Being able to think when caught in the maelstrom - how adolescents used mindfulness when facing exams.

PURPOSE: Research indicates that exam anxiety may decline with mindfulness-based interventions but there is a lack of research on adolescents' accounts of the processes involved. We explored high-school students' descriptions of how they perceived and applied mindfulness in managing anxiety-inducing thoughts related to academic performance following an 8-week Mindfulness-Based Stress Reduction (MBSR) course. METHOD: Post-course individual semi-structured interviews with 22 high school students (2 males, mean age 17.8 years) were transcribed verbatim and analysed using reflexive thematic analysis. RESULTS: The analyses identified six themes: (1) Noticing and attending to the attention-binding "maelstrom" of anxious thoughts and feelings (2) Attending to the breath to cope with the maelstrom, (3) "removing" and "getting rid of" anxious thoughts (4) Being able to "think" (5) awareness of more helpful thoughts, and (6) Agency and control. The findings are discussed in light of the Buddhist notion of "unwholesome thoughts" and the distinction between thought suppression and the use of breathing as a benign distraction. We propose that mindfulness encompasses both a receptive, nonjudgmental awareness and an active, intentional redirection of attention. CONCLUSION: Mindfulness training aided participants by enhancing their capacity to disengage from fear-engaging thoughts, thereby maintaining them within their window of tolerance and facilitating cognitive processing.

The mediating role of cognitive test anxiety on the relationship between academic procrastination and subjective wellbeing and academic performance.

Background: Promoting wellness as a predictor of sustainable development empowers schools to model healthy behavior. The multiple interactions in real and virtual environments that today's youth are subjected to force schools to explore effective educational strategies to provide a quality education for students and their families. Purpose: This study examines the relationship between academic procrastination, assessment anxiety, subjective wellbeing, and academic performance. Methods: A convenience sample of 322 undergraduate students () was used, and questionnaires were administered to students measuring academic procrastination, cognitive test anxiety, and subjective wellbeing. For the same target group, the level of academic performance was identified using personal reports. The questionnaires were administered between May and June 2023 in an online format. For the data analysis, we applied correlational analysis and path analysis using. Results: Both test anxiety and academic procrastination negatively correlate with performance and subjective wellbeing, leading to decreased performance and subjective wellbeing. Procrastination correlates positively with test anxiety. Cognitive test anxiety partially mediated the relationship between academic procrastination and subjective wellbeing and fully mediated the relationship between academic procrastination and academic performance. Thus, high procrastination leads to decreased performance and subjective wellbeing both directly and indirectly through increased test anxiety, leading to decreased performance and subjective wellbeing. Significance/discussions: As a result of theoretical and practical investigations, it emerges that joint action of educational actors is required in the generation of effective educational strategies for the prevention and control of procrastination and evaluation anxiety, given the fact that both a high level of procrastination as well as assessment anxiety led to the decrease of students' wellbeing, to the registration of low academic performances. In the long term, disruptive behavior (procrastination and anxious behavior) could generate low social and professional performance, which is a research question for a future longitudinal study.

Short-term equine interaction for reducing test anxiety and facilitating coping skill development in college students during examination periods: A preliminary study.

Mental health concerns are common among college students and more prevalent during examination periods when stress and anxiety are heightened. While the benefits of equine interaction have been reported, the impact of short-term equine interaction on coping skills valuable for managing test anxiety have yet to be studied. Therefore, the purpose of this preliminary study was to evaluate the impact of short-term equine interaction during the college examination period on development of coping skills and anxiety levels associated with testing, both self-reported and those reflected in physiological measures. Full-time college students engaged in a one-hour equine interaction session held on campus at the onset of final exam week. Participants completed a survey targeting perception of anxiety levels and coping skills. Heart rate and salivary cortisol measurements were collected pre- and post-session. Paired t-tests were performed between pre- and post- session measures and correlations between survey answers and physiological measures determined. Significant reductions were found in all areas of anxiety (Overall Academics P = 0.0003, Final Exam Preparation P = 0.0003, Taking Final Exam P = 0.0003). The reduction in exam-related anxiety was positively correlated to cortisol concentrations (r = 0.69, P = 0.03) with lower concentrations (P = 0.05) and increased heart rate (P = 0.003) post-session. Regarding coping skills, improvements were observed post-session in assertiveness (P = 0.008). Skill development coupled with reduced anxiety supports the potential benefits short-term equine interaction can offer students during the high stress periods, but these findings should be confirmed with more in-depth study.

