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Test Anxiety and its Impact on first year University Students and the over View
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DOI: 10.5958/0974-360X.2018.00411.0

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Research J. Pharm. and Tech. 11(6): June 2018

ISSN 0974-3618 (Print) www.rjptonline.org


0974-360X (Online)

RESEARCH ARTICLE

Test Anxiety and its Impact on first year University Students and the over
View of mind and body Intervention to Enhance coping Skills in Facing
Exams
Farrahdilla Hamzah1, Khairi Che Mat2, Vidya Bhagat2*, NurSyakilah Mahyiddin1
1
School of Nursing Science, Faculty of Medicine, University Sultan Zainal Abidin, Terengganu, Malaysia
2
Faculty of Medicine, University Sultan ZainalAbidin Terengganu, Malaysia
*Corresponding Author E-mail: 55vidya42@gmail.com

ABSTRACT:
Test anxiety has an impact on students either negative or positive. It is normal to have exam anxiety that help the
students to prepare them for facing examination on the other hand it can also distress the students ‘and disturb
them physically, emotionally; cognitively that can result in poor examination performance. The current study
had analysed the past reviews regarding test anxiety impacting student performance in their examinations. The
purpose of this study is to give overview of mind-body interventions for first year university students who facing
test anxiety. This literature review was completed using electronic databases. The current study had analysed
reviewing 70 articles from year 1961 to 2017. The reviewed articles were regarding test anxiety it’s negative and
positive correlates, Mind- body intervention and its benefits. Current study concludes though the test anxiety is
common among students the academicians and educationalists in the universities should have awareness about
negative and positive aspects of this test anxiety that can impact students’ performance. Further, current study
suggests that practicing mind- body interventional programmes in the university to promote overall health and
wellbeing among student population.

KEYWORDS: Test Anxiety, Mind- Body Interventions, and First year university students

INTRODUCTION: Examination stress experienced by students ‘cause test


Test anxiety can also be termed as anticipatory anxiety, anxiety however, experiencing too much anxiety can
examination anxiety that occurs in situation like facing result in emotional and physical distress leads to
exam. Indeed, there is a stirred up state in physiological difficulty in concentrating, and emotional worry.
level causing over-arousal, tension and somatic Inferior performance arises not because of intellectual
symptoms and psychological level causing poor problems or poor academic preparation, but because
attention, deterioration in perception and thought testing situations create a sense of threat for those
fluency this can lead to worry, dread, fear of failure, and experiencing test anxieties; further this anxiety disrupts
catastrophic experiences before or during test situations attention and memory function.[1]
among the students. At the same time normal anxiety is
helpful in preparing the students to face the exam. The Test anxiety is one of the common problems among first
current review analysis is often helpful to stay mentally year university students’ the number studies regarding
and physically alert.[1] test anxiety is carried out over the globe. The current
study analyses the past literature on test anxiety has been
studied uni-dimensionally and bi-dimensionally learned
its edifice components such as worry and emotions
that’s apart of cognition and affective behaviour
Received on 28.02.2018 Modified on 26.04.2018 respectively. The current study had analysed this fact in
Accepted on 31.05.2018 © RJPT All right reserved the previous research that indicate test anxiety was a
Research J. Pharm. and Tech 2018; 11(6): 2220-2228. singular attribute, which could be measured with uni-
DOI: 10.5958/0974-360X.2018.00411.0
dimensional scales. However, observing one of the past
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Research J. Pharm. and Tech. 11(6): June 2018

