Public speaking anxiety (PSA) significantly impairs academic and professional outcomes among university students. While virtual reality exposure therapy (VRET) shows promise for PSA treatment, the specific contribution of social and emotional interviewer reactions remains unclear. This study examines whether VRET with graded interviewer reactions leads to greater reduction in public speaking anxiety than standard automated VR exposure. This two-arm, parallel-group, superiority randomized controlled trial will recruit 92 Korean university students aged ≥18years with elevated PRPSA (Personal Report of Public Speaking Anxiety-18 ≥ 58). Participants will be randomized 1:1 to receive either VR interview training with graded interviewer reactions or control VR training with automated voice prompts only. The intervention consists of three VR sessions, with assessments conducted at baseline, immediately after each session, and at 6- and 12-week follow-ups. The primary outcome is change from baseline in Public Speaking Anxiety Scale (PSAS) total scores at each post-baseline assessment occasion, analyzed using a linear mixed-effects model including fixed effects for group, assessment occasion, and their interaction. Secondary outcomes include Liebowitz Social Anxiety Scale-Self Report and Fear of Negative Evaluation-Brief scores, as well as physiological indicators reflecting anxiety responses during VR exposure, including heart rate variability and electrodermal activity. Exploratory analyses will examine behavioral synchrony using motion energy analysis of video recordings and acoustic features of speech to capture anxiety-related movement and vocal patterns. This trial addresses the limited evidence regarding the added value of graded interviewer reactions in VRET for public speaking anxiety by examining whether they improve outcomes beyond those achieved with standard automated VR exposure. The findings may clarify the role of socially responsive feedback in virtual exposure and inform the development of VR-based anxiety interventions. Clinical Research Information Service (CRiS) KCT0011111. Registered on 06 November 2025.

The impact of multiple stressors on college students' anxiety: The moderating roles of interpersonal sensitivity and perceived social support.

Acute aerobic exercise improves inhibitory control in individuals with test anxiety: evidence from event-related potentials.

Dynamic Association between Stressful Life Events and Social Anxiety in University Students: Within-Person Longitudinal Mediation by Rumination.

Public Speaking Anxiety (PSA) is a form of social anxiety spread among university students, negatively affecting both academic performance and overall psychological well-being. Virtual Reality (VR)–based interventions combined with Cognitive Behavioral Therapy (CBT) represent a promising approach for treating PSA, as they enable gradual and controlled exposure to feared social situations by simulating realistic audiences and environments. The primary aim of this study is to evaluate whether the use of VR as a support to standard psychotherapy is effective in managing anxiety and PSA in university students who access the University Psychological Counseling Service (UPCS). This article outlines the study protocol for a randomized controlled trial (RCT). Participants will be divided into two groups: (1) a control group receiving psychological counseling, and (2) an experimental group that receives psychological counseling integrated with VR interventions based on 360° video scenarios. The intervention will include two VR-based modules: a VR–Exposure and Response Prevention (ERP) module, designed to provide graded immersive exposure to anxiety-provoking scenarios, and a VR–Acceptance and Commitment Training (ACT) module, aimed at enhancing mindfulness and psychological flexibility through guided experiential practice. Psychological and physiological data collected during the sessions will be analyzed to compare the effectiveness of VR-integrated psychotherapy with traditional counseling alone. This study will introduce a novel VR-based ERP and ACT training protocol designed to reduce public speaking anxiety in university students by integrating innovative, immersive VR scenarios within a psychological counseling context. The proposed approach may be particularly relevant for university settings, as it offers a scalable, standardized, and controllable VR-supported counseling protocol aimed at reducing PSA, enhancing students’ academic functioning (e.g., oral exams and presentations), and strengthening the overall effectiveness of university psychological counseling services. This protocol was registered at the Clinical Trials.gov (Identifier: NCT07351409) on January 16, 2026.

