With only weeks left in the semester and final exams and board exams looming, most students are experiencing increased levels of stress. For some students, the stress of exams before, during and after can become so overwhelming they may experience “Test anxiety”. While Test anxiety is not a formal diagnosis recognized by the Diagnostic and Statistical Manual of Mental Disorders it is a common presenting concern that we in behavioral health often assist students with managing.
Concisely, Test anxiety is the reaction an individual has to the process of being evaluated. Test anxiety exists on a spectrum of intensity as cognitive, physiological and behavioral reactions to the evaluation.
Cognitions: We all have a constant internal dialogue; those with high-test anxiety find themselves berated with a stream of negative thoughts such as “I am going to fail”. Experiencing these negative thoughts prior to taking an exam can negatively affect studying as they can be very distracting and may induce a negative self-fulfilling prophecy. If I think I am going to fail, I give up more easily on my studying (e.g., “What’s the point? I will fail no matter how much effort I put in”) and this behavior feeds into the negative outcome.
Physiological: Anxiety can manifest in many ways, including shortness of breath, increased heart rate, sweating, headaches, and stomachaches. These symptoms can cause distress from their discomfort or from the belief that these symptoms signal a larger issue. For example, if a student during an exam notices their breathing is becoming shallower, the student might start to feel panic and assume the shortness of breath is an indicator of escalating anxiety. The intersection of physiological and cognitive symptoms of anxiety can contribute to each other and exacerbate discomfort.
Behavioral: When we are fearful of something our instinctual reaction is to avoid it (e.g., If I have a fear of snakes, which I do, I am going to avoid snakes as much as possible). Lucky for me, I am not required to be around snakes for my job, but tests are not so easy to avoid. Often we see students avoid things associated with exams, such as studying since studying conjures up those pesky negative thoughts and brings us closer to the very thing we are fearful of.
How do I know if I have Test Anxiety?
If we conceptualize test anxiety as a spectrum of discomfort and impairment, we all fall somewhere on the spectrum, some with very minimal distress related to exams, some with moderate but manageable discomfort, and some with anxiety causing severe impairment. It is important to remember that not all anxiety is bad anxiety. If we did not experience any anxiety related to testing it might be more difficult to muster the motivation to dedicate the time necessary to study. However, if you find yourself having difficulty concentrating leading up to and during exams, worrying so much before and after exams you find yourself exhausted, and thinking of failure during exams it might be a concern to further address. Learning relaxation strategies to implement before and during exams to decrease physiological distress along with some cognitive techniques to address negative thinking can go a long way with feeling more confident and focused during finals!
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