Music's Dual Role in Emotion Regulation: Network Analysis of Music Use, Emotion Regulation Self-Efficacy, Alexithymia, Anxiety, and Depression

Music serves as a prevalent emotional regulation tool among young people. However, the correlational and causal relationships between music use, emotion regulation ability, and emotional symptoms remain unclear. This study aimed to investigate the associations and causal relationships between healthy and unhealthy music use, emotion regulation ability, and emotional symptoms, including alexithymia, depression, and anxiety. This study included 16,588 college students nationwide in China. All participants were assessed online with the Healthy-Unhealthy Music Scale (HUMS), the Regulatory Emotional Self-Efficacy Scale (RESE), the Toronto Alexithymia Scale (TAS-20), and the 10-item Kessler Psychological Stress Scale (K10) using a cluster convenience sampling method. We applied a regularized partial correlation network (RPCN) and Bayesian network to analyze the network characteristics of the outcomes. In the RPCN analysis, healthy music use showed the second strongest expected influence (one-step) and correlated positively with emotion regulation self-efficacy while inversely correlating with externally oriented thinking of alexithymia and depression. The Bayesian network indicated that healthy music use was located downstream of the network, positively predicted by managing anger-irritation and expressing positive affect in emotion regulation self-efficacy. In contrast, unhealthy music use in the RPCN displayed the strongest bridge strength and bridge expected influence (one-step). It negatively correlated with expressing positive affect in emotion regulation self-efficacy and positively correlated with alexithymia, anxiety, and depression. The Bayesian network highlighted that unhealthy music use was positively affected by anxiety, depression, and difficulty identifying feelings. In addition, managing despondency-distress influences difficulty identifying feelings through depression, subsequently affecting unhealthy music use and, finally, influencing externally oriented thinking. This study provides a novel framework for understanding the role of emotion regulation self-efficacy and alexithymia in the relationship between music use and emotional symptoms. Emotion regulation and mental health may benefit from music-based interventions and therapies informed by the findings of this study.