researches conducted in the early 1970s found with evaluation is due to students being unable to retrieve
consensus that test anxiety (TA) is a bi-dimensional previously learned information during the evaluative
construct, consisting of the components worry and situation. This fact had further analysed the reasons for
emotionality.[2, 3] inability for retrieval during the assessment is due to
intruding thoughts and interfering thoughts include fears
Current research analysis also observes the stated fact of failure, self-critical thoughts and comparing self to
that the ‘worry’ has been referred as cognitive test peers.
anxiety, cognitive reaction or internal dialogue during
and after evaluative situations.[4] Current research Current study examined facts indicates that
analysis further indicates that individuals with high level conceptualization of test anxiety is said to be naïve
of cognition reported regarding their thoughts of approach that fails to take into consideration that the
comparing self-performance with their peer group, effect of interfering thoughts in the preparation and lead
worries related consequences of failure, loss of self- up to an examination.[11, 12] Further analysed fact reveals
esteem and self-worth, low levels of confidence, that students with high levels of test anxiety experienced
underestimating their own abilities as well as excessive problems at all levels of information processing, that is
worry over evaluation increases the frequently test encoding, storage and retrieval. [13] Current study
anxiety.[5,6] The anxiousness is a part of emotionality supplements with explored facts found in the previous
referring to the physiological responses to the research model that includes different stages of
examination had studied in the current review analysis. information processing model of test anxiety.[14] Further
Further examining the past reviews indicate that test examining the previous researches in the literature study
anxiety causing physiological manifestations include revealed that information processing model, is thought
increased galvanic skin response and heart rate, to be the most comprehensive and widely accepted
dizziness, nausea, or becoming panicky.[4,7] Current theoretical model for understanding test anxiety and its
study had revealed the fact reported by one of the relation to exam performance though it does not address
previous literature that the emotionality is a component the self-critical thought patterns which interfere with
of test anxiety that refers not only the physiological information retrieval. Further it is understood that
arousal but also to the individual’s subjective importance of self-criticism in the development and
interpretation of internal events. This study also maintenance of test anxiety. [13, 15]
observes the subjective arousal of individuals with high
test anxiety moderately correlated with objective The current study had reviewed the past literature
arousal.[8] It is a learned fact that role of cognition indicates that self-criticism can be described as scrutiny
impacting test anxiety. Current study had examined this and censorship of personal behaviours, thoughts and
fact in the past literature had revealed that the emotions. It has been learned through analysed fact that
relationship between these two components of test criticism arises when there is a gap between the
anxiety; the cognitive component directly impacts individual’s perception of reality and their own
performance in evaluative situations and the emotional expectations; this fact has been observed in one of the
component though it is related but does not directly studies on high school students, showed that test anxiety
influence test performance. Another literature with this was highly correlated with self-criticism.[16] This review
regard on the cognitive aspect of anxiety indicates that analyses the fact in the previous studies conducted on
students with high, medium and low cognitive test individuals with high test anxiety students who reported
anxiety differed considerably in their performance in the higher levels of helplessness over test performance than
examinations and scholastic assessment test.[6, 9] low test anxiety students.[17] This analysis of literature
study identified some of the facts such as the low level
The current study in its review analysis makes an effort of self-efficacy among students with high test anxiety is
to examine the test anxiety causing performance error; associated with learned helplessness, failure, avoidance
examining the past literature with the correlational and low personal goal setting, these students are less
studies had revealed that experimental data likely to find coping strategies for their anxiety which
demonstrated students with high test anxiety make more reinforces the cycle of low self-expectations, high levels
performance errors than that of students with low test of cognitive test anxiety and poor performance on
anxiety.[10] This study also observes that absence of tests.[17] Literature review analyse by the present study
evaluative stress and there were no differences in had found that self-efficacy and learned helplessness
performance between the students; here cognitive aspect plays an important part in the self-critical thinking of
of test anxiety was indicated as causal determinant of students with high levels of test anxiety thus role of both
poor performance.[10] Current study had analysed in its self-esteem and self-criticism in the development and
review examination on the past studies that discloses the persistence of test anxiety is vital to our understanding
fact studied regarding poor performance during of this concept and should be considered when thinking
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Research J. Pharm. and Tech. 11(6): June 2018

