Resilience Mitigates the Link between Adverse Childhood Experiences and Musician's Dystonia: A Neuroendocrine and Psychological Perspective.

Abstract

Background: Musician's dystonia (MD) is a task-specific movement disorder affecting up to 1% of all professional musicians. Although adverse childhood experiences (ACEs) have been proposed as risk factors, the etiology of MD is not fully understood, and protective factors remain largely unexplored.

Objective: This study investigated a possible protective role of psychological resilience on the association between MD and adverse childhood experiences and examined the influence of dystonia, resilience and ACEs on the stress reactivity of musicians.

Methods: Forty participants with MD were compared to 39 matched healthy musicians. While undergoing the "Montreal Imaging Stress Task", cortisol responses of the participants were measured. Furthermore, participants completed two psychological assessments, the Connor-Davidson Resilience Scale and the Childhood Trauma Questionnaire. Mediation and moderation analyses evaluated the mitigating role of resilience on the relationship between ACEs and MD. Bayesian multilevel models were used to analyze links between cortisol responses, ACEs and MD.

Results: Healthy musicians showed higher resilience than MD patients, especially when looking at the dimensions "adaptability/flexibility" (W = 517, p = 0.004) and "regulation of emotion and cognition" (W = 554, p = 0.011). Resilience moderated the association between ACEs and dystonia (-0.29 [-0.47, -0.10]). MD patients and healthy participants did not differ in their cortisol output.

Discussion: While links between acute stress reactivity, ACEs and MD were more equivocal, resilience seems to decrease the negative effects of ACEs on MD development.The results of this study emphasize the need to implement resilience enhancing interventions at an early state of musical education.

Highlights: Musicians suffering from musician's dystonia (MD) and healthy musicians were compared concerning resilience, adverse childhood experiences (ACEs) and their stress reactivity.Healthy musicians showed tendencies of higher resilience than MD patients.Resilience appears to decrease the negative effects of ACEs on the development of musician's dystonia.MD patients and healthy musicians did not display differences in their cortisol output when presented with an acute stress task.