1. Akande, A. (1990). Influence of urban-rural upbringing on Nigerian students' test anxiety.

Psychol Rep, 67(3 Pt 2), 1261-1262.

To examine the effects of urban and rural upbringing on test anxiety 221 Nigerian high
school students completed measures of test anxiety and environment/academic
performance. Analysis showed that younger urban groups scored better than older rural
groups in academic performance, rural students having high scores in
environment/academic performance scales. The findings corroborate earlier work on
urban and rural upbringing and text anxiety. Suggestions for cross-cultural research
which incorporates test anxiety and the construct of concentration are detailed.

2. Aysan, F., Thompson, D., & Hamarat, E. (2001). Test anxiety, coping strategies, and perceived
health in a group of high school students: a Turkish sample. J Genet Psychol, 162(4),
402-411.

A group of high school juniors and a group of high school seniors in Izmir, Turkey
completed measures of test anxiety, coping skills, and perceived health status both
before and after a major exam period. Students with high test anxiety used less effective
coping mechanisms and tended to have poorer perceptions of their health. Prior to the
exams, juniors displayed higher test anxiety and used less effective coping mechanisms
than seniors. After the exam periods, improvements were seen for both age groups on
perceived health, but scores of younger students remained significantly higher than
scores of seniors on one of the key measures of test anxiety. Results of the study lend
support to those of previous studies done in other cultural contexts, and findings have
implications for the development of interventions designed to help students cope with
stress.

3. Baghurst, T., & Kelley, B. C. (2014). An examination of stress in college students over the
course of a semester. Health Promot Pract, 15(3), 438-447.

The purpose of this study was to determine whether differing stress reduction
interventions could alter stress levels experienced by male and female college students
from the beginning to the end of a semester. Components of stress examined included
overall perceived stress, test anxiety, and personal burnout. Participants (N = 531) were
part of courses that during the course of a 16-week semester focused specifically on
cognitive-behavioral stress management, cardiovascular fitness, generalized physical
activity, or a control with no intervention. In addition to gender differences, both the
stress management and physical activity groups had significantly lower levels of
perceived stress, test anxiety, and personal burnout at the end of the semester. The
fitness group scored significantly lower on perceived stress and personal burnout, but
there was no difference in scores for test anxiety. The important ramifications of reducing
 stress in college students are discussed, including the pros and cons of implementing
differing physical and psychological intervention modalities.

4. Boyacioglu, N., & Kucuk, L. (2011). Irrational beliefs and test anxiety in Turkish school
adolescents. J Sch Nurs, 27(6), 447-454.

The purpose of this descriptive and correlational study was to determine the extent to
which irrational beliefs of students in early adolescents predict test anxiety. The study
sample consisted of 557 students recruited from primary schools in Turkey. The Irrational
Beliefs Scale for Adolescents (IBS-A) and the Test Anxiety scale were used as
data-collection instruments. As a result of this study, there was a positive, significant
correlation between mean scores on the Text Anxiety scale and total score, and the three
subscale (demand for success, demand for comfort, and demand for respect) scores on
the IBS-A. It was also found that demand for comfort and success are more statistically
significant predictors of test anxiety levels of the students compared to demand for
respect.

5. Call, G., Beer, J., & Beer, J. (1994). General and test anxiety, shyness, and grade point average
of elementary school children of divorced and nondivorced parents. Psychol Rep, 74(2),
512-514.

116 boys and girls in elementary Grades 4, 5, and 6 were administered the General
Anxiety Scale, Test Anxiety Scale, and the Shyness Scale. Their GPAs were obtained from
school records as were Normal Curve Equivalents from the Iowa Tests of Basic Skills
given the previous school year. Children of divorced parents (n = 31) had lower GPAs
than children of nondivorced parents (n = 85). The girls had higher GPAs and general
anxiety scores than the boys. The students who scored lower on test anxiety had higher
Normal Curve Equivalents. Pearson correlations were significant for scores on Test
Anxiety with those on general anxiety (r = .57), GPA (r = -.25), and Normal Curve
Equivalents (r = -.26). Normal Curve Equivalents correlated significantly with GPA (r =
.66), but shyness did not correlate significantly with any other measure.

6. Chang, A. C. (2008). Sources of listening anxiety in learning English as a foreign language.

Percept Mot Skills, 106(1), 21-34.

In this study of college students' listening anxiety in learning English in a classroom

context, participants were 160 students (47 men and 113 women) ages 18 to 19 years. To
address their listening anxiety, participants were chosen from students enrolling in a
required listening course. A listening questionnaire was used to assess learners' anxiety
about spoken English, its intensity, and the main sources of listening anxiety. Overall,
participants showed moderately high intensity of anxiety in listening to spoken English,
 but were more anxious in testing than in general situations. In contrast to previous
research on the nature of spoken English as the main source of listening anxiety, this
study found that low confidence in comprehending spoken English, taking English
listening courses as a requirement, and worrying about test difficulty were the three main
factors contributing to participants' listening anxiety in a classroom context. Participants'
learning profiles both in the classroom and outside the class yielded data which provides
suggestions for reducing anxiety.

7. Christensen, H. (1979). Test anxiety and academic achievement in high school students.
Percept Mot Skills, 49(2), 648.

8. Cotler, S., & Palmer, R. J. (1970). The effects of test anxiety, sex of subject, and type of verbal
reinforcement on maze performance of elementary school children. J Pers, 38(2),
216-234.

9. Cunha, M., & Paiva, M. J. (2012). Text anxiety in adolescents: the role of self-criticism and
acceptance and mindfulness skills. Span J Psychol, 15(2), 533-543.

The current study sets out to explore test anxiety in adolescent students. The effect of
sociodemographic variables on test anxiety was controlled for and the relationship
between test anxiety and other psychological constructs, such as self-criticism, social
anxiety, acceptance and mindfulness, was examined. In addition, the predictive
effect/power of these variables was analyzed and a comparative study between high and
low test anxiety adolescents was conducted. Participants in this study were 449 high
school students, 211 boys and 238 girls, with a mean age of 16.28 years. These
participants completed a battery of self-report questionnaires composed by the
Portuguese versions of Test Anxiety Inventory (TAI), Child Acceptance and Mindfulness
Measure (CAMM), Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS),
and the Social Anxiety and Avoidance Scale for Adolescents (SAASA). Results showed
that gender, self-criticism and competencies for acceptance and mindfulness had a
significant and an independent contribution on the prediction of test anxiety. The
comparative study revealed that adolescents with high test anxiety score significantly
higher in negative forms of self-criticism, social anxiety and lower in self-reassurance,
acceptance and mindfulness, when compared to those with low test anxiety. Despite its
exploratory nature, the current study adds to the existing knowledge on the influence of
psychological processes, such as self-criticism and acceptance, on test anxiety. These
findings might constitute a relevant contribution to psychological intervention with
adolescents.
10. Duty, S. M., Christian, L., Loftus, J., & Zappi, V. (2016). Is Cognitive Test-Taking Anxiety
Associated With Academic Performance Among Nursing Students? Nurse Educ, 41(2),
70-74.

