Differing subjective and psychophysiological response patterns to a music-based auditory intervention for anxiety

Anxiety comprises partially dissociable cognitive and somatic components, yet it remains unclear whether brief interventions modulate these systems in parallel. This randomized controlled trial examined subjective and psychophysiological responses to a brief music-based auditory intervention relative to an active auditory control (pink noise) in undergraduate students reporting recent generalized anxiety symptoms. Participants (N = 83) were randomized to the auditory intervention or pink noise. Cognitive and somatic anxiety were assessed before and after the intervention, while salivary cortisol, heart rate variability (HRV), and electroencephalography (EEG) indexed endocrine, autonomic, and neural processes. Cortisol showed a significant Condition × Time interaction, with larger reductions following the auditory intervention. Midline theta power also exhibited a significant Condition × Time interaction, reflecting opposing patterns of change across conditions, although within-condition changes were only significant in the pink noise condition. Cognitive anxiety, somatic anxiety, affective arousal, frontal alpha lateralization, and HRV did not show significant differential baseline-to-post change. During listening, HRV increased across conditions, but the Condition × Epoch interaction observed in the primary growth model was not retained when participant-specific slopes were included. Together, these findings indicate differing patterns of response across levels of analysis, with broad reductions in self-reported anxiety and arousal across both auditory conditions and greater condition sensitivity in the primary cortisol and midline-theta analyses. Because the cortisol and theta interactions were not retained in models including all physiologically valid observations, these condition-dependent findings should be interpreted cautiously.