PurposeThis research investigated factors affecting statistics anxiety in university students to find out whether perfectionists are at greater risk of experiencing it. This topic is known to be amongst the most anxiety-provoking matter among undergraduate students in the social sciences, humanities, and psychology. Herein, we sought to better characterize the aims and strivings of subgroups of students with regard to statistics.Participants and MethodsA final sample of 210 participants answered questionnaires measuring statistics anxiety, perfectionism and excellencism, academic goals, emotion regulation strategies, attitude towards statistics, and statistical ability.ResultsThe results show that participants better able to discriminate affirmations of flawlessness from affirmations of excellence report lower anxiety in interpreting statistics. Excellencists endorse more mastery-oriented academic goals, less avoidance-oriented goals, and favor adaptive emotion regulation strategies. Profile analysis shows that for the perfectionism-oriented profile, anxiety to interpret statistics correlates positively with avoidance goals whereas for excellencists, it correlates negatively with mastery goals. Further, excellencists who show high anxiety to interpret statistics tend to use less adaptive emotion regulations strategies while perfectionists tend to use more maladaptive emotion regulation strategies.ConclusionOne outstanding result is that discriminating flawless wordings from wordings aiming at excellence is a main determinant in keeping positive attitude in anxiety-triggering courses.

Leveraging low-cost app-based step count data to assess depression and anxiety in university students: A cross-sectional mobile health study.

Future anxiety is a specific type of anticipatory anxiety involving persistent worry and fear about potential adverse future outcomes. It is especially common among university students, as they undergo significant developmental transitions and face uncertainties regarding their careers, relationships, and identities. This study examined the mediating roles of cognitive control of emotions and problem-solving (PS) skills in the relationship between intolerance of uncertainty (IU) and future anxiety. Drawing on Bandura's social cognitive theory, the research explored how cognitive and behavioral self-regulation mechanisms are related to students' responses to uncertainty within a theoretically informed associational framework. A sample of 348 undergraduates completed validated self-report measures, including the Intolerance of Uncertainty Scale Short Form, the Cognitive Control and Flexibility Scale, the Problem-Solving Inventory, and the Future Anxiety Scale in University Students. Parallel mediation analyses revealed that IU was significantly associated with both dimensions of future anxiety. Notably, the relationship between IU and fear of the future was partially mediated. In contrast, the association between IU and hopelessness about the future was fully accounted for by cognitive control of emotions and PS skills in the mediation model. These results suggest that higher levels of IU are associated with greater future anxiety, particularly when individuals exhibit lower levels of cognitive control of emotions and PS skills. Cognitive control of emotions was found to be a more potent mediator than PS skills, highlighting the important role of emotional regulation in relation to future-oriented distress. These findings suggest that interventions targeting emotional regulation strategies, such as cognitive reappraisal, may hold promise for addressing future anxiety among university students. The current study enhances our understanding of future anxiety by highlighting key psychological mechanisms that are associated with its maintenance.

Childhood interpersonal trauma and social anxiety in college students: the roles of experiential avoidance and mentalized affectivity

Abstract Background At present, the detection rate of anxiety among college students is on the rise and has become an important factor affecting their physical and mental health. Existing studies have confirmed that music intervention can effectively regulate emotions, but there are relatively few targeted intervention studies focusing on piano performance practice for the anxiety of college students. Based on this, the research takes the emotional regulation mechanism of music practice as the theoretical support and uses the experimental method to explore the intervention effect of piano performance practice on the anxiety of college students, providing a new practical path for colleges and universities to carry out mental health education for college students. Methods The study adopted a randomized controlled experimental design. A total of 120 college students with positive anxiety screening were recruited from a certain university as the research subjects. They were divided into the experimental group (60 people) and the control group (60 people) through the random number table method. The experimental group received piano performance practice intervention for 8 weeks, twice a week, for 45 minutes each time. The content included basic performance skills training, classic soothing music practice and group performance demonstration. The control group received no intervention and only maintained a normal study and life. The study takes the Self-Rating Anxiety Scale (SAS) as the core assessment tool, and at the same time uses the Heart Rate Variability (HRV) index to assist in quantifying emotional physiological responses. Results After 4 weeks of intervention, the standard score of SAS in the experimental group decreased to 45.67 ± 3.89, significantly lower than 51.23 ± 4.01 in the control group (t = 7.215, p<.001), and the high-frequency component of HRV rose to 41.56 ± 5.89, significantly higher than 34.12 ± 5.23 in the control group (t = 6.892, p<.001). After 8 weeks of intervention, the standard score of SAS in the experimental group further decreased to 38.21 ± 3.56, while that in the control group was 50.98 ± 3.78 (t = 16.324, p<.001). The high-frequency component of HRV in the experimental group reached 48.34 ± 6.21, and that in the control group was 33.98 ± 5.09 (t = 13.567, p<.001). The one-month follow-up after the intervention showed that the standard SAS score of the experimental group remained at 39.56 ± 3.72, significantly lower than that of the control group (51.12 ± 3.89) (t = 14.893, p<.001), and the total effective rate of anxiety relief in the experimental group within 8 weeks reached 83.33%. Discussion The research results confirm that piano performance practice has a significant and sustained intervention effect on the anxiety of college students. The mechanism may be related to the shift of attention, emotional expression and release, and physiological relaxation response during the performance process. This research achievement provides an operational practical plan for mental health education in colleges and universities. Colleges and universities can incorporate piano performance practice into the mental health service system by offering basic piano courses, forming piano interest groups and other forms. Future research can further explore the differentiated effects of different performance contents and intervention durations on college students with different anxiety types. Funding No. BTTCKYQD2024-BS10.