The cognitive component of test anxiety was correlated with academic performance
among nursing students. Modest but statistically significant lower examination grade T
scores were observed for students with high compared with low levels of cognitive test
anxiety (CTA). High levels of CTA were associated with reduced academic performance.

11. Dzhebrailova, T. D., & Sulejmanova, R. G. (2012). Dynamics of heart rate parameters in
students with various personal anxiety levels during computerized testing. Bull Exp Biol
Med, 153(5), 627-630.

Students with low level of initial (pre-test) personal anxiety demonstrated a high level of
modulating effects on the heart rate in all basic frequency ranges (VLF, LF, and HF)
resulting in a greater total power of heart rate variability spectrum compared to students
with high personal anxiety. The peculiarities of dynamics of heart rate variability were
revealed during a real learning task, which correlated with personal anxiety level. In
comparison with highly anxious students, the low-anxious group demonstrated more
pronounced drop in the power of all ranges of the heart rate variability spectrum during
testing followed by restoration of these power indices to initial levels after completion of
the test. In contrast, the drop of the total power of the heart rate variability spectrum and
in the power of its individual components persisted in students with high anxiety level
even after the end of the testing.

12. Eric, L., Radovanovic, Z., Jevremovic, I., & Marinkovic, J. (1988). Psychiatric disorders and
selected variables among medical students in Belgrade (Yugoslavia). Soc Sci Med, 27(2),
187-190.

The mental health of a group of 523 medical freshmen (97% of the respective
population) was assessed 1 month after enrollment. Students with psychiatric
impairment (84 or 16.1%) were compared with those assessed to be mentally healthy in
respect of a number of variables. Cluster, correlation, and principal component analyses
revealed that psychiatric disorders were related to the result of the screening test, in a
lesser degree to the test anxiety, and not at all to any of the other tested variables
(separation from parents, family completeness, education of parents, number of siblings,
number of employees in the family, grade point average in high school, and smoking).

13. Faigel, H. C. (1991). The effect of beta blockade on stress-induced cognitive dysfunction in
adolescents. Clin Pediatr (Phila), 30(7), 441-445.
 Test anxiety is severely disabling to students whose fear of examinations causes cognitive
dysfunction that paralyzes their thinking the way stage fright impairs actors ability to act.
In studies using subjective evaluations among actors and musicians, beta-blockade
relieved stage fright and has been used informally to treat test anxiety in students
without objective measures of effectiveness. The Scholastic Aptitude Test (SAT) was
chosen as an objective test instrument to confirm the effect of beta-blockade on test
anxiety and performance. Thirty-two high school students who had already taken the
SAT before enrolling in this study and who had stress-induced cognitive dysfunction on
exams were given 40 mg of propranolol one hour before they retook those tests. Mean
SAT scores with beta-blockade were 130 points higher than on the initial SAT done
before entering the study without medication (p = less than .01). A single dose of
propranolol immediately before the SAT permitted improved performance in students
prone to cognitive dysfunction due to test anxiety.

14. Fernandez-Castillo, A., & Caurcel, M. J. (2015). State test-anxiety, selective attention and
concentration in university students. Int J Psychol, 50(4), 265-271.

The principal aim of this study was to assess the level of selective attention and mental
concentration before exams in a sample of university students and to determine a
possible relationship between anxiety and reduction of levels of attention in this
circumstance. A total of 403 university students, 176 men and 227 women, aged from 18
to 46 years, participated in the study. Of them, 169 were first-year undergraduates, 118
were second to fourth-year undergraduates and 116 were postgraduate Master's degree
students. All of them completed the Spanish version of the Spielberger State-Anxiety
Inventory and the D2 Attention Test just before taking an exam. Our results showed that
participants with lower levels of anxiety had higher levels of selective attention and
mental concentration before the exam. These results specifically indicate that when
anxiety levels are very high, this could over-activate the orientating and alerting
functions and to reduce the capacity of attentional control. These processes could have a
negative impact on specific attentional processes and become a negative influence on
performance in exams.

15. Gibson, H. A. (2014). A conceptual view of test anxiety. Nurs Forum, 49(4), 267-277.

PURPOSE: The purpose of this study is to clarify the term test anxiety with a focus on
nursing education. CONCLUSION: Walker and Avant's concept analysis technique was
used to examine the term test anxiety. The attributes of the concept of test anxiety
include administration of a test, negative subjective feelings, behavioral aspects, physical
signs, and cognitive aspects. PRACTICE IMPLICATIONS: Understanding test anxiety in the
nursing student can help develop research-based interventions. Assessing test anxiety in
nursing students is important for nurse educators to better understand the challenges
 that face these upcoming nursing professionals. Nursing research that further explores
test anxiety is needed.

16. Goetz, T., Preckel, F., Zeidner, M., & Schleyer, E. (2008). Big fish in big ponds: a multilevel
analysis of test anxiety and achievement in special gifted classes. Anxiety Stress Coping,
21(2), 185-198.

This study analyzes the effects of individual achievement and achievement level of
student reference group on test anxiety in a national sample of 769 gifted Israeli
students (grade levels 4-9), which was previously investigated by Zeidner and Schleyer
(1999a). We hypothesized that when controlling for individual achievement, students'
experiences of test anxiety should increase with the increasing ability level of their peer
reference group. It was assumed that this effect was largely mediated by reference group
effects on academic self-concept (big-fish-little-pond effect). Zeidner and Schleyer found
that gifted students within a gifted peer reference group showed higher levels of test
anxiety than gifted students within a non-gifted peer reference group. Of note, the
present study focused exclusively on gifted students attending special gifted classes. The
main research question was whether or not the assumed effects of individual and class
achievement can be found for gifted students in special gifted classes when taking the
variance of achievement level (grades) of the special gifted classes into account. Using
hierarchical linear modeling (HLM) methodology, the assumed effects were vindicated
for this special group of high ability students. Thus, in line with previous results, the
Worry component of test anxiety was more highly reactive to the effects of individual
achievement than the Emotionality component. Also, in line with our theoretical
assumptions, achievement/anxiety relations were largely mediated by the effects of
academic self-concept.

17. Hoferichter, F., Raufelder, D., Ringeisen, T., Rohrmann, S., & Bukowski, W. M. (2016).
Assessing the Multi-faceted Nature of Test Anxiety Among Secondary School Students:
An English Version of the German Test Anxiety Questionnaire: PAF-E. J Psychol, 150(4),
450-468.

The current study concerns the validation of an English version of the German Test
Anxiety Inventory, namely the PAF-E. This questionnaire is a multi-faceted measure of
test anxiety designed to detect normative test anxiety levels and in consequence meet
the need of consultancy. Construct and criterion validity of (PAF-E) were examined with a
sample of 96 secondary students (Mage = 12.8, SD = 0.67; 55% girls) from an
international school in Berlin (Germany) and 399 secondary students (Mage = 13.4, SD =
0.80; 56% girls) from Montreal (Canada). Both samples completed the PAF-E and related
constructs, such as school-related self-efficacy, inhibitory test anxiety, achievement
motivation, and the Big Five. Exploratory and confirmatory factor analyses confirmed the
four-factor-structure (worry, emotionality, interfering thoughts, lack of confidence) of the
 original German Test Anxiety Inventory (PAF). Each subscale consists of five items with a
total of 20 questions. Cronbach's alpha, ranging from.71 to.82 among Germans and.77
to.87 among Canadians as well as the re-test reliability (from.80 to.85 among Canadians)
were sufficient. The differential patterns of correlations between other constructs and the
indices of test anxiety indicate good construct validity.