about possible intervention strategies.[17] Furthermore performance is one of the important cognitive content
explored facts by current review analysis among high they need to cling on along with their adaptation
test anxiety students identified higher feelings of process. Their normal anxiety level or the mild to
inadequacy, feelings of self-disgust, a lower capacity for moderate anxiety to do better in their academic
self-acceptance, self-compassion and also other aspects performance makes them to work heard this paves a way
such as influence of self-expectations, self-efficacy on for positive performance in their examination. One of
test anxiety,[18] one of the analysed studies also found the previous literature analysis reveals that a little
with negative correlation between test anxiety and self- anxiety during exams is required that will help students
efficacy.[19] to get motivated and learn.[23] Test anxiety has its can
affect students positively or negatively. Indeed, anxiety
The current study had made an effort to explore different is an important element of emotion that that drives the
procedures that can help the students with test anxiety. students’ towards their academic achievement. Thus it
This review study had identified a range of different has been constantly studied the relationship between test
therapeutic procedures employed in the attempt to treat anxiety and academic achievement among
test anxiety; one of the most commonly used undergraduate nursing students. The review analysis of
behavioural techniques for reducing exam anxiety is previous studies shows that the test anxiety undeniably
found as systematic desensitization which is made up of plays an important role in students' performance.[23, 24]
two components where the students are taught relaxation
techniques and trained them for using these techniques It is also understood that some level of anxiety is
to remain calm when in an anxiety provoking situation important for achievement motivation that is an
(test) is encountered, students are then exposed to of the important aspect of behaviour needed to enhance
situation which evoke anxiety hierarchically, for students’ performance in the examination. Review
example imagine walking in to an exam hall, when they analysis done by the current study has found an
grow anxious they need to practice using these acceptable level of test anxiety in students motivates
relaxation techniques. This teaching is repeated until the them to work hard and provides them with its positive
individual is able to imagine the testing situation with consequences.[25] The relationship between test anxiety
considerably reduced amount of anxiety. Further it also and academic performance is challenging; current study
found that students with test anxiety who took part in a had analysed this fact indicates that important aspect of
systematic desensitization intervention showed a student’s life influenced by one of the factors is
significant drop in levels of test anxiety. [20] Current anxiety level leading to hard work or preparations done
review analysis of the previous studies had found that prior to the examination.[26] Present study had observed
systematic desensitization and cognitive-behavioural in one of the previous study that showing the results
techniques such as cognitive modification, attention indicating positive relationship between students’ high
training and insight therapy were shown to significantly level of academic achievement and anxiety as predictor
reduce test anxiety.[7] of aspiration among the achievers.[27] It is a learnt fact
that anxiety varies its level and intensity in individuals
Test anxiety promoting students’ performance: when they face challenges. It differs person to person.
Anxiousness is a one of the normal emotional states, is Review analysis of the past literature observes anxiety
experienced in varying degrees and intensities, it is as a conceivable factor that affects a person’s academic
helpful for individuals to cope with the stressors. As a ability and achievement. It varies markedly from one
fact anxiety is structured into individuals brain plays an individual to another.[28] Current study had also observed
important role in preparing individuals for fight-or-flight in the past reviews indicates that anxiety as a predictor
response and to face threatening situations. Test anxiety of aspiration among the students who are going to face
is normal phenomenon for the students facing examination. Further analysis of this review reveals that
examination. It helps the students to prepare for their aspirations of high grades are an additional locomotive
mind set to face exam related stress. The current study that could affect student motivation and academic
has found in the literature that the anxiety is an obvious achievement. It is also found that this determination of
element in human being’s life that affect their learning is an important psychological construct that
performance and effectiveness in different situations, an provides two aspects of the effort, namely anxiety and
average level of anxiety is useful in keeping people motivation.[29]
hardworking and responsible for their work and also
helpful for people to be more workable for their affluent Test anxiety is a serious problem among student
life.[21,22] It is an understandable fact that first year population:
university students in their adaptation process to the new It is a normal response of an individual being anxious
environment distracted from the main stream of when individuals face ambiguity and unprepared to cope
academics. The motivation to do well in their academic with stressful situations. Preparedness for taking exam
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Research J. Pharm. and Tech. 11(6): June 2018