Abstract Background College students with social anxiety often exhibit negative self-evaluation, social avoidance, and excessive self-focus, which significantly impair their social functioning and academic performance in classroom presentations, interviews, and interpersonal interactions. Although cognitive behavioral interventions and group counseling are widely used, some individuals still experience residual tension, persistent rumination, and heightened sensitivity to physiological arousal, indicating the need to explore more effective intervention approaches that improve emotional processing patterns and reduce self-focused biases. Mindfulness-based cognitive therapy (MBCT), through mindfulness practices and cognitive decentering training, may reduce reactivity to internal experiences and enhance emotional regulation flexibility. However, randomized controlled trials and follow-up evidence for MBCT in college students with social anxiety remain insufficient, and key psychological mechanisms lack longitudinal validation. To address this, the study employs randomized grouping and multi-timewide measurements to compare intervention effects and examine the predictive value of mechanism indicators on symptom trajectories, aiming to evaluate the sustained intervention value of MBCT for college students with social anxiety. Methods The study enrolled 318 college students for baseline assessment, with 240 participants meeting social anxiety screening criteria randomized into intervention groups. A control group of 78 low-anxiety students served as baseline reference. Participants were randomly assigned to one of three 8-week interventions: (1) Mindfulness-Cognitive Therapy (n = 80), (2) Group Cognitive Behavioral Intervention (n = 78), or (3) Waiting List Control (n = 82). Key outcomes included Social Anxiety Symptom Scale scores, negative self-focus and rumination levels, emotion regulation strategies, and mindfulness awareness. Results Experimental results demonstrated that compared to the traditional cognitive behavioral intervention group and waiting control group, the mindfulness cognitive therapy group showed significant reduction in social anxiety symptoms at the end of intervention (p<.001, d = 0.52), with the improvement remaining stable during follow-up (p=.004). In terms of psychological mechanism indicators, the mindfulness awareness level in the mindfulness cognitive therapy group increased significantly (p=.002, d = 0.48), while negative self-focus decreased markedly (p=.009, d = 0.41), and emotional reactivity also showed a significant downward trend. Physiological indicators revealed that the heart rate variability in the mindfulness cognitive therapy group during social situational tasks increased significantly (p=.01, d = 0.39), indicating improved autonomic nervous system regulation. Further analysis showed that both the elevated mindfulness awareness (p=.02) and reduced negative self-focus (p=.03) could predict lower social anxiety symptom levels during follow-up, and were associated with reduced risk of symptom relapse. Discussion The findings demonstrate that mindfulness-based cognitive therapy (MBCT) significantly alleviates social anxiety in college students, with sustained improvements observed during follow-up periods. Its efficacy matches or surpasses that of group cognitive behavioral interventions. The core psychological and physiological mechanisms underlying its effects may include enhanced mindfulness awareness, reduced rumination and negative self-focus, and diminished arousal responses in stressful situations. This study suggests MBCT serves as an effective group intervention for social anxiety in higher education, providing a scalable alternative to conventional psychological services. Future research should compare different training intensities and digital implementation approaches, while identifying subgroups more responsive to mindfulness interventions to enhance targeted effectiveness.

ABSTRACT In the post-pandemic era, the sense of uncertainty among Chinese college students has generally increased, further leading to the emergence of future anxiety. However, the discussion on the internal psychological mechanisms triggered by uncertainty and intervention strategies remains insufficient. In this study, two sub-studies were conducted among Chinese college students to explore the psychological mechanisms through which uncertainty triggers future anxiety and examine the role of letter-writing intervention in alleviating future anxiety caused by uncertainty. In Study 1, a questionnaire survey (N = 833) was administered to examine the mediating effect of future self-continuity on the link between uncertainty and future anxiety, utilizing a simple mediation model for analysis. In Study 2, a randomized controlled trial (N = 185) was conducted to confirm that improving future self-continuity through letter-writing can interrupt the emergence of future anxiety prompted by uncertainty. The findings of this research indicated that future self-continuity functions as a mediating factor in the relationship between uncertainty and future anxiety among college students. Additionally, engaging in letter-writing activities may act as an indirect means to alleviate future anxiety.