18. Hoffman, M. L., Mitsos, S. B., & Protz, R. E. (1958). Achievement striving, social class, and test
anxiety. J Abnorm Psychol, 56(3), 401-403.

19. Jeon, J. H., & Hwang, S. K. (2014). [A structural equation modeling on premenstrual syndrome
in adolescent girls]. J Korean Acad Nurs, 44(6), 660-671.

PURPOSE: The aims of this study were to construct a hypothetical structural model which
explains the premenstrual syndrome (PMS) in adolescent girls and to test the fitness with
collected data. METHODS: The participants were 1,087 adolescent girls from 3 high
schools and 5 middle schools in B city. Data were collected from July 3 to October 15,
2012 using self-reported questionnaires and were analyzed using PASW 18.0 and AMOS
16.0 programs. RESULTS: The overall fitness indices of hypothetical model were good
(chi(2) =1555, p<.001), chi(2)/df=4.40, SRMR=.04, GFI=.91, RMSEA=.05, NFI=.90, TLI=.91,
CFI=.92, AIC=1717). Out of 16 paths, 12 were statistically significant. Daily hassles had
the greatest impact on PMS in the adolescent girls in this model. In addition, PMS in
adolescent girls was directly affected by menarche age, Body Mass Index (BMI), amount
of menstruation, test anxiety, social support, menstrual attitude and femininity but not by
academic stress. This model explained 27% of the variance in PMS in adolescent girls.
CONCLUSION: The findings from this study suggest that nursing interventions to reduce
PMS in adolescent girls should address their daily hassles, test anxiety, menstrual attitude
and BMI. Also, social support from their parents, friends, and teachers needs to be
increased.

20. Laurin-Barantke, L., Hoyer, J., Fehm, L., & Knappe, S. (2016). Oral but not written test anxiety
is related to social anxiety. World J Psychiatry, 6(3), 351-357.

AIM: To examine the associations of test anxiety (TA) in written vs oral exam situations
with social anxiety (SA). METHODS: A convenience sample of 204 students was recruited
at the Technische Universitat Dresden (TU Dresden, Germany) and contacted via e-mail
asking to complete a cross-sectional online survey based on established questionnaires.
The study protocol was approved by the ethics committee of the TU Dresden. Full data of
n = 96 students were available for dependent t-tests and correlation analyses on the
associations of SA and TA respectively with trigger events, cognitions, safety behaviors,
physical symptoms and depersonalization. Analyses were run using SPSS. RESULTS:
 Levels of TA were higher for fear in oral exams than for fear in written exams (M = 48.1,
SD = 11.5 vs M = 43.7, SD = 10.1 P < 0.001). Oral TA and SA were positively correlated
(Spearman's r = 0.343, P < 0.001; Pearson's r = 0.38, P < 0.001) contrasting written TA
and SA (Spearman's r = 0.17, P > 0.05; Pearson's r = 0.223, P > 0.05). Compared to
written TA, trigger events were more often reported for oral TA (18.2% vs 30.3%, P =
0.007); which was also accompanied more often by test-anxious cognitions (7.9% vs
8.5%, P = 0.001), safety behavior (8.9% vs 10.3%, P < 0.001) and physical symptoms (for
all, P < 0.001). CONCLUSION: Written, but not oral TA emerged being unrelated to SA
and may rather not be considered as a typical facet of SA disorder.

21. Lee, M. T., Wong, B. P., Chow, B. W., & McBride-Chang, C. (2006). Predictors of suicide
ideation and depression in Hong Kong adolescents: perceptions of academic and family
climates. Suicide Life Threat Behav, 36(1), 82-96.

The unique dimensions of perceptions of school and family contributing to depression

and suicide ideation in Hong Kong adolescents were examined in two studies. In Study 1,
among 327 Hong Kong Chinese female students ages 13-18, 47% reported some suicide
ideation. Suicide ideation was significantly associated with depression, test anxiety,
academic self-concept, and adolescents' perceived parental dissatisfaction with academic
performance. The correlation between test anxiety and depression was especially high (r
= .51). Study 2 examined how three different aspects of perceived family relationship
were associated with depression and suicide ideation. Among 371 Hong Kong Chinese
adolescents ages 14-20, 52.6% reported suicide ideation. Low levels of family cohesion
and support and high levels of parent-adolescent conflict were positively related to
depression and suicide ideation in both genders. Across both studies, depression
mediated associations between academic- and family-related variables and suicide
ideation. Findings underscore the importance of both academic and family climate in
understanding depression and suicide ideation among Chinese adolescents.

22. Lee, S. P., Lee, S. D., Liao, Y. L., & Wang, A. C. (2015). Effects of audio-visual aids on foreign
language test anxiety, reading and listening comprehension, and retention in EFL
learners. Percept Mot Skills, 120(2), 576-590.

This study examined the effects of audio-visual aids on anxiety, comprehension test
scores, and retention in reading and listening to short stories in English as a Foreign
Language (EFL) classrooms. Reading and listening tests, general and test anxiety, and
retention were measured in English-major college students in an experimental group
with audio-visual aids (n=83) and a control group without audio-visual aids (n=94) with
similar general English proficiency. Lower reading test anxiety, unchanged reading
comprehension scores, and better reading short-term and long-term retention after four
weeks were evident in the audiovisual group relative to the control group. In addition,
lower listening test anxiety, higher listening comprehension scores, and unchanged
 short-term and long-term retention were found in the audiovisual group relative to the
control group after the intervention. Audio-visual aids may help to reduce EFL learners'
listening test anxiety and enhance their listening comprehension scores without
facilitating retention of such materials. Although audio-visual aids did not increase
reading comprehension scores, they helped reduce EFL learners' reading test anxiety and
facilitated retention of reading materials.

23. Lewandowski, L., Hendricks, K., & Gordon, M. (2015). Test-taking performance of high school
students with ADHD. J Atten Disord, 19(1), 27-34.

OBJECTIVE: The authors examined the test-taking performance of high school students
with (n = 38) and without (n = 746) ADHD. METHOD: Students were assessed via an
online battery of tests (TestTracker) including reading speed, decoding, vocabulary,
comprehension, effort, test anxiety, and time and strategy usage. RESULTS: Students with
ADHD had poorer decoding scores, and lower comprehension and vocabulary accuracy.
Groups performed similarly on reading speed, number of items attempted, perceived
test anxiety, self-perception of testing skills, and strategy use. CONCLUSION: Students
with ADHD (all of whom were receiving test accommodations in school) made more
errors on some reading tasks, yet performed similarly to typical students on indices of
speed and amount of test items accessed. The finding of more errors but no time
differences might argue for a different intervention beside extended time, unless the
extra time is used to review and correct work.

