Editor’s note: This article is part of a series written by students with first-hand experience of anxiety disorders. Their aim is to help their peers by sharing their personal experiences and the triumphs and setbacks they’ve faced in managing their condition. Haley Blank, a high school senior, worked with Dr Michele Cascardi, a licensed clinical psychologist and university professor, who guided Haley’s research and writing. Dr Cascardi’s expertise adds to the authenticity of Haley’s experiences. For another compelling account, readers may find Kathryn Dewitt’s story of interest.
Final Exam – Question 1 (Multiple Choice): What components primarily contribute to anxiety associated with tests or other academic assessments?
- Physical sensations
- All of the above
Final Examination – Question 2 (Essay): List five actionable steps to effectively manage test anxiety.
(Answer Sheet: see below)
I vividly remember my first encounter with anxiety. It was my freshman year of high school, just before midterms. The weight of my own expectations was crushing – I believed that getting straight A’s was the only way to be perceived as intelligent and successful.
As I lay in bed that Saturday night, trying to calm my nerves and find solace in slumber, I noticed that my breathing was becoming irregular. I felt as if I couldn’t catch my breath and a wave of darkness enveloped my mind, consuming my thoughts and choking the air around me. My breathing quickened, the oxygen slipping away. An unsettling thought loomed: if I fell asleep, my body would forget to breathe and death would be the result. Overwhelmed, I rushed to my parents’ room, confused by the bewildering changes in my body and mind. I believed my physical well-being was in jeopardy.
The next thing I knew I was in the car racing to the hospital. My heart was pounding like never before. In the back seat, I struggled with the desire to escape the confines of my own skin during the seemingly endless 20-minute drive to the emergency room. Finally, at 3am, we arrived. My dad and I rushed into the emergency room. Numerous tests were carried out, involving several doctors. They all came to the same conclusion: I was suffering from anxiety.
That incident was the first of many recurring anxiety attacks I experienced before exams or important assignments. Since then, I have learned to manage them better, but there is still a slight feeling of discomfort and breathlessness before submitting an essay or sitting for a test. A certain amount of anxiety can serve as motivation, pushing you to strive for excellence. However, I have come to understand that an excessive amount can be paralysing.
Navigating life with test anxiety or anxiety about important tasks can leave you feeling isolated, as if no one understands your struggle. However, there is a huge community of people, such as the famous artist Adele, who understand first-hand. Anxiety creates feelings of helplessness and a frightening lack of control over one’s body. Many people do not realise that anxiety often co-exists with various other mental health conditions.
It is a significant disorder that affects people of all ages and is not easily cured. Seeking the necessary support and learning techniques to calm oneself can greatly improve one’s mental state. I have decided to write this article in order to provide students like myself with more knowledge about test anxiety and strategies to overcome it.
What is test anxiety?
Test anxiety, a phenomenon first defined by Spielberger over four decades ago, is an unpleasant state characterised by tension, apprehension, worrying thoughts and activation of the autonomic nervous system during evaluative performance demanding situations.
In modern terms, it can be described as excessive anxiety or worry about formal assessments such as tests or major papers. Individuals who struggle with test anxiety often have concerns about their self-worth, motivation and acceptance by peers, parents or teachers, all of which depend on their academic performance.
This anxiety manifests itself before, during and even while preparing for the test situation. It can be broken down into four primary components:
- Thoughts: Pervasive doubts and worries about one’s ability to succeed, often reinforced by a belief in the inevitability of academic failure or low performance. This intense pressure to perform, coupled with a sense of inadequacy, interferes with concentration and subsequently affects academic performance.
- Emotions: Intense anxiety and discomfort surrounding test situations, characterised by negative emotions such as anxiety, helplessness, anger, irritability and disappointment. Conversely, others may experience only the physical manifestations of this emotional turmoil.
- Physical sensations: Increased physiological arousal, including headaches, nausea, diarrhoea, excessive sweating, shortness of breath, rapid heartbeat, dizziness, and even fainting. Individuals become acutely aware of these physiological changes in their bodies.
- Behaviour: Avoidance of tests, challenging or difficult tasks, and restlessness during preparation and evaluation periods.
How common is test anxiety?
Despite the ubiquity of high-stakes testing in the high school landscape, there remains a surprising lack of research on test anxiety in high school students. Surprisingly, an estimated 20-40% of students experience anxiety that interferes with their test performance. Moreover, this phenomenon persists into college, contributing to lower academic performance and grade point averages.