This study compared anxiety levels in medical students during midterm and final exams in the second semester of 2024, identifying potential significant differences between the two periods. A quantitative, descriptive-comparative study was conducted with 100 medical students from the Domingo Savio Private University in Bolivia. The Hamilton Anxiety Rating Scale (HAM-A) was administered at three points during the semester (first midterm, second midterm, and final). A randomized sample was used, including students over 18 years of age who participated in all assessments. The majority of students presented mild anxiety, which was more frequent during the final exam (66.97%). However, moderate and severe anxiety were higher during the second midterm (43.06%). The majority of the sample were women (66%), with a mean age of 20.25 years. The results indicated that academic anxiety does not follow a linear pattern but fluctuates, being higher during the middle stages of the semester. This may be related to the accumulation of academic workload and the perception of poor prior performance. It aligns with previous studies in Latin America that point to personal and contextual factors as triggers. It is recommended to implement institutional strategies for emotional support and stress management, especially during the intermediate semesters, to preserve the student's mental health and academic performance.

Public speaking anxiety is a frequent manifestation of social anxiety among university students and graduates, with effects on well-being, academic performance, and professional development. Given the high prevalence of anxiety disorders in Chile, accessible and cost-effective interventions are needed. This research evaluated the feasibility and preliminary effects of a brief virtual reality exposure therapy protocol delivered in both face-to-face and remote modalities. Two non-randomized single-group pretest–posttest studies with repeated measures were conducted. Study 1 (n = 9), delivered in person over five sessions, showed a significant reduction in negative self-verbalizations and an increase in confidence for public speaking, along with changes consistent with the expected direction in other variables. Study 2 (n = 5), remote and using a flexible 6–8-session protocol, showed full adherence, a significant increase in positive self-verbalizations, a relevant decrease in negative ones, and a significant improvement in public speaking confidence. In addition, a clinically significant decrease was observed in the CORE-OM subscales of Problems/Symptoms and Functioning. Taken together, the results indicate that this intervention is feasible and potentially effective, with flexibility for implementation in either face-to-face or remote modalities. Its relevance for university settings positions it as a promising tool within mental health promotion and prevention strategies, providing preliminary evidence to improve access to, and the quality of, psychological care in higher education.

This study aimed to investigate the relationships between autonomous fitness behavior and social anxiety among college students, as well as the chain mediation roles of rumination and emotional–social isolation in this relationship. The study used the Autonomous Fitness Behavior Scale, Social Anxiety Scale, Rumination Scale, and Emotional–Social Isolation Scale to investigate 976 college students. Correlation analysis, regression analysis, and structural equation modeling were conducted. (1) Correlation Analysis: Autonomous fitness behavior was significantly positively correlated with rumination (r = .238, p < .01) and significantly negatively correlated with social anxiety (r = −0.224, p < .01) and emotional–social isolation (r = −0.191, p < .01). Significant positive correlations were also found among social anxiety, rumination, and emotional–social isolation. (2) Regression Analysis: Autonomous fitness behavior was negatively associated with social anxiety (β = −0.224, p < .01). (3) Structural Equation Modeling: Rumination and emotional–social isolation played partial mediating and chain mediating roles in the relationship between autonomous fitness behavior and social anxiety. Specific indirect effects included: (a) through rumination alone (effect = .011), (b) through emotional–social isolation alone (effect = −0.049), and (c) through a chain of rumination then emotional–social isolation (effect = .012). In conclusion, autonomous fitness behavior is directly associated with social anxiety. Furthermore, the relationships between autonomous fitness behavior and social anxiety are also explained by the separate and chained mediating effects of rumination and emotional–social isolation.