24. Li, A. K. (1974). Parental attitudes, test anxiety, and achievement motivation: a Hong Kong
study. J Soc Psychol, 93(1), 3-11.

25. Liu, Y. Y. (2012). Students' perceptions of school climate and trait test anxiety. Psychol Rep,
111(3), 761-764.

In a sample of 916 Chinese high school students, the relations among the students'
perceptions of school climate and their trait test anxiety were examined. The results
indicated that students' perceptions of teacher-student relationships and
student-student relationships negatively predicted their trait test anxiety. Furthermore,
girls had higher scores on trait test anxiety than boys.

26. Maimanee, T. A. (2010). The impact of exams anxiety on the level of triglycerides in university
female students. J Egypt Soc Parasitol, 40(1), 259-270.

Anxiety affects the level of blood fats such as the triglycerides according to several
 studies conducted in various conditions causing anxiety as exam for the university
students. The health experts suggested that the anxiety works to stimulate the
autonomic nervous system which in turn leads to the appearance of a group of
physiologic symptoms. The current study showed the changes happened in the
triglycerides' levels in the female university students before and after exams at the
intermediate anxiety level compared to other high and low levels of anxiety. In addition,
there was a difference in triglycerides' levels in female students of college of Science
before and after exam. This difference did not appear in case of other colleges. The exam
type had an impact as the significant difference appeared in the triglycerides' levels
during the periodical tests and these differences did not appear in the final exam.

27. Marszalek, J. M. (2009). Validation of a TAI Short Form with an adolescent sample. J Gen
Psychol, 136(4), 333-349.

Although test anxiety is increasingly used in research with multiple constructs, it is not
always possible to administer a lengthy scale to measure it. Taylor and Deane (2002)
developed a 5-item short form of the 20-item Test Anxiety Inventory (TAI; see
Spielberger, Gonzalez, Taylor, Algaze, & Anton, 1978). Although evidence of reliability
and validity was good, there were several limitations, including the age and gender of
the sample, and the lack of data obtained with the short form rather than the original
TAI. The current study attempts to address those limitations and augment previous
results with additional types of validity evidence (i.e., coefficients of divergent validity and
exploratory factor analysis) in a sample of 152 seventh- and eighth-graders. Results were
high reliability (.86) and good evidence of multiple facets of validity. Previous results
were confirmed and extended for adolescents and for use in applied psychological and
educational settings.

28. Mutchnick, M. G., & Williams, J. M. (2012). Anxiety and memory test performance. Appl
Neuropsychol Adult, 19(4), 241-248.

The present study examined the relationship of extra-test anxiety to memory test
performance among patients undergoing cardiopulmonary bypass (N = 47) and back
surgery (N = 24). These patients were chosen because they are often anxious before
surgery and thus serve as a model of extra-test anxiety. This examination is important in
neuropsychology because anxiety may serve as an extraneous factor compromising the
validity of attention and memory scores. Anxiety level, determined from self-report and
experimenter ratings, and memory performance, as measured by the Memory
Assessment Scales and memory self-report, were assessed 1 to 2 days presurgery and
approximately 6 weeks post surgery. The study further examined whether anxiety's
influence on test performance is mediated by an impulsive cognitive style, as indicated
by the Matching Familiar Figures Test. Multivariate analysis of variance (MANOVA)
revealed no significant change in state anxiety during the testing interval. MANOVA did
 reveal significant differences between the two surgery groups on anxiety, and younger
patients demonstrated greater anxiety about their upcoming surgery. An examination of
the intercorrelations of anxiety and memory scores revealed that they do not share
variance and are essentially unrelated. Although the subjects were moderately anxious
about the upcoming surgery, this did not apparently influence their performance on
memory tests.

29. Nelson, J. M., Lindstrom, W., & Foels, P. A. (2015). Test Anxiety Among College Students With
Specific Reading Disability (Dyslexia): Nonverbal Ability and Working Memory as
Predictors. J Learn Disabil, 48(4), 422-432.

Test anxiety and its correlates were examined with college students with and without
specific reading disability (RD; n = 50 in each group). Results indicated that college
students with RD reported higher test anxiety than did those without RD, and the
magnitude of these differences was in the medium range on two test anxiety scales.
Relative to college students without RD, up to 5 times as many college students with RD
reported clinically significant test anxiety. College students with RD reported significantly
higher cognitively based test anxiety than physically based test anxiety. Reading skills,
verbal ability, and processing speed were not correlated with test anxiety. General
intelligence, nonverbal ability, and working memory were negatively correlated with test
anxiety, and the magnitude of these correlations was medium to large. When these three
cognitive constructs were considered together in multiple regression analyses, only
working memory and nonverbal ability emerged as significant predictors and varied
based on the test anxiety measure. Implications for assessment and intervention are
discussed.

30. Neuderth, S., Jabs, B., & Schmidtke, A. (2009). Strategies for reducing test anxiety and
optimizing exam preparation in German university students: a prevention-oriented pilot
project of the University of Wurzburg. J Neural Transm (Vienna), 116(6), 785-790.

Test anxiety is a significant problem among university students which is frequently

accompanied by a decline in performance and severe psychological problems. Studies of
treatment methods of test anxiety were identified using literature searches of the
Cochrane Library database of randomized controlled trials. A variety of intervention
techniques for the treatment of test anxiety was detected, from which cognitive
behavioral methods were found to be most effective for the treatment of test anxiety.
According to empirical findings, university students should be taught strategies to cope
with the demands and organization of their studies at a very early stage to prevent test
anxiety and its concomitants. The University of Wurzburg (Germany) started a pilot
project in fall 2007 comprising lectures and peer coaching with the aim to optimize
learning skills and exam preparation to prevent test anxiety. The evaluation of the
present concept showed a high level of acceptance among students.
31. Neveu, D., Doron, J., Visier, L., Boiche, J., Trouillet, R., Dujols, P., et al. (2012). Students
perceived stress in academic programs: consequences for its management. Rev Epidemiol
Sante Publique, 60(4), 255-264.

BACKGROUND: Academic stress contributes to the deterioration of the students' quality

of life. Psychological determinants involved in the stress process, trait anxiety and coping,
have been neglected when assessing the role of academic programs in stress. This study
aimed at determining whether academic programs are associated with a high level of
perceived stress above and beyond potential personal and environmental risk factors, as
well as coping strategies. METHODS: A cross-sectional survey was conducted in 2009
among third-year medical (total n=170, participants 88%), dental (n=63, 94%),
psychology (n=331, 61%) and sports sciences (n=312, 55%) students in Montpellier
(France). The stress level experienced during the last 2months, trait anxiety and coping
strategies were appraised. Substance use, psychological care, and stress triggers were
also collected using a self-administered questionnaire. RESULTS: Compared with
medicine and after adjusting for gender and age, only the sports program was associated
with a lower perceived stress risk: adjusted odds ratio: 0.54 [95% Confidence interval:
0.30; 0.99]. Substantial reductions in perceived stress risks were observed in science
students after additional adjustments for non-academic stress triggers, substance use,
psychological care (adjusted odds ratio: 0.20 [95% Confidence interval: 0.09; 0.41]), and
also for trait anxiety and coping strategies (adjusted odds ratio: 0.23 [95% Confidence
interval: 0.10; 0.54]). Compared with medicine and after these additional adjustments,
psychology had a significantly lower perceived stress risk (0.34 [0.18; 0.64]; 0.40 [0.19;
0.86], respectively), dentistry had a similar risk (0.82 [0.35; 1.91]; 0.53 [0.20; 1.43],
respectively). CONCLUSION: Sports and psychology programs had a lower perceived
stress risk compared with medicine. Personal and environmental risk factors and coping
strategies modified the association between academic program and perceived stress.
Developing efficient coping strategies in students and improving academic environment
could contribute to prevent the potential deleterious consequences of stress.