Addressing and alleviating test anxiety during the high school years is critical, as it holds immense potential for many positive outcomes. In the short term, reducing test anxiety can improve emotional well-being, optimise academic performance and increase motivation and engagement in learning. In the long term, it can support academic achievement in college and facilitate the realisation of career aspirations.
What are the causes of test anxiety?
While the causes of test anxiety are complex, it appears to be more prevalent in individuals who interpret physical sensations of fear as threatening. Such individuals may feel compelled to maintain excessively high or perfectionistic standards, have difficulty tolerating uncertainty, and may have specific academic skill deficits. This anxiety can be exacerbated by a repetitive cycle of worry, heightened physiological arousal, underachievement, and negative beliefs about the significance of their performance.
First, worry interferes with concentration and memory, hindering the acquisition of knowledge during test preparation and the recall of information during test taking. Problems with concentration and memory contribute to underachievement or academic failure, which further undermines self-confidence, increases worry and anxious arousal, and fosters harmful beliefs that academic success and learning are unattainable.
As a result, test anxiety can lead to reduced effort, lower self-esteem and a loss of motivation for educational tasks. In addition, external factors such as pressure and expectations for high performance from parents, peers, the school or the community can exacerbate test anxiety.
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Effective strategies to reduce test anxiety
Mental health professionals offer various interventions to effectively reduce test anxiety. These interventions can be broadly categorised as behavioural, cognitive, cognitive-behavioural or skill-building approaches. A crucial first step in any intervention is to understand how test anxiety interferes with test preparation, test taking, or both.
Behavioural interventions focus on reducing anxious arousal. Techniques such as relaxation training (including muscle relaxation and deep breathing exercises), biofeedback, and systematic desensitisation have been shown to be effective in combating test anxiety. Relaxation training involves learning to release tension in different muscle groups or practising deep breathing to counteract shallow breathing, which increases anxious feelings.
Biofeedback teaches individuals to manage anxiety by providing feedback on heart rate, skin temperature and muscle tension, enabling them to gain control over these physiological processes. Through practice, individuals learn to use relaxation techniques when faced with worry or anxiety. Systematic desensitisation helps individuals to overcome avoidance of anxiety-provoking situations. By combining relaxation techniques with gradual exposure to increasingly challenging or anxiety-provoking scenarios, individuals develop confidence in their ability to cope with anxiety and worry.
Cognitive interventions focus on identifying self-defeating or unrealistic thoughts that undermine confidence and concentration during test preparation and test taking. While the specific thoughts that contribute to test anxiety vary from person to person, some common themes emerge. Thoughts such as ‘I will fail’, ‘I am not good at maths/science/English’, ‘My performance reflects my intelligence and worth’, ‘Others will outperform me’ or ‘I am not capable of passing this class’ are common.
Mental health professionals help individuals counter these negative thoughts in three ways. First, they help to identify and replace negative thoughts with more realistic ones (“I will study and do my best”). Second, they focus on developing coping and problem-solving skills (“I will practice calm breathing when I feel anxious”). Finally, they emphasise positive affirmations (“I believe in my abilities”). Cognitive-behavioural approaches combine both cognitive and behavioural interventions.
Additional interventions target test anxiety resulting from academic deficiencies or study skills deficits. Skills-based approaches aim to address these deficits and improve study habits through content-specific tutoring, time management and organisation training, improved reading comprehension, note-taking techniques and other test-taking strategies.
A recent review of research on interventions with high school students highlighted promising approaches for reducing test anxiety, including biofeedback, deep breathing, guided progressive muscle relaxation, and systematic desensitisation. These strategies have been shown to be effective when used alone or in conjunction with cognitive interventions that address self-destructive and unrealistic thoughts. Skill-building strategies have also shown positive results, particularly with college-aged students.
Acceptance-based behavioural therapy is a more recent intervention that, in contrast to cognitive and behavioural approaches, emphasises learning to accept and tolerate uncomfortable emotions, thoughts and physiological arousal without judgement or distraction. Although less extensively researched, this approach shows promise in reducing anxiety and improving academic performance.
Seeking help from a mental health professional is important if anxiety feels unmanageable, gets worse, or interferes with other activities, such as socialising with friends or participating in extracurricular activities.
