Abstract Background Adolescence is a critical stage of emotional and psychological development, facing enormous academic, social, and physical and mental pressures, with anxiety becoming increasingly prominent. Emotional regulation ability, as a core psychological skill for individual management and coping with emotional reactions, has been proven to be a key factor in preventing and alleviating anxiety. In the field of non pharmacological intervention, the therapeutic value of art education, especially music education, is receiving widespread attention. Piano education, as a structured musical activity, combines sensory motor coordination, cognitive engagement, and emotional expression. This study conducted a randomized controlled trial to explore the effects of systematic piano education intervention on adolescent anxiety levels and emotional regulation abilities, aiming to preliminarily reveal its potential mechanisms of influence. Methods This study adopted a randomized controlled experimental design, recruiting 120 students who met the screening criteria from two ordinary high schools in a certain city, and dividing them into an intervention group (n = 60) and a control group (n = 60). The intervention group received a structured group piano education course of 60 minutes twice a week for 6 months. The course content includes basic music theory, fingering exercises, playing classic pieces, and simple improvisation. The control group did not receive any music intervention during this period. The study evaluated all participants before intervention, 3 months after intervention, and 6 months after intervention. The study used SPSS 25.0 to process and analyze the data, and compared the anxiety and emotion regulation scores of the two groups through repeated measures ANOVA. The Bootstrap method was used to test the mediating effect of emotion regulation between piano intervention and anxiety relief. Results The results of repeated measures ANOVA showed that in terms of anxiety levels, the total anxiety score of the intervention group after 3 and 6 months of intervention was significantly lower than that of the control group at the baseline level before intervention, while there was no significant change in the anxiety level of the control group. The mediation effect analysis shows that the indirect effect value of cognitive reappraisal ability improvement is -0.28, with a 95% confidence interval of -0.49, -0.10; The indirect effect value of reducing emotional regulation difficulty is -0.35, with a 95% confidence interval of -0.60, -0.15. This indicates that piano education intervention can effectively enhance the cognitive reappraisal ability of adolescents and reduce their emotional regulation difficulties. Discussion The research results indicate that piano education intervention can effectively alleviate anxiety symptoms in adolescents and enhance their emotional regulation ability. The mediation analysis results show that the improvement of emotional regulation ability is the key internal mechanism for piano education to exert its anti anxiety effect. Integrating piano music education into the mental health education system can serve as an effective supplementary means for preventing and intervening in emotional problems among adolescents. Future research can further explore the differences in the effects of different forms of music activities, as well as the targeted effects of this intervention on specific anxiety. Funding No. HX202517.
Zhang et al. (Sun,) studied this question.