Effects of music-based interventions on test anxiety in students: a systematic review and meta-analysis.

OBJECTIVE: Test anxiety is one of the most prevalent psychological problems among adolescents and university students and is associated with impaired academic performance, emotional distress, and reduced psychological wellbeing. This study aimed to systematically evaluate the effects of music-based interventions on test anxiety among students. METHODS: A comprehensive literature search was conducted in CNKI, Wanfang Data, VIP Database, China Biology Medicine (CBM), PubMed, Web of Science, the Cochrane Library, and Embase from database inception to April 2026. Published randomized controlled trials (RCTs) investigating the effects of music-based interventions on test anxiety among students were included. Meta-analyses were performed using RevMan 5.4 and Stata 18.0. The primary outcomes were test anxiety measured using the State Anxiety Subscale of the State-Trait Anxiety Inventory (STAI-S/SAI), Test Anxiety Scale (TAS), Test Anxiety Inventory (TAI), and Generalized Test Anxiety Inventory (GTAI). Fixed- or random-effects models were applied according to heterogeneity, and subgroup analyses were conducted. RESULTS: A total of 10 RCTs involving 681 students were included, with 371 participants in the intervention groups and 310 in the control groups. The meta-analysis showed that music-based interventions were significantly more effective than control conditions in reducing test anxiety among students (SMD = -1.21, 95% CI: -1.79 to -0.63, P < 0.0001). Subgroup analyses indicated that interventions lasting ≥8 weeks (SMD = -2.14), sessions lasting ≥60 min (SMD = -1.89), and active music-based interventions (SMD = -2.21) produced greater reductions in test anxiety. CONCLUSION: Music-based interventions appear to be a promising non-pharmacological strategy for improving students' psychological wellbeing by reducing test anxiety and may serve as an effective adjunct to school-based mental health education. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier: CRD420261414547.