDERS, EPILEPSY
Professional as well as semi-professional musicians and music students with different majors (e.g., artistic/ artistic-pedagogical/ pedagogical with an artistic focus), aged between 18 and 60 years and suffering from MPA, are included in the study. Further inclusion criteria are sufficient knowledge of the German language and compliance with Covid-regulations for local study appointments. Concerning the presence of a performance-disruptive MPA only musicians are included reporting a moderate or severe level of psychological distress (≥ 5 out of 10) and/or impaired functioning due to their fear of musical performance situations. This is assured by asking the subjects to rate on a scale ranging from 0 “not at all” to 10 “maximum possible” (1) how much they suffer due to their fear of musical performance situations and (2) how much they feel impaired in their functioning (i.e. every day or musical performance) due to their fear of musical performance situations. The musicians are included when rating at least one of the questions with at least 5 out of 10. Exclusion criteria comprise current or recent (< 6 months ago) psychotherapy because of the MPA and severe comorbid psychiatric or physical disorders, possessing a contraindication for exposure therapy (e.g. epilepsy, serious disorders of the cardiovascular system, psychotic disorders, borderline personality disorder, substance dependence or acute suicidality). Further exclusion criteria are concerning the characteristics and design of the study (e.g. small VR-cabin, assessment of blood samples, standing first-person view of the VR videos). Therefore, the subjects have to assure they are not suffering from severe claustrophobia or blood-injection-injury type phobia and can sing or play their instrument blindfolded and standing in the VR-cabin. For this reason and also because of the comparability of the HRV assessment, musicians with larger instruments and playing in a sitting position such as drummer, pianists, harpists and cellists cannot take part in the study. An overview of all inclusion and exclusion criteria can be found in Table 
Overview of the selection criteria for sample recruitment