Influence of Adverse Childhood Experiences and Perfectionism on Musician’s Dystonia: A Case Control Study

Background: Musician’s dystonia (MD) is a task-specific movement disorder characterized by muscle cramps and impaired voluntary motor-control whilst playing a musical instrument. Recent studies suggest an involvement of adverse childhood experiences (ACEs) in the development of MD. Objectives: By investigating the prevalence of ACEs in MD patients with perfectionism as possible mediating factor this study aims to gain further insights into the etiology of MD.Methods: The Adverse Childhood Experiences Scale (ACE-S), the Childhood Trauma Questionnaire (CTQ) and Frost’s Multidimensional Perfectionism Scale (FMPS) were answered by 128 MD patients and 136 healthy musicians. Regression and mediator analyses were conducted to identify relevant predictors of MD and to investigate the role of perfectionism.Results: The CTQ total score (OR: 1.04; 95% CI [1.01, 1.08]) and the sub-score “emotional neglect” (OR: 1.13; 95% CI [1.02, 1.25]) were identified as two predictors of MD. Patients scored significantly higher than healthy controls on the sub-score emotional neglect, but no significant differences were observed for other forms of ACEs. Perfectionism had no mediating function on the association between ACEs and MD and the two groups did not differ in their FMPS score.Conclusion: Emotional neglect in childhood seems to be a risk factor in the development of musician’s dystonia. A possible explanation for this association could be a lower stress resilience in musicians with a history of ACEs, which increases vulnerability to acquire dysfunctional movement patterns. Further research is needed to investigate underlying psychological and neurological mechanisms of this association.