Group sports games for social anxiety in university students: a randomized controlled trial revealing gender-specific efficacy.

BACKGROUND

Social anxiety is a prevalent issue among college students, with many experiencing chronic anxiety in social situations and a strong fear of negative evaluation. This condition can severely impair both occupational and social functioning, leading to significant consequences.

OBJECTIVE

This study aimed to evaluate the efficacy of Therapeutic Group Sports Games (TGSG) for reducing social anxiety. The TGSG intervention incorporates Yalom's therapeutic principles into structured sports activities.

METHODS

A total of 105 college students with elevated social anxiety were randomly assigned to either the Therapeutic Group Sports Games (TGSG) group (n = 53), which systematically integrated Yalom's therapeutic principles into structured group sports activities, or an active control group engaging in standard aerobic exercise (AE, n = 52). Both interventions were delivered twice weekly for ten weeks, for 60 min per session. The primary outcomes were scores on the Interaction Anxiousness Scale (IAS) and the Brief Fear of Negative Evaluation Scale (BFNES), assessed at baseline and post-intervention.

RESULTS

A significant time × group interaction was observed, which was moderated by gender. For female participants, the TGSG intervention demonstrated superior efficacy over aerobic exercise on both the IAS (F (1, 50) = 25.313, p < .001, partial η²= 0.336) and the BFNES (F [1,, 50] = 7.208, p = .010, partial η²=0.126), representing large effect sizes. For male participants, both the TGSG and AE groups showed significant within-group improvements over time (p < .01 for both measures), but no significant between-group differences emerged (p >.09).

CONCLUSIONS

The TGSG intervention is a highly effective, gender-sensitive approach for alleviating social anxiety in female college students. Its superiority over physical activity alone confirms that the therapeutic mechanisms reside in its structured social and psychological components. These findings offer a promising, scalable mental health intervention that can circumvent the avoidance characteristic of social anxiety.

TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR) ChiCTR2500108203. Registered on 26 August 2025. Retrospectively registered.