Do Chosen Learning Strategies Predict Academic Performance in First-Year DPT Anatomy Students?

INTRODUCTION: The purpose of this study was to identify predictors of anatomy final course grades from first-year physical therapist students' characteristics and chosen learning strategies, as indicated on the Motivated Strategies for Learning Questionnaire (MSLQ). Identifying factors that contribute to success in content intensive classes may aid in coaching successful learning strategies as students transition from undergraduate coursework to Doctor of Physical Therapy (DPT) programs. REVIEW OF LITERATURE: Previous studies show that first-year graduate students use ineffective learning strategies that are insufficient for graduate-level study. The MSLQ correlates with academic performance at several educational levels. To date, only one study has examined the correlation of MSLQ with physical therapist students' academic performance for an anatomy course. SUBJECTS: Thirty-nine first-year physical therapist students participated in the study (27 from a hybrid program, 12 from a traditional program). METHODS: This study analyzed MSLQ scores for the total instrument, each domain, and each subscale using regression analyses to determine predictors of final anatomy grades. RESULTS: The subscales of Self-Efficacy and Test Anxiety had significant predictive value for anatomy grades (R2 = 0.455, F = 5.203, P = .029). Test Anxiety had an inverse relationship to anatomy grades, meaning lower test anxiety scores correlated with higher anatomy grades. The combination of Self-Efficacy, Test Anxiety, and Critical Thinking subscales resulted in a significant prediction of anatomy grades (R2 = 0.603, F = 6.659, P = .014). DISCUSSION AND CONCLUSION: This study found moderate correlations between MSLQ Motivation subscales and final grades in DPT anatomy classes. Self-Efficacy and Test Anxiety subscales had the strongest correlations and were significantly predictive of anatomy grades. Faculty may benefit from using inventories like the MSLQ for first-year physical therapist students to identify motivational characteristics associated with success and to remediate students' learning strategies to prevent academic failure.

The Effect of Distance Reiki on State Test Anxiety and Test Performance: A Randomized Controlled Trial of Nursing Students.

BACKGROUND: This randomized controlled, pretest-post-test intervention study examined the effect of distance reiki on state test anxiety and test performance. METHOD: First-year nursing students (n = 71) were randomized into two groups. One week before the examination, intervention group participants performed reiki remotely for 20 minutes for 4 consecutive days, and control group participants received no intervention. RESULTS: The intervention group had lower posttest cognitive and psychosocial subscale scores than pretest scores (p > .05). The control group had a significantly higher mean posttest physiological subscale score than pretest score (p < .05). Final grade point averages were not significantly different between the intervention and control groups (p > .05). One quarter of the intervention group participants noted reiki reduced their stress and helped them perform better on the examination. CONCLUSION: Reiki is a safe and easy-to-practice method to help students cope with test anxiety. [J Nurs Educ. 2024;63(5):298-303.].

