Are attitudes toward music therapy associated with lower social anxiety in university students? The roles of emotion regulation and psychological flexibility

Background Social anxiety in university students is a mental health risk and is linked to various psychological resources. Emotional regulation and psychological flexibility are related to how students manage distress. This study explores how these factors are associated with the relationship between attitudes toward music therapy and social anxiety in students. Methods This study collected questionnaire data from 689 university students in China through class-based convenience sampling. Established scales were used to measure social anxiety, emotion regulation, and psychological flexibility, while attitudes toward music therapy were assessed using a previously used seven-item Music Therapy Scale. Structural equation modeling was used to test the hypotheses. Results Attitudes toward music therapy were negatively associated with social anxiety. Cognitive reappraisal (β = −0.147, t = 8.685, p < 0.001) and expressive suppression (β = −0.115, t = 7.641, p < 0.001) showed significant indirect associations in this relationship. Psychological flexibility moderated the relationship between attitudes toward music therapy and social anxiety (β = −0.176, t = 7.483, p < 0.001). Students with higher psychological flexibility showed a stronger negative link between attitudes toward music therapy and social anxiety compared to those with lower psychological flexibility. Conclusion This study provides preliminary correlational evidence that university students’ attitudes toward music therapy are associated with social anxiety, emotion regulation, and psychological flexibility. The findings should not be interpreted as evidence for the effectiveness of music therapy intervention.