BackgroundThis study aimed to explore the mechanisms through which physical activity affects social anxiety in college students, with a specific focus on the sequential mediating roles of family support and self-efficacy.MethodsA total of 391 valid responses were analyzed using the Physical Activity Rating Scale (PARS-3), the Interaction Anxiousness Scale (IAS). Family Support Scale (PSS-Fa), and the General Self-Efficacy Scale (GSES). Mediation analyses were conducted with structural equation modeling (SEM) and bootstrapping procedures (5,000 resamples).ResultsPhysical activity significantly predicted lower social anxiety (β = − 0.187, p < .001). Both family support (β = − 0.309, p < .001) and self-efficacy (β = − 0.390, p < .001) mediated this association, with the sequential pathway (β = − 0.073, p < .001) accounting for 13.35% of the total effect.ConclusionPhysical activity was associated with lower social anxiety indirectly via higher family support and self-efficacy, while the direct effect was not statistically significant in the full mediation model. These findings provide empirical support for incorporating physical activity into university-based mental health strategies aimed at alleviating social anxiety.

Background/Objectives: The Mediterranean diet (MD) constitutes one of the most broadly studied dietary patterns, which has been linked to the prevention of non-communicable diseases and mental health disorders. University students, a population exposed to significant psychosocial stressors and lifestyle changes, may particularly benefit from healthy eating patterns such as the MD. This study was designed to examine the potential associations of MD adherence with symptoms of depression and anxiety among Greek university students. Methods: A cross-sectional study was initially conducted among 7160 active university students from ten diverse geographic regions in Greece. After the enrollment procedure and the application of relevant exclusion criteria, 5191 university students (52.0% female; mean age: 21.3 ± 2.4 years) constituted the study population. MD adherence was assessed using the KIDMED index, while depressive and anxiety symptoms were evaluated using the Beck Depression Inventory-II (BDI-II) and State–Trait Anxiety Inventory (STAI-6), respectively. Sociodemographic and anthropometric data were collected for all the enrolled university students. All the questionnaires were completed by face-to-face interviews with expert personnel. Results: Students with low adherence to the MD were significantly more likely to report symptoms of depression (OR = 2.12; p ˂ 0.001) and anxiety (OR = 2.27; p ˂ 0.001) and to be overweight or obese (OR = 2.45; p ˂ 0.001) after adjustment for multiple confounding factors. Low MD adherence was also associated with male gender (OR = 0.73; p ˂ 0.01), living alone (OR = 0.78; p ˂ 0.01), smoking (OR = 0.75; p ˂ 0.01), low physical activity (OR = 1.84; p = 0.001), and poorer academic performance (OR = 0.83; p ˂ 0.01). Conclusions: Low adherence to the MD is significantly associated with increased likelihood of depression, anxiety, and excess body weight among university students in Greece. These findings underscore the importance of promoting healthy dietary habits and related lifestyle behaviors in young adult populations as a potential strategy for mental health prevention and intervention. Due to the presence of several limitations in the present study, future longitudinal and interventional studies should be performed to confirm the present findings.

Fatigue occurs at a high rate among college students. Anger and anxiety are thought to be important triggers for fatigue. The mechanisms underlying the association between anger and fatigue remain unclear. The objective of this longitudinal study was to examine a sequential predictive pathway in which anger prospectively predicts fatigue through anxiety among Chinese university students. The participants in this current study were 3475 college students (2686 females and 789 males, 15-42 years old, M = 19.78 years, SD = 1.96) from a university in Xinxiang City, Henan province, mainland China. Data for this two-wave longitudinal study were collected via online surveys at two timepoints: October 2023 (T1) and April 2024 (T2). The Patient-Reported Outcomes Measurement Information System (PROMIS) Anger scale, Anxiety scale, and Fatigue scale were used to assess state-like emotional functioning (anger and anxiety assessed over the past 7 days) at each wave. These week-based assessments were conceptualized as indicators of participants' proximal emotional conditions at each timepoint rather than emotions persisting across the entire 6-month interval. In longitudinal structural equation models, T1 anger significantly predicted higher anxiety at follow-up (β = 0.314, 95% CI [0.267,0.362], p < 0.001). The autoregressive effect of T1 anxiety on T2 anxiety was also significant (β = 0.315, 95% CI [0.264, 0.368], p < 0.001). Likewise, T1 anxiety significantly predicted increases in T2 fatigue (β = 0.267, 95% CI [0.225,0.310], p < 0.001) even after accounting for the autoregressive effect of T1 fatigue (β = 0.339, 95% CI [0.296,0.382], p < 0.001). To enhance transparency, a supplementary structural model was estimated to assess the direct predictive effect of T1 anger on T2 fatigue. After controlling for T1 fatigue, T1 anger showed a significant direct association with T2 fatigue (β = 0.396, 95% CI [0.316,0.477], p < 0.001). Overall, the findings support a sequential prediction pattern in which earlier anger predicts later increases in anxiety, which subsequently predict increases in fatigue. This study provides evidence for a sequential predictive pathway linking anger to fatigue via anxiety in college students. These findings suggest that baseline state-like emotional functioning-rather than enduring traits-can initiate longer-term psychological processes. Interventions that reduce anger and anxiety at their point of emergence may help interrupt this temporal chain and ultimately alleviate fatigue.