Ansiedad frente a exámenes, un tipo de ansiedad fóbica que se presenta en el contexto académico / Test anxiety, a type of phobic anxiety that occurs in the academic context

Experimentar ansiedad frente a exámenes desencadena una respuesta emocional acompañada de cambios fisiológicos que el estudiante siente ante una situación percibida como amenazante, específicamente ante una evaluación, examen escrito u oral; actualmente, se la cataloga dentro de las fobias específicas. El individuo que busca evitar o eludir dicho escenario cae en la conducta de procrastinación. Esto afecta su rendimiento académico y acarrea consecuencias graves de salud mental, el estudiante comienza a percibirse afectado en su autovalia, autoestima y en su ambiente social, que muchas veces lo lleva a contraer trastorno depresivo e ideación suicida. El presente artículo es un estudio de revisión bibliográfica y su objetivo fue describir la experiencia de la. ansiedad frente a exámenes como fobia específica situacional, las consecuencias de dicho padecimiento, su comorbilidad con otros trastornos psicológicos y los tratamientos disponibles. Fueron analizados y comparados unos 26 artículos científicos, basados en ensayos controlados de manera aleatoria, otros son estudios controlados de caso único, publicados en importantes revistas electrónicas de impacto. La búsqueda se realizó utilizando las palabras clave. Como conclusión, se destacó la importancia del conocimiento de esta patología, a fin de realizar un diagnóstico precoz y prevención en psicoterapia, evitando así un mayor deterioro en la salud mental de los estudiantes. No obstante, es necesaria la realización de más investigación controlada al respecto.

Experiencing test anxiety triggers an emotional response accompanied by physiological changes that the student feels in a situation perceived as threatening, specifically in the face of an evaluation, written or oral exam; Currently, it is classified as a specific phobia. The individual who seeks to avoid or avoid this scenario falls into procrastination behavior. This affects their academic performance and has serious mental health consequences. The student begins to feel affected in his or her self-worth, self-esteem, and social environment, which often leads him or her to contract a depressive disorder and suicidal ideation. This article is a bibliographic review study regarding experiencing test anxiety as a situational specific phobia, the consequences of said condition, its comorbidity with other psychological disorders and the available treatments. Some 26 scientific articles were analyzed and compared, based on randomized controlled trials, others are controlled single case studies, published in important impact electronic journals. The search was carried out using keywords. In conclusion, the importance of knowledge of this pathology was highlighted, in order to make an early diagnosis and prevention in psychotherapy, thus avoiding further deterioration in the mental health of students. However, more controlled research is needed in this regard.

The relationship between COVID-19 stress and test anxiety in art students: the chain mediating roles of intolerance of uncertainty and sleep quality.

BACKGROUND: The global spread of COVID-19 has brought immense physiological and psychological distress to students, such as test anxiety and poor sleep quality. This study aims to explore the relationship between COVID-19 stress and test anxiety and the mediating roles of intolerance of uncertainty and sleep quality between them. METHODS: A study was conducted in China during the late stage of the pandemic. A total of 936 Chinese art students (age M = 18.51, SD = 2.11, 46.6% female) completed the Coronavirus Stress Measure (CSM), the 12-item Intolerance of Uncertainty (IUS-12), the Brief Version of the Pittsburgh Sleep Quality Index (B-PSQI), and the Test Anxiety Inventory (TAI). A chain mediation model analysis was conducted to examine the mediating effects of intolerance of uncertainty and sleep quality on the association with COVID-19 stress and test anxiety. RESULTS: COVID-19 stress was positively associated with test anxiety (ß = 0.50, p < 0.001). The intolerance of uncertainty and sleep quality partially and serially mediated the relationship between COVID-19 stress and test anxiety (ß = 0.01, 95% CI = 0.01 to 0.02). CONCLUSION: These findings suggest that art students' intolerance of uncertainty and sleep quality partially and serially mediate the relation between COVID-19 stress and test anxiety. The results have significant implications for the intervention and prevention of test anxiety, providing additional evidence for the relationship between COVID-19 stress and test anxiety.

Coping with test anxiety using imagery rescripting: A two-session randomized controlled trial.