makes students less anxious than that of the students of the previous study about habits among undergraduate
who are unprepared. The current review analyses of past students causing test anxiety.[36] It is a learned fact that
literature study conducted on nursing students had anxiety is a normal emotion significant aspect needed
observed that higher level of test anxiety experienced by for survival. Thus students to prepare for their
the students affecting their emotional wellbeing. The examination need to have this normal anxiety. However,
further analysis of the past review had also indicated the there is an individual difference that some become
test anxiety effecting among nursing student’s more than highly anxious with the least provocation that can
general public and high school students in their trigger emotional disturbances in them. Analysing the
comparison.[30] past reviews on this aspect it has been observed that
students who have on-going and excessive fear get and
It is common fact that the exams that may leave distressed leads to poor performance in the examination
individuals upset. The stress converts into distress when thus this study indicates that physical, emotional,
the individuals’ adhere constantly regarding cognitive state had proven detrimental to their
unsubstantiated worry about the exams can distress them achievement.[37]
that can lead them to high level of anxiety that disturbs
their social life and interferes with their performance. The anticipation is generally reflects in anxiety and fear
Generally the stress converting in to distress is that signifies need adaption to challenge the fear-
commonly seen in first year students who are newly provoking circumstance. The anxious state has its own
adapting to university are more anxious during their significance in readying individuals to cope with a
examination. The current review study reveals the facts future problem situation. If anticipation cause over
observed in the past literature that the students’ anxiousness may cause harm if not prevented. The
psychological changes that often correlate multi factors current review study had examined the chronicity of this
like financial, academic and adaption difficulties to the higher level anxiety leading to ill health particularly
new environment and adjusting to university life perceived stress causing unhealthy behaviours among
indicated higher level of anxiety.[31,32] university students, such as substance abuse, poor
psychological health, poor physical health, reduced
The adjustment period among the year one students who social involvement, and poor academic performance.[38,
study in the university take longer period in adapting to 39]
the new environment and there is a proclivity to pile up
their academic work till the foot of the exam dates thus Current review study basing the past literature had
commonly find them over anxious during examination. learned that physiological changes and HPA axis
This literature review examines the fact that university is activity changes when individuals experience anxiety.
a totally new environment for the students therefore [38]
Further this review analysis on several other studies
there is a delay in their adjustment to the academic, indicates that stress and anxiety can stimulate
social, personal and lifestyle encounters.[33] Generally psychological and physiological responses in
the everyday events that demanding more adjustment cardiovascular, hypothalamic-pituitary-adrenal axis
lead to persistent anxiety that can interfere with life this activity[40,41] and observed that changes in blood pressure
kind of interference in students’ life that may cause poor and increased heart rate in situations like
performance in their examinations. This fact had examinations.[42] Over anxiousness among students who
observed in the past review had analysed by the current are preparing for their exam is led by their own thoughts
study that reveals high demands of nursing curriculum, concerning passing or failing in their exam. The current
workload and family responsibilities with the long hours study analysis of past literature reveals that regarding
of studying are the demanding aspect of the nursing fear and anxiety hipping students that prepares their
students life that causes test anxiety in them.[34] mind and body for automatic action. However, it has
been noticed that they are also at risk for very serious
The reviewed fact by the current study indicates that the negative consequences. The experience of fear or
individuals’ negative thoughts about the threatening anxiety may at times unpleasant and may lead to loss of
situations contribute higher level of anxiety in them. physical and psychological homeostasis that may cause
One of the reviewed studies also revealed that the anxiety that leads to autonomic changes such as increase
factors contributing of test anxiety that include heart rate, blood pressure and changes in breathing
psychological factors, thinking negatively about test pattern and also the body changes HPA activity with
causes higher level of anxiety among the students.[35] increased serum cortisol. These facts are analysed in the
Students’ transiting from the school to the university current review analysis of the past literature that had
need to mend their already set habits and study patterns indicated the increased level of cortisol from relaxed
to fit in university patterns this adjustment may threaten state to stress state during viva examination among the
them during exams and cause test anxiety among many students.[43]
of them. The current review analyses the results of one
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Research J. Pharm. and Tech. 11(6): June 2018