College students have high anxiety due to academic and social stress. Heart rate variability (HRV) reflected sympathetic-parasympathetic balance through the LF / HF ratio and was positively associated with anxiety; the SCL-90 scale (total score 160 or factor 2 is abnormal) was used for mental health assessment. In this study, a double-blind experiment was used to compare the effect of Baduanjin (Chinese guidance) and yoga (physical and mental practice) in India on the anxiety of college students and analyze the physical and mental synergy mechanism with HRV and SCL-90 data, so as to provide evidence-based basis for mental health intervention in universities. Method: A total of 120 college students with high anxiety levels (SCL-90 anxiety factor 2 points) were randomly divided into an eight-stage brocade group, a yoga group, and a blank control group, with 40 students in each group. A double-blind randomized controlled design was used: the Baduanjin group in 12 weeks of standardized training (3 times a week, 60 minutes each time), the yoga group the same frequency, and the control group maintained daily activities. Resting HRV (SDNN, RMSSD, LF / HF) was measured using Firstbeat Bodyguard 2 devices before and after the intervention, and anxiety and depression scores from the SCL-90 scale were collected. Data were analyzed using repeated measures analysis of variance (RM-ANOVA) and Pearson's correlation test (p &lt; 0.05, p &lt; 0.01), with control for confounding variables such as sleep and diet. HRV improved significantly, with 14.2 ± 3.5 ms of SDNN, RMSSD 18.6 ± 4.3 ms (all p &lt; 0.001), LF / HF 0.7 ± 0.3 (p=0.002), and increased parasympathetic activity; SDNN and RMSSD increased only slightly (7.8 ± 2.8 ms and 9.2 ± 3.1 ms, p &lt; 0.05), with no change in LF / HF. The SCL-90 score showed that anxiety decreased by 9.1 ± 1.6 points (p &lt; 0.001) and depression by 7.5 ± 1.4 points (p &lt; 0.001), which was better than the yoga group (4.3 ± 1.1 points, p=0.021). HRV improvement was strongly negatively associated with anxiety relief (r=-0.58, p &lt; 0.001), with no significant change in the control group. This study confirmed for the first time through a double-blind experiment that Baduanjin is better than yoga in regulating autonomic function and relieving anxiety, and the mechanism of body-body synergy may originate from the traditional concept of "interest-mind adjustment".

Objective To examine the chain‐mediating role of self‐worth and employment pressure in the relationship between subjective well‐being and anxiety among college students, and to evaluate the potential effect of receptive music therapy. Methods This study adopted a pre‐post test design without a control group. College students with scores &gt; 4 on the Generalized Anxiety Disorder Scale (GAD‐7) were recruited. Measurements included the General Well‐Being Schedule (GWB), the Adolescent Self‐Worth (ASWS), and the College Student Employment Pressure Scale. Pearson correlation and multiple regression analyses were conducted to explore relationships among variables, and structural equation modeling (SEM) was used to test the chain‐mediating effect. Results Correlation analyses showed significant pairwise correlations between subjective well‐being, self‐worth, employment pressure, and anxiety ( p &lt; 0.05). Regression analyses indicated that subjective well‐being negatively predicted anxiety, while self‐worth and employment pressure positively predicted anxiety ( p &lt; 0.01). The chain‐mediation model confirmed that self‐worth and employment pressure played a significant chain‐mediating role in the path through which subjective well‐being influences anxiety. Through adopting receptive music therapy, participants demonstrated significant improvements in scores on the GAD‐7, GWB, ASWS, and the College Student Employment Pressure Scale compared to pre‐treatment levels (all p &lt; 0.05). Conclusion Subjective well‐being among college students can influences anxiety levels through the chain‐ mediating roles of self‐worth and employment pressure. Receptive music therapy has positive effects on enhancing subjective well‐being and self‐worth, as well as alleviating perceived anxiety and employment pressure in this population.