BACKGROUND: Up to 55 % of students experience test anxiety (TA), which is characterized by intense physiological and psychological symptoms before or during exams, such as anxiety, fear of failure, sweating, or increased heart rate. Furthermore, TA increases graduation times and can result in discontinuance of the graduate program all together. Previous research demonstrated the beneficial effects of combining cognitive behavioral therapy with imagery rescripting, however, treatment programs are comparably long. Hence, they do not account for the students´ time-sensitive schedules. Therefore, the present study investigates a two-session short-intervention using imagery rescripting to treat TA. METHODS: 44 students and pupils were randomly assigned to either the two-session imagery rescripting intervention (22 participants) or the waitlist-control condition (22 participants). One week before the intervention clinical interviews were conducted and self-report questionnaires on TA, self-efficacy, symptoms of depression, and intrusive prospective images were completed (T1). The same questionnaires were completed one week (T2) and six months after the intervention (T3). RESULTS: Test anxiety significantly decreased from T1 to T2, as well as from T1 to T3 within the intervention group. Furthermore, there were medium to large within and between group effects for situational test anxiety, self-efficacy, symptoms of depression, as well as prospective intrusive images, showing significant improvements for the intervention group at six months follow-up. LIMITATIONS: The study is limited to the comparably small sample size, as well as the sole usage of self-report measurements. CONCLUSIONS: The presented short-intervention provides a feasible treatment technique, which can be easily applied within school and university counseling centers.

Estudio exploratorio de un taller basado en el Protocolo Unificado para el manejo de ansiedad ante exámenes.

Introducción: La ansiedad ante exámenes es un constructo multidimensional, caracterizado por respuestas fenomenológicas, fisiológicas, conductuales y cognitivas asociadas a una preocupación excesiva sobre posibles consecuencias negativas ante una situación evaluativa. En estudiantes universitarios, presenta tasas de  ocurrencia entre 10 % y 40 %. El objetivo es evaluar la utilidad de un taller grupal y online para el manejo de esta problemática, basado en el Protocolo Unificado. Método: Participaron 31 estudiantes argentinos con edades de 18 a 35 años (M=25; DE= 5,24), siendo el 93.5 % mujeres. Se evaluó medidas pre, post y seguimiento en sintomatología asociada a la ansiedad ante exámenes (GTAI-AR) como variable primaria, y estrategias de regulación emocional (ERQ) y conciencia plena (MAAS) como variables secundarias. Para corroborar diferencias intra grupo se calculó la prueba de Wilcoxon, y como medida de tamaño del efecto (TE), la g de Hedges. Resultados: En cuanto a la variable primaria entre las tres medidas aplicadas, las diferencias fueron significativas con TE moderados y grandes. En las variables secundarias, solo la  reevaluación cognitiva reflejó TE considerables (pequeños) en el pre-post; en el post-seguimiento la supresión expresiva fue la única dimensión que reflejó TE significativos (moderados); y en el pre-seguimiento, únicamente la conciencia plena arrojó TE relevantes (pequeños). Discusión: Los resultados son coherentes con el marco del Protocolo Unificado y las investigaciones actuales sobre su aplicación. Conclusiones: Se espera que estos resultados sean útiles para el diseño de intervenciones similares. Si bien éstos fueron alentadores, se requieren investigaciones de mayor rigurosidad que permitan estudiar su eficacia.

Examining attentional control deficits in adolescents with test anxiety: An evidential synthesis using self-report, behavioral, and resting-state EEG measures.

Attentional control theory suggests that test anxiety hinders individuals' attentional control, aiding our understanding of how test anxiety may impair cognitive function. However, various methods used to assess attentional control have yielded inconsistent findings. Moreover, past studies, especially on adolescents, that examine the distinct impacts of worry and the emotional components of test anxiety on individuals' attentional control capacity are scarce. This study, using self-report, behavioral, and resting-state EEG measures, explores how worry and emotionality, impact attentional control in adolescents. It enhances our understanding of the link between test anxiety and cognitive function. Referring to the effect size from prior studies, a total of 42 adolescents took part in the study. We used the Test Anxiety Inventory, due to it can assess worry and emotionality components. We employed three widely-utilized measures of attentional control: the Attentional Control Scale (ACS), the Go/Nogo task, and resting-state electroencephalography measures (alpha oscillation and the theta/beta power ratio). Both worry and emotionality components were significantly and negatively correlated with the ACS scores. Unlike worry, emotionality demonstrated a significant positive correlation with response times for the Go trials and alpha power in the parietal cortex. These results suggest that, emotionality, but not worry, is highly correlated with attentional control deficits in adolescents. This study underscores the significance of distinguishing between the components of test anxiety, which aids in comprehending the negative impacts of test anxiety on adolescents' academic performance.