Answers To Question #2
Reflecting on my own experiences as a high school student approaching my junior year, I realise the importance of understanding and addressing test anxiety early on. I’ve conducted extensive research and gained personal insights that I believe can help others facing similar challenges. Here are some tips I would like to share:
- Put things into perspective: Remember that tests and essays are only part of the academic journey. A less than desired performance is not the end of the world, nor does it define your worth as an individual or undermine your work ethic.
- Manage your breathing: If you feel short of breath, remind yourself that it’s OK and accept the discomfort. Maintain a calm demeanour as your body knows how to breathe naturally.
- Use mobile apps: There are several smartphone apps available on the App Store that can guide you through regular breathing exercises. These apps, such as Breathe2Relax, Universal Breathing, Paced Breathing, Relax Stress and Anxiety Relief, and Breathing Zone, can be helpful in managing anxiety attacks or providing support during challenging moments.
- Use soothing music: Listening to relaxing music can have a profound effect on synchronising your body and mind, ultimately lowering your heart rate (BPM). Look for soothing melodies that can help reduce anxiety.
- Seek support and communicate: Don’t hesitate to confide in someone and ask for help. I wish I had shared my struggles with my teachers earlier as they can provide valuable support at school. Once the school administration and teachers became aware of my situation, they were more understanding and supportive.
- Spielberger, C. D. (1972). Anxiety as an Emotional State. In C. D. Spielberger (ed.) Anxiety: Current Trends in Theory and Research. New York: Academic Press.
- Lowe, P. A.,&Lee, S.W. (2008). Factor structure of the TestAnxiety Inventory for Children and Adolescents (TAICA): Scores across gender among students in elementary and secondary school settings. Journal of Psychoeducational Assessment, 26(3), 231 – 246.
- Lowe, P. A., Lee, S. W., Witteborg, K. M., Prichard, K. W., Luhr, M. E., Cullinan, C. M., et al. (2008). The Test Anxiety Inventory for Children and Adolescents (TAICA): Examination of the psychometric properties of a new multidimensional measure of test anxiety among elementary and secondary school students. Journal of Psychoeducational Assessment, 26(3), 215 – 230.
- von der Embse, N., Barterian, J., & Segool, N. (2013). Test anxiety interventions for children and adolescents: A systematic review of treatment studies from 2000–2010. Psychology in the Schools, 50(1), 57-71.
- Ergene, T. (2003). Effective interventions on test anxiety reduction a meta-analysis. School Psychology International, 24(3), 313-328.
- Gregor, A. (2005). Examination anxiety: Live with it, control it or make it work for you? School Psychology International, 26, 617 – 635.
- McGuire, D. P., Mitic, W. and Neumann, B. (1987) ‘Perceived Stress in Adolescents: What Normal Teenagers Worry About?’ Canadian Mental Health, June: 2–5.
- Connor,M. J. (2003). Pupil stress and standard assessment tasks (SATs): An update. Emotional and Behavioural Difficulties, 8(2), 101 – 107.
- Chapell, M.S., Blanding, Z., Silverstein, M.E., Takahashi, M., Newman, B., Gubi, A., & McCann, N. (2005). Test anxiety and academic performance in undergraduate and graduate students. Journal of Educational Psychology, 97(2), 268274.
- Naragon-Gainey, K. (2010). Meta-analysis of the relations of anxiety sensitivity to the depressive and anxiety disorders. Psychological Bulletin, 136( 1), 128 – 150.
- Eum, K., & Rice, K. G. (2011). Test anxiety, perfectionism, goal orientation, and academic performance. Anxiety, Stress, & Coping, 24(2), 167-178.
- Berger, J. I. (2013). Cognitive vulnerabilities associated with test anxiety. Proquest: Dissertation UMI Number: 3578542.
- Cassady, J. C., & Johnson, R. E. (2002). Cognitive test anxiety and academic performance. Contemporary Educational Psychology, 27(2), 270-295.
- McDonald, A. S. (2001). The prevalence and effects of test anxiety in school children. Educational Psychology, 21(1), 89-101.
- Brown, L. A., Forman, E. M., Herbert, J. D., Hoffman, K. L., Yuen, E. K., & Goetter, E. M. (2011). A randomized controlled trial of acceptance-based behavior therapy and cognitive therapy for test anxiety: A pilot study. Behavior Modification, 35(1), 31-53.