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Symptomatology is one of the two broad scoring categories in the MPADQ, and it answers a fundamental question: when performance anxiety affects you, how does it actually show up? While Contributing Factors explores the deeper roots of your anxiety, Symptomatology maps its surface expressions — the physical sensations in your body, the mental patterns in your mind, and the behavioral changes in how you act before and during performances. Understanding your symptom profile is often the first step toward addressing anxiety effectively, because you cannot manage what you cannot clearly see.

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How Symptomatology Is Scored

The Symptomatology broad category score is the rounded average of your three sub-category scores: Physical Symptoms, Cognitive Symptoms, and Behavioral Symptoms. Each sub-category score is itself the rounded average of all non-N/A Likert responses for questions assigned to that sub-category. Scores range from 0% (most symptomatic) to 100% (least symptomatic or no symptoms). A lower Symptomatology score means more frequent or severe symptoms; a higher score means fewer or milder symptoms.
Experiencing symptoms of performance anxiety is entirely normal — nearly every performer does, at some level. The presence of symptoms is not a sign of weakness or inadequacy. The MPADQ measures symptoms so that you and the book can address them with targeted, practical strategies.

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The Three Symptomatology Sub-Categories

What it measures: The Physical Symptoms sub-category captures the bodily manifestations of performance anxiety — the sensations that arise in your body when anxiety is present before or during a performance.Example questions from this sub-category include:
  • “My heart races when I perform.”
  • “I breathe faster than normal when I perform.”
  • “I sweat because of anxiety when I perform.”
  • “I get cold because of anxiety when I perform.”
  • “My stomach gets upset when I perform.”
  • “I feel jittery when I perform.”
  • “I feel uneasy when I perform.”
  • “My voice is affected by my nervousness during a performance.”
  • “My throat gets dry because of anxiety during performances.”
  • “I tend to get sick near a performance.”
Interpreting your score: A lower Physical Symptoms score indicates that bodily symptoms are a significant feature of your performance anxiety. This is among the most commonly reported and easily recognized forms of performance anxiety. Physical symptoms have both physiological and psychological drivers — an elevated heart rate, shallow breathing, and muscle tension are all part of the body’s stress-response system activating at an inopportune moment.Using this score with the book: If your Physical Symptoms score is low, prioritize the chapters that address somatic (body-based) approaches to anxiety management, including breathing techniques, physical warm-up strategies, and body awareness practices. These chapters will give you concrete tools to interrupt the physical anxiety cycle before and during performances.
What it measures: The Cognitive Symptoms sub-category captures the mental and psychological manifestations of performance anxiety — how anxiety shapes your thoughts, attention, memory, and inner dialogue in the lead-up to and during a performance.Example questions from this sub-category include:
  • “I am embarrassed by my nervousness.”
  • “I can’t get motivated for performances.”
  • “I am more critical of myself than usual when a performance is imminent.”
  • “I have trouble staying focused when anticipating a performance.”
  • “I make more mistakes than I should when anticipating a performance.”
  • “I imagine the worst when anticipating a performance.”
  • “During performances I am concerned about the outcome of that performance.”
  • “I have memory slips because of anxiety when I perform.”
  • “I’d rather be singing/playing in a practice room than in front of people.” (also counts toward Behavioral Symptoms)
Interpreting your score: A lower Cognitive Symptoms score indicates that anxiety frequently disrupts your mental experience of performing — through negative self-talk, catastrophizing, concentration failures, or memory lapses. Cognitive symptoms are often the most persistent form of performance anxiety because thoughts are fast, automatic, and deeply habitual. They can spiral quickly, turning a minor stumble into a perceived catastrophe.Using this score with the book: If your Cognitive Symptoms score is low, focus on the chapters dealing with mental skills training, cognitive reframing, attention management, and performance mindset. These sections will help you build the inner resilience and mental flexibility to stay present and constructive under pressure.
What it measures: The Behavioral Symptoms sub-category captures how performance anxiety changes what you do — the observable actions and patterns that emerge in response to anxiety before, during, and after performances. These are the ways anxiety manifests as behavior rather than as a feeling or a thought.Example questions from this sub-category include:
  • “I have trouble sleeping when anticipating a performance.”
  • “My eating habits change because of anxiety when anticipating a performance.”
  • “Anxiety affects the amount of practicing I do.”
  • “Anxiety affects the quality of my practicing.”
  • “My sleep habits are affected by anxiety.”
  • “I become irritable because of anxiety.”
  • “I drink more alcohol because of anxiety.”
  • “I use recreational drugs because of anxiety.”
  • “I procrastinate because of anxiety.”
  • “My relationships are affected by my anxiety.”
  • “My general activity level is affected by anxiety.”
  • “I often want to cancel or reschedule my performances because of anxiety.”
  • “I’d rather be singing/playing in a practice room than in front of people.” (also counts toward Cognitive Symptoms)
Interpreting your score: A lower Behavioral Symptoms score indicates that anxiety is visibly changing your daily habits and choices — disrupting sleep, altering eating patterns, causing avoidance of performances, or affecting the way you practice and relate to others. Behavioral symptoms are important to recognize because they often create a negative feedback loop: avoidance, for example, reduces exposure to performances and can make the fear grow stronger over time.Using this score with the book: If your Behavioral Symptoms score is low, the book’s chapters on behavioral strategies will be especially important for you. These include guidance on consistent performance exposure, healthy pre-performance routines, avoidance-reduction techniques, and lifestyle habits that support psychological resilience.

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Reading Your Broad Symptomatology Score

Your overall Symptomatology score is the rounded average of the three sub-category scores above. Because the three sub-categories can diverge significantly — a musician might have strong physical symptoms but few behavioral changes, for instance — the broad score is a useful starting point but the sub-category breakdown is where the most actionable insight lives.
When one or more sub-categories receive an N/A score (because too many questions in that sub-category were answered N/A), they are excluded from the Symptomatology broad average. This prevents a single unanswerable sub-category from distorting your overall picture.

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Next Steps

Score Overview

Review how all MPADQ scores are calculated and how to use them together as a complete profile.

Contributing Factors

Explore the 21 sub-categories that reveal the underlying influences shaping your performance anxiety.

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