The presence of test anxiety is needed to be focused. could help to improve both psychological wellbeing and
The current review analysis principally focused on the test performance in anxious students.[49] The current
element studied in the past literature found that test review study also focus at the use of mindfulness
anxiety contributes to poor examination performance. [8, interventions on test anxiety explored the effectiveness
44,45]
The current review analysis indicates the of a brief mindfulness intervention on maths test anxiety
importance also of having test anxiety to keep the and exam scores in a high school population where the
students motivational spirit during examination. participants were trained for brief guided meditation
Observation of the past literature is also found that exam directly before taking their math exam; the result of
anxiety maintains students’ alertness that they are able which is found with significant reductions in anxiety, as
to change examination answers from incorrect to well as improvements in exam scores from before to
correct.[46] Test anxiety is the emotional reaction when after the intervention.[50] Observation of past literature
students’ need to cope with examination. However it also explored the effectiveness of a classroom
varies among students depends on their preparedness mindfulness colouring activity for test anxiety in
and certainty to facing the exam. One of the past primary school aged children.[51] Analysed past
researches identified test anxiety emotional reaction that literature studies in the current study had identified the
experienced by some students that they faced before suggestions and thoughts that has been put forward by
exams; this emotional reaction consists of two one of the past literature is that structured colouring of a
components; “worry” identified as cognitive expression reasonably complex geometric pattern may induce a
students concern about performance and “emotional” meditative state that benefits individuals suffering from
identified as an autonomic reactions which tend to occur anxiety and mindfulness colouring pair the creative
examination stress.[47] One of the negative aspects of test manipulation of materials of art making has the benefits
anxiety observed by the current study of past reviews of mindfulness meditation.[52]
reveals that the effects of anxiety on student
concentration impacts performance prior to the Mind- body interventions to help students with
examination, preparatory time of examination and also anxiety :
completion time of examination.[2,48] Mindfulness prospective interventions that can be
introduced to first year university students; more
The relationship between mindfulness and test specifically who face test anxiety and vulnerable to have
anxiety: negative impact on their examinations. Mindful
In management of test anxiety students’ can get trained breathing and cognitive reappraisal practices shown
in mindfulness activities or related techniques of effective in reducing test anxiety. Review analysis had
intervention. The current review study explores the indicated that training students to be mindful and
relationship between mindfulness and test anxiety breathing exercise could increase s positive automatic
through analysing previous researches regarding this thoughts more than that of cognitive reappraisal. [53]
aspect. One of the analysed studies reveals the important Tests and exams are vital part in people’s lives it’s
mechanisms of mindfulness training and its benefits in though the significance differs person to person. Higher
mindfulness based interventions. Further analysed fact education in the university has an own demands to cope
indicates there is an expanded interest in cultivating with. Students newly joined commonly find difficulties
mindfulness activities in helping students with test to adapt to these demands more commonly fist year
anxiety. [16] Current study had analysed in its review on students face stress and anxiety during their exams. Test
past literature indicates that students with high test anxiety can be described as a significantly unpleasant
anxiety \found with higher levels of negative self- experience of worry and emotionality. Current review
criticism, high levels of self-critical thoughts is found to study analyses that the test anxiety is an important factor
have an association with low levels of self-acceptance that has a negative impact reduces psychological
and lacking mindfulness skills this has played an wellbeing and hamper student’s academic achievement.
important role in the development and maintenance of This review analysis also indicates the potential use of a
test anxiety. [16] mindfulness intervention that has been delivered in an
ad hoc basis, via an online mobile application, found to
Current study has further explored the implications of be useful in reducing test anxiety among university
mindfulness in its review analysis indicated students. [54]
interventions could be cultivated to help students with
test anxiety identify and have an increased awareness of The current study had also focused on reviewing articles
thoughts of self- criticism, and to accept these thoughts that is informative in indicating its benefit to the
without judgment. It may be suggested that students who has high level of test anxiety; further this
acknowledgement of negative, self-critical thoughts study had observed that last of decades there has been an
which maintain and exacerbate test anxiety this in turn outpouring interest in mindfulness working as
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Research J. Pharm. and Tech. 11(6): June 2018

