Emotional Distress Profile in Performing Artists and Researchers: The Balance of Anxiety and Depressive–Anhedonic Symptoms

Abstract

Abstract

Background. Total emotional distress scores may fail to capture differences in the balance between anxiety and depressive-anhedonic symptoms. For professions involving public evaluation and the need to mobilize resources quickly, analyzing the structure of distress may be more informative than relying on an overall score.

Objective. The goal is to compare the overall level and profile of emotional distress in performing artists, researchers, and a comparison group while accounting for sex and age.

Sample. The analysis included 299 adults from different professions: 87 performing artists, 89 researchers, and 123 participants in the comparison group; 190 women and 109 men. The mean age of the performing artists was 35.92 years (SD = 15.73), that of the researchers was 34.97 years (SD = 15.31), and that of the comparison group was 28.78 years (SD = 11.85).

Methods. Emotional distress was assessed using the Hospital Anxiety and Depression Scale (HADS; A.S. Zigmond, R.P. Snaith). Two subscales — anxiety (HADS-A) and depression (HADS-D) — along with their sum (the total HADS-T score) and a profile contrast calculated as the difference HADS-A minus HADS-D, reflecting the predominance of anxiety over depressive symptoms, were analyzed. Cronbach's α, the Kruskal — Wallis test, multivariate analysis of covariance, linear regression with robust standard errors, and comparison of screening proportions were used.

Results. Total HADS-T scores showed virtually no difference between groups: 10.09 in artists, 10.39 in researchers, and 10.08 in the comparison group; p = 0.900. The profile, however, was not uniform. After adjusting for sex and age, artists scored 2.03 points higher than the comparison group on the anxiety subscale (HADS-A) (p = 0.001) and 1.11 points lower on the depression subscale (HADS-D) (p = 0.018). The profile contrast in artists exceeded that of the comparison group by 3.14 points and that of researchers by 2.32 points (both p < 0.001). The proportion of elevated anxiety scores did not differ, whereas elevated depressive-anhedonic scores were less common among artists.

Conclusion. Comparable overall emotional distress may have a different internal structure. Artists are characterized by a relative predominance of the anxiety-mobilization component alongside less pronounced depressive-anhedonic symptoms. Thus, HADS-T should not be used without separately analyzing its subscales.

References

Ascenso, S., Williamon, A., Perkins, R. (2018). Resounding meaning: A PERMA wellbeing profile of classical musicians. Frontiers in Psychology, (9), 1895–1909. https://doi.org/10.3389/fpsyg.2018.01895

Bjelland, I., Dahl, A.A., Haug, T.T., Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale: An updated literature review. Journal of Psychosomatic Research, 52(2), 69–77. https://doi.org/10.1016/S0022-3999(01)00296-3

Hammoudi Halat, D., Abdel-Rahman, M.E., Al-Jayyousi, G.F., Malki, A. (2024). Associations between perceived occupational stressors and symptoms severity of depression, anxiety and stress among academic faculty: First cross-sectional study from Qatar. BMC Psychology, (12), 393–410. https://doi.org/10.1186/s40359-024-01801-x

Kotenko, K.V., Mikhailova, A.A., Nagornev, S.N., Vasilyeva, E.S., Frolkov, V.K., Olifer, Ya.S., Badimova, A.V., Reshetova, I.V., Korchazhkina, N.B. (2025). Biochemical markers of stress in medical workers with occupational burnout syndrome and their dynamics under the influence of physiotherapeutic factors. Voprosy Kurortologii, Fizioterapii i Lechebnoi Fizicheskoi Kultury = Problems of Balneology, Physiotherapy and Exercise Therapy, 102(5–2), 17–27. (In Russ.). https://doi.org/10.17116/kurort202510205217

Li, S.A., Sakata, N., Donn, G. (2025). A scoping review of mental health literacy in performing and creative artists. Frontiers in Psychology, (16), 1329029–1329045. https://doi.org/10.3389/fpsyg.2025.1329029

Lloyd, M., Sugden, N., Thomas, M., McGrath, A., Skilbeck, C. (2023). The structure of the Hospital Anxiety and Depression Scale: Theoretical and methodological considerations. British Journal of Psychology, 114(3), 642–664. https://doi.org/10.1111/bjop.12637

Lopatkina, L.V., Kotenko, K.V., Korchazhkina, N.B. (2014). Comprehensive non-pharmacological programs in the correction of autonomic and psychoemotional disorders in metabolic syndrome. Fizioterapiya, Balneologiya i Reabilitatsiya = Russian Journal of Physiotherapy, Balneology and Rehabilitation, 13(4), 4–6. (In Russ.)

Marakshina, Yu.A., Pavlova, A.A., Ismatullina, V.I., Lobaskova, M.M. (2025). Analysis of psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in a sample of Russian-speaking students. Acta Biomedica Scientifica, 10(5), 182–193. (In Russ.). https://doi.org/10.29413/ABS.2025-10.5.20

Morozova, M.A., Potanin, S.S., Beniashvili, A.G., Burminsky, D.S., Lepilkina, T.A., Rupchev, G.E., Kibitov, A.A. (2023). Validation of the Russian-language version of the Hospital Anxiety and Depression Scale in the general population. Profilakticheskaya Meditsina = The Russian Journal of Preventive Medicine, 26(4), 7–14. (In Russ.). https://doi.org/10.17116/profmed2023260417

Musgrave, G., Gross, S.A., Carney, D. (2025). Determinants of anxiety, depression and subjective wellbeing among musicians in Denmark: Findings from the "When Music Speaks" project. Scandinavian Journal of Psychology, 66(3), 429–445. https://doi.org/10.1111/sjop.13095

Snaith, R.P. (2003). The Hospital Anxiety and Depression Scale. Health and Quality of Life Outcomes, (1), 29–35. https://doi.org/10.1186/1477-7525-1-29

Szabó, M., Seton, M., Maxwell, I., Cunningham, M.L. (2022). Psychological well-being of Australian actors and performing artists: Life satisfaction and negative affect. Medical Problems of Performing Artists, 37(2), 106–117. https://doi.org/10.21091/mppa.2022.2016

Walton, C.C., Kirby, J.N., McKenzie, S., Gao, C.X., Purcell, R., Rice, S.M., Osborne, M.S. (2025). A preliminary investigation into self-compassion and performing artists' mental health and wellbeing. Frontiers in Psychology, (16), 1512114–1512130. https://doi.org/10.3389/fpsyg.2025.1512114

Willis, S., Neil, R., Mellick, M.C., Wasley, D. (2019). The relationship between occupational demands and well-being of performing artists: A systematic review. Frontiers in Psychology, (10), 393–413. https://doi.org/10.3389/fpsyg.2019.00393

Zigmond, A.S., Snaith, R.P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x