EEG correlates of trait test anxiety in the flanker task for adolescents.

Adolescents face constant exams and often experience severe test anxiety. Previous studies suggested that test anxiety impairs individuals' inhibitory control. Neurophysiological evidence suggests that anxiety interferes with the recruitment of the prefrontal region of the brain, which modulates top-down attentional control during the completion of inhibitory control tasks. However, there is little neurophysiological evidence regarding how test anxiety impairs inhibitory control in adolescents. This study used the flanker task to measure individuals' inhibitory control ability, and both event-related potential and electroencephalography indicators were used to measure neurophysiological processes. The results showed that increased trait test anxiety was significantly negatively correlated with theta power oscillation, while adolescents performed both incongruent and congruent trials. This finding suggests that trait test anxiety adolescents are less able to exert greater effort to complete the inhibitory control task and show impoverished top-down attentional control resources.

Test anxiety: Perceptions of Omani nursing students - A descriptive qualitative study.

BACKGROUND: Excessive anxiety may have a detrimental effect on nursing students' performance. Understanding students' experiences of test anxiety (TA) is crucial to improve their academic performance and help them lead a successful professional life. OBJECTIVES: To explore TA from the perspective of nursing students, identify the factors that affect TA and possible interventions to reduce it. METHOD: the setting is a nursing college from Oman. All regular undergraduate nursing students from years 2, 3, 4 and 5 and bridging students (those doing BSc nursing after a diploma in nursing) were invited through their cohort leaders. The interested participants from each cohort signed the consent to participate in the focus group. RESULTS: Thirty students from different academic years participated in five focus groups, each comprising 5-8 undergraduate students and lasted from 45 to 60 minutes. Approximately 80% of the students experienced moderate to severe TA. The causes were divided into students, courses and examiner-related factors. Other themes were signs and symptoms of TA, the impact of TA on different aspects of life, effective management techniques and suggestions for improvement. The findings indicate that TA improves with experience as students advance academically. Furthermore, bridging students face less TA in their clinical practice than regular students and TA impacts more aspects of their lives. CONCLUSION: This study highlights the TA experiences of nursing students at different levels and in different programs. the findings showed that most students experienced test anxiety, but the perception of TA improved when students advanced their academic lives. the distinct experiences of Omani nursing students highlight the importance of tailored interventions to mitigate its impact on academic performance and overall well-being.

The effect of working memory training on test anxiety symptoms and attentional control in adolescents.

OBJECTIVE: The percentage of adolescents with test anxiety is increasing rapidly. Working memory (WM) training has been demonstrated to reduce anxiety levels and enhance attentional control in individuals. Therefore, we investigated whether adaptive dual n-back WM training could lower test anxiety level and improve attentional control in adolescents. METHODS: Forty adolescents were allocated to either adaptive dual n-back WM training (n = 21) or non-adaptive dual 1-back WM training (n = 19) for 10 days. The Test Anxiety Scale was applied to measure individuals' test anxiety symptoms. The Attentional Control Scale (ACS), the flanker task, and the Go/Nogo task were used to measure attentional control. RESULTS: Compared with the control group, the training group reported significantly relief of test anxiety symptoms; however, there were no significant differences between the two groups in pre-to-post changes in ACS scores or performance on the flanker task and Go/Nogo task. CONCLUSION: In sum, adaptive dual n-back WM training effectively reduced adolescents' level of test anxiety but did not improve their attentional control.

Integrative neuro-cardiovascular dynamics in response to test anxiety: A brain-heart axis study.