32. Peker, I., Alkurt, M. T., Usta, M. G., & Turkbay, T. (2009). The evaluation of perceived sources
of stress and stress levels among Turkish dental students. Int Dent J, 59(2), 103-111.

OBJECTIVE: The purpose of this study was to identify sources of stress and to evaluate
stress levels among Turkish dental students and also to investigate the role of year of
study and gender on perceived stressors. METHODS: This study included 308 dental
students. Dental Environment Stress (DES) questionnaire, Beck Depression Inventory
(BDI) and Spielberger State Trait Anxiety Inventory (STAI) were used to collect data. Also,
some factors considered to be effective on stress levels of dental students were
questioned. Data were statistically analysed with Kruskal Wallis and Mann Whitney U
tests. RESULTS: The most stress provoking factors were fear of failing the year,
 completion of clinical requirements and amount of assigned work. Statistically significant
differences were found between years of study and gender for many stressors. There was
statistically significant difference between years of study and gender for mean DES
scores but no statistically significant differences were found between years of study for
mean BDI, STAI scores. There was statistically significant difference between genders for
STAI-1. Choice rank of dental school has affected stress levels of dental students.
CONCLUSION: This study showed that perceived sources of stress of clinical students
were very similar and stress levels of these students were lower than preclinical students,
also gender was effective on stressors and stress levels.

33. Perpina-Galvan, J., Richart-Martinez, M., Cabanero-Martinez, M. J., & Martinez-Dura, I. (2011).
Content validity of the short version of the subscale of the State-Trait Anxiety Inventory
(STAI). Rev Lat Am Enfermagem, 19(4), 882-887.

The goal was to describe the content validity of a short version of the state subscale of
Spielberger's "State-Trait Anxiety Inventory (STAI)", based on the original version
adapted to Spanish, in Spanish patients receiving invasive mechanical ventilation (IMV).
The sample consisted of 16 patients receiving IMV at the Alicante Hospital (Spain), who
selected the items from the full Spanish version of the STAI-state that were most relevant
to them. Items 1, 5, 9, 10, 12 and 20 from the original scale are the most relevant for the
Spanish patients receiving IMV and 5 of these are included in the short version of the
scale (83.3% agreement). The short scale has shown adequate content validity for
Spanish patients receiving IMV.

34. Preuss, D., Schoofs, D., Schlotz, W., & Wolf, O. T. (2010). The stressed student: influence of
written examinations and oral presentations on salivary cortisol concentrations in
university students. Stress, 13(3), 221-229.

Laboratory research has demonstrated that social-evaluative threat has an influence on

the hypothalamus pituitary adrenal axis (HPA). In two studies using independent
samples, we evaluated the anticipatory cortisol response to a written university
examination (n = 35) and to an oral presentation (n = 34). Saliva samples were collected
before and after the examinations and on a control day. Additionally, saliva samples were
collected on the day before the written examination and a control day. Results revealed
significantly elevated cortisol concentrations on the day prior to the examination;
however, this effect occurred only in those participants who had their control day after
the examination. Cortisol concentrations were elevated on the examination day, with
increased concentrations before but not after the examination. For the oral presentation
study, the results revealed substantially elevated cortisol concentrations before and after
the oral presentation. Taken together the results indicate that written examinations cause
a mild anticipatory HPA response while oral presentations induce a strong HPA response.
These findings appear to support the idea that social-evaluative threat is an important
 factor determining the size of the HPA response to laboratory stressors as well as to
real-life stressors.

35. Putwain, D. W. (2007). Test anxiety in UK schoolchildren: prevalence and demographic

patterns. Br J Educ Psychol, 77(Pt 3), 579-593.

BACKGROUND: Despite a large body of international literature concerning the

antecedents, correlates of and treatments for test anxiety, there has been little research
until recently using samples of students drawn from the UK. There is a need to establish
some basic normative data for test anxiety scores in this population of students, in order
to establish whether international research findings may generalize to UK schoolchildren.
AIM: To collect some exploratory data regarding test anxiety scores in a sample of UK
schoolchildren, along with socio-demographic variables identified in the existing
literature as theoretically significant sources of individual and group differences in test
anxiety scores. SAMPLE: Key Stage 4 students (1348): 690 students in the Year 10 cohort
and 658 students in the Year 11 cohort, drawn from seven secondary schools in the
North of the UK. METHOD: Data on test anxiety were collected using a self-report
questionnaire, the Test Anxiety Inventory (Spielberger, 1980) and additional
demographic variables through the Student Profile Questionnaire. The factor structure of
the Test Anxiety Inventory was explored using principal components analysis and
multiple regression analysis used to predict variance in self-reported test anxiety scores
from individual and group variables. RESULTS: The principal components analysis
extracted two factors, worry and emotionality, in line with theoretical predictions.
Gender, ethnic and socio-economic background were identified as significant predictors
of variance in test anxiety scores in this dataset. Whether English was an additional, or
native, language of students did not predict variance in test anxiety scores and year
group was identified as a predictor of emotionality scores only. CONCLUSION: Variance
in the test anxiety scores of Key Stage 4 students can be predicted from a number of
socio-demographic variables. Further research is now required to assess the implications
for assessment performance, examination arrangements and appropriateness of using a
North American measure of test anxiety in a UK context.

36. Putwain, D. W., Connors, L., Symes, W., & Douglas-Osborn, E. (2012). Is academic buoyancy
anything more than adaptive coping? Anxiety Stress Coping, 25(3), 349-358.

Academic buoyancy refers to a positive, constructive, and adaptive response to the types
of challenges and setbacks experienced in a typical and everyday academic setting. In
this project we examined whether academic buoyancy explained any additional variance
in test anxiety over and above that explained by coping. Two hundred and ninety-eight
students in their final two years of compulsory schooling completed self-report measures
of academic buoyancy, coping, and test anxiety. Results suggested that buoyancy was
inversely related to test anxiety and unrelated to coping. With the exception of
 test-irrelevant thoughts, test anxiety was positively related to avoidance coping and
social support. Test-irrelevant thoughts were inversely related to task focus, unrelated to
social support, and positively related to avoidance. A hierarchical regression analysis
showed that academic buoyancy explained a significant additional proportion of variance
in test anxiety when the variance for coping had already been accounted for. These
findings suggest that academic buoyancy can be considered as a distinct construct from
that of adaptive coping.