psychological construct as well as a clinical that the patients with more previous episodes of
intervention.[55] Current studies reviewed that depression, mindfulness based cognitive therapy
mindfulness is intentionally accepting and it is a non- significantly reduced risk of relapse.[66] One of the
judgmental focus of one's attention on the emotions, studies that had been analysed found with their attempt
thoughts and sensations occurring in the present to explain the mechanisms of mindfulness skills and
moment.[56] Further analyses on literature done by the how they may lead to both reductions in symptoms and
current study indicate that mindfulness is an ability to changes in behaviour.[67] Further one another study
direct one’s attention in a way that has been practiced comes out with thought that one of these mechanisms is
through meditation with regard to this concept current cognitive change.[68]
study had also reviewed the literature on mindfulness
meditation thus finds its roots in ancient spiritual Anxiety related thoughts and feelings are not always
traditions of Buddhism which is over 2550 years old. reflection of reality it is resultant of our belief system
Further it had been observed by the current study that thus do not need to be avoided in such cases
mindfulness has been both theoretically and empirically mindfulness training can help the individuals in their
associated with wellbeing of the people in general; study self-management and coping skills. Awareness of
also indicates that despite its ancient roots currently the cognitive and emotional events as they happens the
application of mindfulness also found in mental health mindfulness training can help individuals to recognise
practices in western psychology is a recent phenomenon. early signs of a problem so they can work non it.
[57]
Analyses done by the current study had found the Analysed literature by the current study indicates that
elements of mindfulness that have been thought to be mindfulness training can allow and promote recognition
potentially effective tools to treat psychological distress, of these early signs of a problem in individuals who are
such as anxiety, stress and depression.[58,59] Indeed the equipped with previously learned coping strategies and
mindfulness has been cultivated to prevent maladaptive they can effectively manage this problem. [65] Analysing
tendencies to avoid, suppress, or over-engage with one of the past literature the current study indicates that
distressing thoughts and emotions.[58,59] Another mindfulness training teaches acceptance of self and
identified fact by this research analysis is the positive experiencing events fully without using defence, as they
correlations between self-reported mindfulness and are thus do not cling on faulty defensive behaviours.[67]
psychological health.[58, 59, 60]
Current review study had examined although beginning
Observed facts analysed by the current review study of mindfulness practice as a spiritual back ground it has
found that clinical psychology has developed therapeutic been considerably changed in the last forty years
applications based on mindfulness that is most mindfulness being used in a variety of different context
frequently cited mindfulness training for stress from mental health to the work place. Further studying
reduction.[61] Further it had been reviewed by the this issue analysing the past literature current study had
current study that the national health services in United found that the mindfulness as a flexible tradition that its
Kingdom has adapted treatment of depression and use has been seen in various cultures further it has been
anxiety using mindfulness based stress reduction observed that mindfulness ways changing and adapting
programme that is a structured group program uses in response to things has never encountered even in
techniques such as the body scan and take part in group western psychology, technology and it has been
meditations. [62] It is also found that mindfulness based accepted well.[69]
stress reduction course for patient with depression
helped in decreasing levels of depression and anxiety; The current study had observed the reviews of past
further basing on this mindfulness-based cognitive literature in the current scenario there is increase in
therapy has been structured.[63] This therapeutic Mindfulness-based mobile apps as an alternative
intervention has taken a base on mindfulness stress delivery medium for mindfulness training through
reduction intervention programmes. [64] mobile apps that state two major issues. Current study
indicate these two issues observed in the literature; first
The reviewed fact by the current study is the skill of is regarding mental health issues being able to provide
intentional control on individuals thought in mindfulness services and support to the many millions of people, the
meditation could be helpful in preventing relapse of second issue describes how mindfulness and technology
major depression further incorporating elements of are often presented as being in opposition to each other.
[68]
cognitive therapy, patients are taught to observe their Mobile health is a new emerging field which utilizes
thoughts and feelings without judgment and to view technology such as smartphones to enhance and monitor
them as events that will come and go, rather than physical and psychological health.[69]
something which is part of themselves.[65] It is also
identified by current review analysis of past literature
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Research J. Pharm. and Tech. 11(6): June 2018

This study had observed that the highest quality apps studies exhibits mindfulness from the ancient history to
attractively included in the mindfulness education as current advances in mindfulness based mobile apps.
well as guided meditations indicated the effectiveness of Thus suggest that landing with various mindfulness
the headspace mindfulness app used on happiness training programme for the first year students of
seekers’ found to be useful and that had paved a way for university to promote emotional and psychological
significant gains in reducing depressive symptoms.[70] wellbeing can endorse overall healthiness in the
Current study reveals that the very few studies on educational system as well in the communities.
mindfulness based mobile applications has been
suggested that it is an acceptable and innovative method FUNDING:
of delivering mindfulness that can bring the This study obtains Research Acculturation Grant
improvements in mental and emotional wellbeing. Scheme (RAGS), Ministry of Education Malaysia.
Current study finds the need for further research that can
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