Test anxiety (TA), a recognized form of social anxiety, is the most prominent cause of anxiety among students and, if left unmanaged, can escalate to psychiatric disorders. TA profoundly impacts both central and autonomic nervous systems, presenting as a dual manifestation of cognitive and autonomic components. While limited studies have explored the physiological underpinnings of TA, none have directly investigated the intricate interplay between the CNS and ANS in this context. In this study, we introduce a non-invasive, integrated neuro-cardiovascular approach to comprehensively characterize the physiological responses of 27 healthy subjects subjected to test anxiety induced via a simulated exam scenario. Our experimental findings highlight that an isolated analysis of electroencephalographic and heart rate variability data fails to capture the intricate information provided by a brain-heart axis assessment, which incorporates an analysis of the dynamic interaction between the brain and heart. With respect to resting state, the simulated examination induced a decrease in the neural control onto heartbeat dynamics at all frequencies, while the studying condition induced a decrease in the ascending heart-to-brain interplay at EEG oscillations up to 12Hz. This underscores the significance of adopting a multisystem perspective in understanding the complex and especially functional directional mechanisms underlying test anxiety.

[A Cognitive Behavioural-Based Intervention in Reducing Test Anxiety in High School Students: A Pilot Cluster Randomized Controlled Trial]. / Intervenção de Base Cognitivo-Comportamental na Redução da Ansiedade Perante os Testes em Alunos do Ensino Secundário: Estudo Piloto Aleatorizado e Controlado Por Clusters.

INTRODUCTION: School-age test anxiety is an important risk factor for school performance. Notwithstanding, few studies seek to identify which strategies are effective in improving test anxiety. The aim of this study was to assess whether a cognitive-behavioural intervention for high school students could significantly reduce test anxiety. MATERIAL AND METHODS: Two-arm, cluster-randomized controlled, unblinded, parallel, trial. Participants were 10th grade students from Alves Martins High School in Viseu, Portugal. Students were randomized at class level to receive a cognitive-behavioural-based intervention combined with mindfulness, psychoeducation, and relaxation techniques, or to a control group with no intervention. Participants' anxiety levels were measured using the Test Anxiety Questionnaire. The analysis of the effect of the intervention was carried out on an intention-to-treat basis at the class level, using multilevel mixed effects models and Bayesian modelling. RESULTS: The intervention had a significant effect in reducing test anxiety (d = 0.81, 95% CI 0.45;1.17, Bayes factor = 31.3). Male gender was an independent risk factor for smaller reductions in anxiety levels. The intervention was more effective in reducing the worry component of test anxiety (d = 0.76, 95% CI 0.41;1.11, Bayes factor = 19.9) than the emotionality component (d = 0.63, 95% CI 0.31;0.95, Bayes factor = 6.6). CONCLUSION: A cognitive-behavioural intervention specifically designed to reduce test anxiety, using a combination of mindfulness, psychoeducation and relaxation techniques, was effective in reducing test anxiety levels. TRIAL REGISTRATION: Retrospectively registered on clinicaltrials.gov (NCT05481099) in 08/01/2022.