37. Putwain, D. W., Woods, K. A., & Symes, W. (2010). Personal and situational predictors of test
anxiety of students in post-compulsory education. Br J Educ Psychol, 80(Pt 1), 137-160.

BACKGROUND: Recent models of evaluation anxiety emphasize the importance of

personal knowledge and self-regulatory processes in the development of test anxiety,
but do not theorize a route for situational influences. AIM: To investigate the relationship
between test anxiety and personal knowledge beliefs (achievement goals and perceived
academic competence), parental pressure/support, and teachers' achievement goals.
SAMPLE: One-hundred and seventy five students at a sixth-form college following
pre-degree courses in Psychology and Sociology. METHOD: Self-report data were
collected for test anxiety, personal achievement goals, academic self-concept, perceived
test competence, teachers' achievement goals, and parental pressure/support.
Relationships were examined through correlational and regression analyses. RESULTS:
The relationship between test anxiety and personal knowledge beliefs differed for the
various components of test anxiety. A mastery-avoidance goal was related to worry and
tension, and a performance-approach goal to bodily symptoms. Perceived academic
competence was related to worry and tension. Parental pressure was associated with
stronger worry and test-irrelevant thinking components directly, and with a stronger
bodily symptoms component indirectly through a performance-approach goal. Teachers'
performance-avoidance goals were related to worry, tension, and bodily symptoms
indirectly through personal performance-avoidance goals, and in the case of bodily
symptoms additionally through a performance-approach goal. CONCLUSION: Findings
provide partial support for the self-regulatory model of test anxiety suggesting that
additional routes are required to account for the role of parental pressure and teachers'
performance-avoidance goals and a re-examination of the relationship between test
anxiety and achievement goals.

38. Rahafar, A., Maghsudloo, M., Farhangnia, S., Vollmer, C., & Randler, C. (2016). The role of
chronotype, gender, test anxiety, and conscientiousness in academic achievement of
high school students. Chronobiol Int, 33(1), 1-9.

Previous findings have demonstrated that chronotype

(morningness/intermediate/eveningness) is correlated with cognitive functions, that is,
people show higher mental performance when they do a test at their preferred time of
 day. Empirical studies found a relationship between morningness and higher learning
achievement at school and university. However, only a few of them controlled for other
moderating and mediating variables. In this study, we included chronotype, gender,
conscientiousness and test anxiety in a structural equation model (SEM) with grade point
average (GPA) as academic achievement outcome. Participants were 158 high school
students and results revealed that boys and girls differed in GPA and test anxiety
significantly, with girls reporting better grades and higher test anxiety. Moreover, there
was a positive correlation between conscientiousness and GPA (r = 0.17) and
morningness (r = 0.29), respectively, and a negative correlation between
conscientiousness and test anxiety (r = -0.22). The SEM demonstrated that gender was
the strongest predictor of academic achievement. Lower test anxiety predicted higher
GPA in girls but not in boys. Additionally, chronotype as moderator revealed a significant
association between gender and GPA for evening types and intermediate types, while
intermediate types showed a significant relationship between test anxiety and GPA. Our
results suggest that gender is an essential predictor of academic achievement even
stronger than low or absent test anxiety. Future studies are needed to explore how
gender and chronotype act together in a longitudinal panel design and how chronotype
is mediated by conscientiousness in the prediction of academic achievement.

39. Raju, P. M., Mesfin, M., & Alia, E. (2010). Test Anxiety Scale: reliability among Ethiopian
students. Psychol Rep, 107(3), 939-948.

Sarason's Test Anxiety Scale, translated into an Ethiopian language, was administered to
391 students in Grade 8 and to 422 students in preparatory school (Grades 11 and 12). In
the first sample, 32 items loaded above the 0.3 criterion of acceptable item-remainder
correlations and Cronbach alpha of .84. In the second sample, Cronbach alpha was .84
for the 34 items, but only 19 items had acceptable item-remainder correlations. The
internal consistency reliabilities were comparable with those reported in the literature.
However, the results of confirmatory factor analyses with extraction of four factors did
not confirm the item loadings on factors as reported in the literature. Younger students
(Grade 8) were found to have higher mean Test Anxiety than Grades 11 and 12 students.
The Amharik version of the Test Anxiety Scale as a whole could be considered reliable
and useful for Ethiopian students.

40. Rhine, W. R., & Spaner, S. D. (1983). The structure of evaluative anxiety among children
differing in socioeconomic status, ethnicity, and sex. J Psychol, 115(2d Half), 145-158.

Following Anastasi and Thurstone, the factor structure of evaluative anxiety was
examined among six groups of primary age boys and girls (N = 8064). A factor matching
technique was used to study hypotheses about the effects of group differences in
socioeconomic status (SES), ethnicity, and sex on the pattern of the children's responses
to the Test Anxiety Scale for Children (TASC). Hypotheses about the congruence of factor
 patterns were based on both demographic differences and results of developmental
research. The hypothesis of an SES X ethnicity X sex interaction was strongly supported.
Implications for comparing factor structures, measuring evaluative anxiety, and future
research of evaluative anxiety are discussed.

41. Rosario, P., Nunez, J. C., Salgado, A., Gonzalez-Pienda, J. A., Valle, A., Joly, C., et al. (2008).
[Test anxiety: associations with personal and family variables]. Psicothema, 20(4),
563-570.

Test anxiety is a common behavior among students facing social pressure centered on
mastery. Only a few studies have analyzed the relations between test anxiety, academic
procrastination, personal and family variables and math grades. This work focus on the
analysis of the impact of students' social-personal variables such as parents' education
level, number of siblings and under-achievement by performing ANOVAs in two samples
of 533 and 796 students from junior high-school. Corroborating the findings in other
studies, the data stress that test anxiety is higher in girls and decreases when students'
parents have higher educational levels, with the number of courses flunked, and when
students' math grades were lower. Test anxiety and procrastination correlate positive and
significantly. Findings are discussed and compared with those of previous researches.
The implications for teaching practice are also analyzed.

42. Sena, J. D., Lowe, P. A., & Lee, S. W. (2007). Significant predictors of test anxiety among
students with and without learning disabilities. J Learn Disabil, 40(4), 360-376.

In the present study, the relationship between students with and without learning
disabilities (LD) and different aspects of test anxiety was examined on a new
multidimensional measure of test anxiety. A sample of 774 elementary and secondary
school students--195 students with LD and 579 students not identified with
LD--completed the Test Anxiety Inventory for Children and Adolescents (TAICA), a new
multidimensional measure of test anxiety for elementary and secondary school students
in Grades 4 through 12. Examination of the factor structure of the TAICA scores across LD
status to determine whether accurate test score interpretation was possible revealed that
the majority of the coefficient of congruence values between each pair of six
corresponding factors of the TAICA (Cognitive Obstruction/ Inattention, Performance
Enhancement/Facilitation Anxiety, Physiological Hyperarousal, Social Humiliation, Worry,
and Lie) and the Total Test Anxiety factor were above .90, and the salient variable
similarity index values were statistically significant, suggesting that the factor structure of
the TAICA was similar across groups. The results of seven multiple regression analyses
revealed that LD predicted higher Cognitive Obstruction/Inattention and Worry scores
and lower Performance Enhancement/Facilitation Anxiety and Lie scores. Implications of
the findings for school personnel who work with students with LD are discussed.
43. Skybo, T., & Buck, J. (2007). Stress and coping responses to proficiency testing in school-age
children. Pediatr Nurs, 33(5), 410, 413-418.

