Musician’s Focal Dystonia: A new, holistic perspective

Musician’s Focal Dystonia (MFD) is a task-specific, neurological movement disorder affecting highly skilled musicians which disrupts the fine motor control of the movements necessary for playing an instrument. The understanding of the pathophysiology and aetiology is limited, resulting in the lack of reliable treatment strategies; therefore, full recovery is extremely rare. The multifactorial origins of the condition are acknowledged, yet the bulk of the research is conducted from a medical perspective, focusing on maladaptive neuroplasticity and the genetic setup of the sufferers. Following the initiative of more recent research which broadened the scope of the investigations, this thesis explores the condition from a holistic perspective, including psychosocial, psychological, and behavioural factors. To reach this goal, a large-scale mixed-method research study was planned with three distinct stages and methodologies which allowed the triangulation of the findings. The first, exploratory Grounded Theory interview study collected the life stories of 15 musicians affected by the disorder to identify potential risk factors. These findings informed the interview schedule of the second qualitative study, which was conducted with 14 practitioners who frequently work with musicians with MFD. This still subjective qualitative data provided information about a large in-direct sample, and insights into the ongoing treatment strategies. The identified risk factors then were tested in a quasi-experimental questionnaire study, comparing musicians with and without MFD. The triangulated findings indicate the musicians who were later affected by MFD had maladaptive psychological traits and cognitive strategies, exercised negative health and practice behaviours, and experienced traumatic events prior to the onset of the condition. Moreover, it was concluded that many seemingly individual maladaptive characteristics were prompted or aggravated by the social context, especially the educational and work environments. Implications for treatment approaches and preventative strategies and suggestions for further research are discussed in the final chapters of the work.