Introdução: A ansiedade face aos testes é um importante fator condicionante da performance escolar. Contudo, são escassos os estudos que procuram identificar quais as estratégias eficazes na sua melhoria. Este estudo teve como objetivo testar a eficácia de uma intervenção cognitivo-comportamental na redução da ansiedade face aos testes em alunos do ensino secundário. Material e Métodos: Estudo experimental, aleatorizado por clusters (turmas), controlado, sem ocultação, com dois grupos paralelos, com alunos do 10.º ano da Escola Secundária Alves Martins em Viseu, Portugal. Os alunos foram aleatorizados ao nível da turma para receber uma combinação de técnicas cognitivas e comportamentais, de mindfulness, psicoeducação e técnicas de relaxamento, ou para um grupo controlo sem intervenção. Os níveis de ansiedade dos participantes foram medidos através do Questionário de Ansiedade face aos Testes. A análise do efeito da intervenção foi realizada na base de intenção de tratar ao nível da turma recorrendo a modelos de efeitos mistos multinível e modelação bayesiana. Resultados: A intervenção teve um efeito significativo na redução da ansiedade face aos testes (d = 0,81, IC 95% 0,45;1,17, fator de Bayes = 31,3). Pertencer ao sexo masculino revelou-se um fator de risco independente para uma menor redução nos níveis de ansiedade. O efeito da intervenção foi mais pronunciado na redução da preocupação face aos testes (d = 0,76, IC 95% 0,41;1,11, fator de Bayes = 19,9) quando comparado com a emocionalidade (d = 0,63, IC 95% 0,31;0,95, fator de Bayes = 6,6). Conclusão: Uma intervenção especificamente desenhada para reduzir a ansiedade face aos testes, usando uma combinação de técnicas cognitivas e comportamentais de mindfulness, psicoeducação e técnicas de relaxamento, foi eficaz na redução dos níveis de ansiedade. Registo do Estudo: Estudo registado a posteriori (registo retrospetivo) em ClinicalTrials.gov com o número NCT05481099 em 01/08/2022.

Reducing Test Anxiety During the COVID-19 Pandemic: A Comparison of the Effectiveness of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy.

Educational assessments can affect students' mental health, particularly during a pandemic. Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) are widely efficacious for reducing test anxiety, as well as general anxiety and rumination. However, the effectiveness of these two therapies for students during COVID-19 is unclear. We measured the effectiveness of ACT and CBT for managing test anxiety, general anxiety, and rumination during COVID-19 for 77 students taking Türkiye's national university entrance exam, assigned to either the ACT or CBT psychoeducation programs. Both programs reduced test anxiety, general anxiety, and rumination, and showed similar levels of effectiveness. This suggests that ACT and CBT are both important for improving students' mental health during COVID-19 and either may be beneficial.

Self-regulated learning profiles including test anxiety linked to stress and performance: A latent profile analysis based across multiple cohorts.

INTRODUCTION: Medical educators aim to understand why students differ in performance and stress. While performance and stress are associated with student demographics, school factors and aspects of self-regulated learning (SRL), it remains unclear how these elements interact within individuals. This multi-cohort study identified SRL profiles among medical students and explored their associations with performance and stress. Additionally, we examined the identified profiles' associations with gender, migration status and assessment policy. METHODS: We used latent profile analysis (LPA) to identify profiles on Motivated Strategies for Learning Questionnaire (MSLQ) scores of six cohorts (2014-2019) of Year 1, first semester medical students (n = 1894) in a Dutch medical school. We used nine MSLQ subscales that measure test anxiety (TA), self-efficacy, deep learning, resource management and value. The university's assessment policy varied, demanding students to obtain 100% or 75% of Year 1 credits to remain enrolled. We defined optimal performance as obtaining all credits at the end of Year 1. Two cohorts completed the Perceived Stress Scale (PSS-14, n = 409) in the 2nd semester. RESULTS: We identified three distinct student profiles: 693/1894(36.6%) were classified as TAhighSRLhigh, 661/1894(34.9%) as TAlowSRLhigh and 540/1894(28.5%) as TAmoderateSRLlow. Females were more likely to belong to TAhighSRLhigh profiles compared to males (effect size [ES] Cramer's V = .13, small). Migration background was not associated with these profiles. The TAhighSRLhigh profile was more prevalent under the 100% assessment policy (ES Cramer's V = .10, negligible). TAlowSRLhigh students demonstrated lower stress levels (PSS = 23.9 out of 56) compared to TAhighSRLhigh students (PSS = 28.7, ES Cohen's d = .62, medium) and TAmoderateSRLlow students (PSS = 28.2, ES Cohen's d = .51, medium). Performance differed among the three profiles (ES Cramer's V = .16, small): 82.5% optimal performance in the TAlowSRLhigh, 71.9% in the TAhighSRLhigh and 65.2% in the TAmoderateSRLlow profile. DISCUSSION: Three distinct SRL student profiles associated with gender, academic performance and perceived stress were identified. Test anxiety had additional value in distinguishing subgroups with differential academic performance and stress. These profiles may aid educators to inform personalised support strategies for novice learners.