Nurses encounter school-age children experiencing multiple stressors and stress

symptoms. Performance on proficiency tests is viewed as stressor. The purpose of this
repeated measures study was to assess 53 fourth grade children's appraisal of
proficiency tests, concurrent stressors, stress symptoms, and coping strategies. During
October, February, March, and April, children completed a ranking of their stress
associated with proficiency testing and also reported their stressors, stress symptoms,
and coping strategies. Results indicated that children appraised proficiency tests as most
stressful at the beginning of the school year but less stressful at the time of the test.
Stressors and stress symptoms increased from baseline to 1 month before testing then
declined. The number of coping strategies used by the children decreased throughout
the year. Nurses can work with parents and teachers to identify children with test anxiety
and target these children for interventions to improve their coping strategies.

44. Steinmayr, R., Crede, J., McElvany, N., & Wirthwein, L. (2015). Subjective Well-Being, Test
Anxiety, Academic Achievement: Testing for Reciprocal Effects. Front Psychol, 6, 1994.

In the context of adolescents' subjective well-being (SWB), research has recently focused
on a number of different school variables. The direction of the relationships between
adolescents' SWB, academic achievement, and test anxiety is, however, still open
although reciprocal causation has been hypothesized. The present study set out to
investigate to what extent SWB, academic achievement, and test anxiety influence each
other over time. A sample of N = 290 11th grade students (n = 138 female; age: M =
16.54 years, SD = 0.57) completed measures of SWB and test anxiety in the time span of
1 year. Grade point average (GPA) indicated students' academic achievement. We
analyzed the reciprocal relations using cross-lagged structural equation modeling. The
model fit was satisfactory for all computed models. Results indicated that the worry
component of test anxiety negatively and GPA positively predicted changes in the
cognitive component of SWB (life satisfaction). Worry also negatively predicted changes
in the affective component of SWB. Moreover, worry negatively predicted changes in
students' GPA. Directions for future research and the differential predictive influences of
academic achievement and test anxiety on adolescents' SWB are discussed with regard
to potential underlying processes.

45. Sud, S., & Sharma, S. (1995). Effects of test anxiety, ego stress, and attentional skills training
on arithmetic reasoning: An experimental evaluation of a brief counseling strategy.
Anxiety Stress Coping, 8(1), 73-84.

Abstract Two hundred forty high school students (120 male and 120 female) in India
 performed a moderately difficult multiple choice Arithmetic Reasoning task after
undergoing short-term (40 minutes) cognitive treatment in the form of Attentional Skills
Training. A 2 x 2 x 2 (Test Anxiety x Attentional Skills Training x Stress) design with
separate analysis for boys and girls indicated these results: with intervention the high
anxiety subjects under ego stress conditions, compared to their high-anxious control,
low-anxious ego stress, or low-anxious control counterparts, reported the maximum
significant improvement in performance on the Arithmetic Reasoning test. The
low-anxiety subjects performed consistently well with or without treatment or stress
conditions. The findings shed new light on the attentional theory of test anxiety, and it
was reasoned that long-term effects of cognitive treatment be studied by using varied
performance tasks (difficulty level controlled) on different gender and age groups across
cultures.

46. Szafranski, D. D., Barrera, T. L., & Norton, P. J. (2012). Test anxiety inventory: 30 years later.
Anxiety Stress Coping, 25(6), 667-677.

Research suggests that test anxiety is associated with a number of maladaptive factors.
The majority of test anxiety research includes the Test Anxiety Inventory (TAI) as a
primary outcome variable. However, the TAI was normed on college undergraduates in
1980. The academic landscape has altered in a variety of ways in the past 30 years, which
may result in out-of-date norms. This study examined changes in TAI scores in college
undergraduates (n =437) as well as convergent validity with measures of trait anxiety and
academic performance. Results indicated increases in TAI scores for females while
holding constant for males. Additionally, females and males displayed positive
correlations between the TAI and state-trait anxiety inventory, while only females
displayed a significant negative correlation between the TAI and grade point average.
Data provide evidence of changes in TAI scores. As a result, researchers should be careful
when drawing conclusions based on original TAI norms, especially in the case of female
undergraduates.

47. Thames, A. D., Panos, S. E., Arentoft, A., Byrd, D. A., Hinkin, C. H., & Arbid, N. (2015). Mild test
anxiety influences neurocognitive performance among African Americans and European
Americans: identifying interfering and facilitating sources. Cultur Divers Ethnic Minor
Psychol, 21(1), 105-113.

The current study examined ethnic/racial differences in test-related anxiety and its
relationship to neurocognitive performance in a community sample of African American
(n = 40) and European American (n = 36) adults. The authors hypothesized the following:
(a) Test-anxiety related to negative performance evaluation would be associated with
lower neurocognitive performance, whereas anxiety unrelated to negative evaluation
would be associated with higher neurocognitive performance. (b) African American
participants would report higher levels of anxiety about negative performance evaluation
 than European Americans. (c) European Americans would report higher levels of anxiety
unrelated to negative performance evaluation. The first two hypotheses were supported:
Ethnic/racial differences in test-taking anxiety emerged such that African Americans
reported significantly higher levels of negative performance evaluation, which was
associated with lower cognitive performance. The third hypothesis was not supported:
African Americans and European Americans reported similar levels of test-anxiety
unrelated to negative evaluation.

48. Wachelka, D., & Katz, R. C. (1999). Reducing test anxiety and improving academic self-esteem
in high school and college students with learning disabilities. J Behav Ther Exp Psychiatry,
30(3), 191-198.

Test anxiety seems like a benign problem to some people, but it can be potentially
serious when it leads to high levels of distress and academic failure in otherwise capable
students. Because test anxiety is common in older students with learning disabilities (LD),
it is surprising that little research has been done on ways to reduce the distress these
students experience in test situations. In this study, we used a randomized
pretest-posttest control group design to examine the effectiveness of a
cognitive-behavioral treatment for reducing test anxiety and improving academic
self-esteem in a cohort (N = 27) of high school and college students with learning
disabilities (LD). All of the students participated voluntarily. They were enrolled in classes
for students with learning problems. Before the study began, they complained of test
anxiety and showed an elevated score on the Test Anxiety Inventory (TAI). Eleven
students (85%) completed the 8-week long treatment, which consisted of progressive
muscle relaxation, guided imagery, self-instruction training, as well as training in study
and test-taking skills. Results showed significant improvement in the treated group which
was not evident in an untreated control group (N = 16). Compared to the control group,
the treated group showed significant reductions in test anxiety on the TAI, as well as
improvement in study skills and academic self-esteem as measured by the Survey of
Study Habits and Attitudes, and the school scale of the Coopersmith Self-Esteem
Inventory. These results extend the generality of similar studies on reducing test anxiety
and improving academic self-esteem in younger students. They also suggest that relief
from test anxiety can be expected fairly quickly when cognitive-behavioral methods are
used. Additional implications and methodological limitations of the study are discussed.

