A Home-based Approach to Reduce Test Anxiety Using a Combination of Methods: A Randomized Controlled Trial

Abstract

Increasing number of students struggle with test anxiety. Evidence based, online, affordable, and accessible solutions for test anxiety are scarce. The purpose of this study was to evaluate an online delivered, assisted intervention (REST-TA) in a randomized controlled trial.Participants (N = 178) were recruited through a university course and were randomized into a treatment group and waitlist control group. The treatment group completed an 8-week program which consisted of relaxation, skill training and cognitive behavioral methods. Both treatment and control group filled out a battery of questionnaires (TAMC-SF, STAI, DASS, MBI-SS, Resilience) pre and post-treatment.According to our results there was a significant reduction in test anxiety between pre and post intervention. We found a significant increase in trait anxiety, negative affectivity, and burnout in the control group, while no change or slight decrease in these scores in the treatment group. Our analyses also yielded a significant increase in resilience scores in the treatment group while resilience scores did not change for the control group.We conclude that REST-TA was successful at reducing test anxiety. Moreover, it helped to maintain the subjective well-being of students, while increasing resilience. Online solutions are a scalable option for universities to implement, therefore programs such as REST-TA could be of great help to improve the mental health of university students.

The Impact of Resilience Interventions on University Students’ Mental Health and Well-Being: A Systematic Review

“…The most common measures of depression were the Beck depression inventory [93] (BDI) [50,70,74,76], the patient health questionnaire [94] (PHQ)-4 or -9 [48,55,68,86,88], and the depression anxiety stress scales [95] (DASS) [51,52,57,[59][60][61]84,91]. The most common measures for anxiety were the generalised anxiety disorder assessment [96] (GAD-7) [48,62,63], state-trait anxiety inventory [97] (STAI) [50,76,89,90], and DASS [52,57,[59][60][61]84]. Stress was most frequently measured with a version of the perceived stress scale [98] (PSS) [46,49,[54][55][56][57]67,68,71,72,74,…”

“…In addition to the outcomes relating to mental health and well-being, several studies measured resilience using a specific resilience measure (n = 18) [51][52][53]58,61,63,64,66,68,69,74,77,83,84,87,89,91]. It was most commonly assessed with the Connor Davidson resilience scale [100](CD-RISC; n = 10) [52,53,63,64,66,67,69,74,84,89], followed by the resilience scale [101] (n = 3) [78,84,88], and the brief resilience scale [101] (n =4) [58,83,87,91]; one study used the cognitive hardiness scale [102] (n = 1), [46]. Perhaps reflecting the high proportion of studies utilising a mindfulness intervention, a significant number measured mindfulness (n = 11) [47,49,50,53,55,56,60,…”

“…Eight studies implemented a non-randomised controlled trial (NRCT) study design [53,58,62,77,79,80,82,87]. Seventeen studies employed a pre-post without control group study design [48,50,51,59,60,[64][65][66][68][69][70]83,84,86,88,89,91], and twenty-two studies adopted a randomised controlled trial (RCT) study design [45][46][47]49,52,[54][55][56][57]61,63,67,[71][72][73][74][75][76]78,81,85,90].…”

“…The most common type of intervention was mindfulness (n = 18) [47,49,53 Across all intervention types, there was a range of modes of delivery, although online interventions were more frequent in recent studies, as may be expected due to COVID and advances in technology. For skills-based interventions, nine used face-to-face delivery [45,50,63,[74][75][76]78,80,82] and five used online delivery [51,52,59,66,68]. For mindfulness interventions, ten used face-to-face delivery [47,53,60,67,69,71,77,81,87,89] and eight used online delivery [49,[55][56][57]72,86,88,90].…”

“…Three studies were rated 'good' [46,57,90]. Twenty-nine studies were rated 'fair' [45,[47][48][49][52][53][54][55][61][62][63][67][68][69][70][71][72][73][74][75][77][78][79]81,83,85,88,89,91]. The remaining fourteen studies were rated 'poor' [50,52,56,[58][59][60][64][65][66]80,82,84,86,87].…”