Validity and reliability of the short Test Anxiety Inventory (TAI-5) in Dutch adolescents.

The present study examined the psychometric properties of the short Test Anxiety Inventory (TAI-5) in a Dutch adolescent sample. The sample consisted of 2063 secondary school students (mean age 13.6 years, 48% girls) who filled out a battery of screening questionnaires for a routine health check. We investigated structural validity with a confirmatory factor analysis, scale reliability with internal consistency coefficients, and construct validity with hypotheses testing and convergent validity. The proposed one-factor structure fitted well in the present sample. However, there was an indication of measurement variance for gender. Scale reliability was high (ω = 0.88), and sufficient positive correlations were found between TAI-5 scores and anxiety, depression, worry, executive functioning, and sleep problems (r ranging from 0.36 to 0.56). Girls had significantly higher test anxiety scores than boys (d = 0.47). The present study provided evidence for the validity and reliability of TAI-5 scores in a general population of Dutch adolescents.

Emotion dynamics of clients with test anxiety before and after an imagery-based treatment.

BACKGROUND AND OBJECTIVES: Imagery-based techniques have become a promising means in the treatment of test anxiety (TA). Although previous studies have demonstrated the effectiveness of imagery-based treatment, not all clients seem to benefit from it. The present study compares clients' pre- as well as post-treatment emotion dynamics between responders and non-responders. Furthermore, it examines treatment-related changes in emotion dynamics in both subgroups. METHODS: The results are based on 44 clients suffering from TA who underwent a six-session imagery-based treatment and include Ecological Momentary Assessment (EMA). Emotions were assessed with the Profile of Mood States four times a day over the course of two weeks before and after the treatment. Temporal networks were computed to index emotion dynamics. RESULTS: Pre-treatment emotion dynamics differed between responders and non-responders. Similarly, post-treatment emotion dynamics differed as well between both groups. Some changes were also observed between pre-treatment and post-treatment networks: for responders, fatigue no longer predicted anger, and depression predicted itself; for non-responders, calmness predicted fatigue, anger, depression, contentment, and anxiety. In addition, fatigue no longer predicted itself and anxiety predicted vigor. LIMITATIONS: The investigation is marked by several limitations: a liberal inclusion threshold of at least a 50% response to EMA prompts, and a relatively homogenous sample. CONCLUSION: These results provide first evidence for the idea that emotion dynamics may be associated with response to treatment for TA. Furthermore, effective imagery-based treatments may be tied to changes within these dynamics.

Prediction of exam scores using a multi-sensor approach for wearable exam stress dataset with uniform preprocessing.

BACKGROUND: Physiological signals, such as skin conductance, heart rate, and temperature, provide valuable insight into the physiological responses of students to stress during examination sessions. OBJECTIVE: The primary objective of this research is to explore the effectiveness of physiological signals in predicting grades and to assess the impact of different models and feature selection techniques on predictive performance. METHODS: We extracted a comprehensive feature vector comprising 301 distinct features from seven signals and implemented a uniform preprocessing technique for all signals. In addition, we analyzed different algorithmic selection features to design relevant features for robust and accurate predictions. RESULTS: The study reveals promising results, with the highest scores achieved using 100 and 150 features. The corresponding values for accuracy, AUROC, and F1-Score are 0.9, 0.89, and 0.87, respectively, indicating the potential of physiological signals for accurate grade prediction. CONCLUSION: The findings of this study suggest practical applications in the field of education, where the use of physiological signals can help students cope with exam stress and improve their academic performance. The importance of feature selection and the use of appropriate models highlight the importance of engineering relevant features for precise and reliable predictions.