49. Wells, A., & Colbear, J. S. (2012). Treating posttraumatic stress disorder with metacognitive
therapy: a preliminary controlled trial. J Clin Psychol, 68(4), 373-381.

OBJECTIVES: Exposure, trauma-focused cognitive therapy and eye-movement

desensitisation and re-processing (EMDR) are effective treatments for posttraumatic
stress disorder (PTSD) producing equivalent outcomes. How might the field advance?
One way is to base new treatments on PTSD maintenance mechanisms. A treatment that
 does this, metacognitive therapy (MCT), underwent preliminary controlled evaluation in
this study. METHOD: Twenty participants aged 18 to 65 years with chronic PTSD were
randomly allocated to either a total of 8 sessions of MCT or a delayed treatment control.
Measures of PTSD, emotional symptoms, and underlying metacognitive variables were
obtained at pretreatment and posttreatment. Patients were followed-up at 3 and 6
months postintervention. RESULTS: Statistically significant reductions in PTSD symptoms,
depression, and anxiety at posttreatment were observed in the MCT group but not in the
control group. Changes were maintained over follow-up. The average number of
sessions delivered was 6.4. Eighty percent of patients (intention to treat) met clinical
significance criteria for recovery based on the IES. Treatment was well tolerated with only
one (10%) dropout. Changes in thought control strategy hypothesized to be involved in
the maintenance of PTSD were found. CONCLUSIONS: MCT appeared to be a brief
treatment producing high recovery rates. The data add to existing uncontrolled
evaluations and provide strong justification for future evaluation of this treatment
against existing evidence-based interventions.

50. Yang, R. J., Lu, Y. Y., Chung, M. L., & Chang, S. F. (2014). Developing a short version of the test
anxiety scale for baccalaureate nursing skills test--a preliminary study. Nurse Educ Pract,
14(6), 586-590.

AIM: In this study, a brief and rapid skills test anxiety scale was developed to measure
nursing students' anxiety before their first skills assessment test, and the measurement
results were assessed using factor analysis. METHODS: A survey questionnaire design was
used to gather cross-sectional data for the scale. The study subjects comprised 250
first-year bachelors of nursing students who completed a test anxiety survey before
taking their first nursing skills test. This questionnaire evaluated first-year baccalaureate
students' anxiety associated with applying nursing skills. RESULTS: The results indicated
that students were most anxious about the attitudes of the teachers proctoring the tests
(94.6%), followed by the test atmosphere (92.2%). These 2 items were determined to be
conducive to high anxiety and were statistically correlated. Exploratory analysis was used
to extract 2 common factors, nonspecific information and test atmosphere. Meanwhile,
factor loadings were 19.45% and 50.41%, respectively. CONCLUSION: This study
evaluated the validity and reliability of the proposed scale. The evidence-based results
presented in this investigation provide teachers with a crucial reference for helping
students reduce their anxiety before their first skills assessment test.

51. Zeidner, M. (1990). Does test anxiety bias scholastic aptitude test performance by gender
and sociocultural group? J Pers Assess, 55(1-2), 145-160.

This study examines the commonly held contention that test anxiety may serve as a
source of bias in the scholastic aptitude test performance of gender and ethnic minority
groups. In addition, this study examines sex and sociocultural group differences in the
 level and pattern of test anxiety among Israeli college students. The sample was
composed of 163 male and 198 female students sitting for scholastic aptitude tests
routinely administered to all student applicants as part of their college admissions
procedures. About 67% were of Western cultural extraction whereas the remainder were
of Eastern extraction. Significant differences in text anxiety scores for males and females
were observed, with greater sex group differentiation on the Emotionality than on the
Worry scale. Test anxiety scores were not discernible by ethnicity or social class.
Furthermore, test anxiety was not differentially related to aptitude test scores by sex or
sociocultural group membership. Thus, this study lends little evidence to the common
contention that test anxiety differentially debilitates the aptitude test scores of females
and ethnic minority student candidates.

52. Zeidner, M., & Safir, M. P. (1989). Sex, ethnic, and social differences in test anxiety among
Israeli adolescents. J Genet Psychol, 150(2), 175-185.

The effects of sex, ethnicity, and social class on levels of test anxiety were examined
among a sample of 416 adolescent students in Israel. Significant sex differences in mean
levels of test anxiety were found, with girls scoring consistently higher than boys across
ethnic, social, and grade categories. Pupils of low socioeconomic status (SES) also scored
consistently higher than pupils of high SES across grades. Nevertheless, this study
provides little support for the commonly held view that sociocultural or sex group
differences in school achievement are due, in any meaningful way, to differences in test
anxiety. The group differences, though significant for SES and sex, were of negligible
magnitude, and the correlation between test anxiety scores and grade point average was
minimal for the group as a whole and nonsignificant for students of Eastern background,
who have been purported to be particularly affected by high levels of test anxiety. The
findings do support other cross-cultural studies, which have found only a modicum of
shared variance between test anxiety and grades. It is concluded that test anxiety is not a
particularly valid predictor of achievement or ability.

53. Zhang, Z., Su, H., Peng, Q., Yang, Q., & Cheng, X. (2011). Exam anxiety induces significant
blood pressure and heart rate increase in college students. Clin Exp Hypertens, 33(5),
281-286.

To investigate the relationship between the anxiety and blood pressure (BP) and heart
rate (HR) increase in peri-exam period. Sixty-four college students(20.0 +/- 0.1 year old)
were included in this study. The BP and HR were measured in the morning and in the
evening for 3 days during the prereview (ba), review, and exam periods. The BP and HR
increase amplitudes (HRIA) of review and exam periods were from the difference of
corresponding values and basic values, and the BPIA/baBP and HRIA/baHR were
calculated. All of the students completed the Self-Rating Anxiety score (SAS)
questionnaire the first day of the exam period. Scores over 50 points were used as the
standard for anxiety. From the prereview to exam periods, the BP and HR increased
gradually. The exam SBPIA (4.3 +/- 1.3 vs. 0.3 +/- 0.5 mmHg, P < 0.05) and DBPIA (4.4
+/- 1.5 vs. 1.0 +/- 0.5 mmHg, P < 0.05) were significantly higher in the anxiety group
than in the no-anxiety group. The SBPIA/DBPIA and HRIA showed a similar profile
also(9.7 +/- 2.1 vs. 1.9 +/- 0.9 bpm, P < 0.05). Strong positive correlations were found
between the SAS score and BPIA and HRIA both in the review and exam period. The
smoking group and family hypertension group had higher anxiety score; meanwhile,
their exam BPIAs and HRIAs were significantly higher than their corresponding group.
The BP and HR increase in the review and exam period, anxiety is an important factor of
BP and HR increase.