Anxiety Disorders: Literature Review on College Student Test Anxiety

This report provides a comprehensive literature review on test anxiety disorders and their effects on college students. It begins with an overview of anxiety disorders, including generalized anxiety disorder, panic disorder, phobia-related disorders, social anxiety disorder, and separation anxiety disorder. The report then focuses on test anxiety, examining its symptoms, causes, and potential treatments. It explores various theoretical frameworks, such as Attention Control Theory and Working Memory Efficiency Theory, to understand the cognitive and emotional aspects of test anxiety. The review also discusses the impact of test anxiety on academic performance and GPA, and the role of college accommodations and financial assistance. The report incorporates research from the past five years, drawing on books, research papers, case studies, and psychology journals to present a thematic analysis of the topic. The report aims to provide a thorough understanding of test anxiety and its implications for college students, offering insights into how this condition affects their academic and personal lives. This document is contributed by a student and is available on Desklib, a platform providing AI-based study tools for students.

Running head: TEST ANXIETY DISORDERS- EFFECT ON COLLEGE STUDENTS
Anxiety in College: The Experiences of College Students with Test Anxiety Disorders
Name of the Student
Name of the University
Author Note

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CHAPTER TWO: LITERATURE REVIEW
Overview
Literature review is a process of collecting secondary data about a particular topic in
order to develop the theoretical understanding as well as the decision making ability for
methodological selection. The purpose of this literature review is to collect and present
secondary data associated with anxiety disorders, test anxiety, potential interventions and
other associated factors. The sources of this literature review are books, previous research
papers, case studies and psychology journals. The presentation of this literature review is
based on thematic review where the themes of the literature review have been chosen based
on the research questions and fields of collecting secondary data. Some themes are also
chosen while reviewing the literatures based on the most frequently discussed topic within
the chosen literatures. The themes of this chosen literature review are Anxiety Disorder,
Types of Anxiety Disorder, Test Anxiety symptoms, causes and treatment, College
Accommodation, Effect of test anxiety on community college students and GPA,
Government financial assistant and Importance of GPAF. This literature review, an inclusion
criteria has been used that is all the chosen literatures have been published within the past
five years.
Theoretical Framework
Several theoretical perspectives and concepts are already present in this field of study
that can be used to develop the theoretical model or concepts about the cognitive
advancement, anxiety issues and measures. The major theories that effectively guide this
study are Eysenck and Calvo's Attention Control Theory, processing efficiency theory,
Yerkes-Dodson law, later by Interference and Learning-deficit Models, Cognitive
Obstruction/Inattention Subscale and Worry Dubscale. Attention Control Theory
conceptualise the pattern of cognition and its association with anxiety. This theory presents

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the association between student environment and the causes of anxiety disorders. However,
the theory is limited to brain functionality and its association with memory processing and
emotional impact. Working memory efficiency theory is highly associated with this theory
further enhanced the understanding connected with this cognition theory and the
psychological attributes of students. The examination and the physiological factors behind the
anxious state in this paper has been driven by the Yerkes-Dodson law and interference and
learning-deficit models. The theory conceptualised the duration of exam and the available
resources for preparedness. Furthermore, Cognitive Obstruction/Inattention subscale and the
along with Worry subscale measures the association of test anxiety with other environmental
factors while assessing the level of negative thoughts the anxiety within students.
Anxiety Disorder
Anxiety disorder is one of the most mental health related problems around the world.
It is reported that the occasional anxiety has become an expected part of the human life and it
is very common to face this during any period of life of an individual. Moreover, it is
reported that the individual may feel anxious when he or she face any type of difficulties in
their life and so it may quite obvious that such condition can hamper the decision making
process of the individual as well. It can be stated that, despite facing such issues during the
decision making process due to the anxiety issues, the individual may face more problems
apart from the issue of dilemma during taking any kind of decision (Stein & Sareen, 2015).
According to the study of Lissek et al. (2015), it is reported that issue of anxiety disorders
present among the individuals are very difficult to overcome and on the contrary, with time
this problem gets worse instead of improvement in the condition. While discussing about the
risk factors of the anxiety disorders, it can be mentioned that both the environmental and
genetic risk factors are highly correlated with the problems of the anxiety disorders among
the people (comprise et al., 2014). According to the study findings of Hofmann and Otto

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(2017), it can be stated that a history of anxiety disorders in the family of the individuals is a
serious risk factor for an individual belongs to that family. In this context it is very crucial to
mention the fact that not only the history of anxiety disorders in the family but the history of
any type of mental illness among the family members or among the biological relatives can
enhance risks of anxiety disorders among an individual. Furthermore, it can be mentioned
that if an individual is exposed to stressful life condition and negative life situation, then there
is a high chances of getting affected by the issue of anxiety disorders. Other crucial risk
factor of anxiety disorder is associated with the physical conditions of the individuals. In this
regard, it can be stated that physical condition such thyroid problems can cause the onset of
anxiety disorders among the patients or individuals (Nelson, Lindstrom & Fels, 2014). In
another study by Peterman, Carper and Kendall (2015), it is stated that the problem of cardiac
arrhythmia can also be a causative factor for the problem of anxiety disorders among the
patients. In this study, it was reported that among the participants who had the problem of
cardiac arrhythmia previously, were more affected by the problem of anxiety disorders.
Therefore, from this study it can be concluded that the cardiac arrhythmia is a major risk
factor for anxiety disorder.
Types of Anxiety Disorder
While discussing about different types of anxiety disorders it can be stated that main types of
anxiety disorders are mainly as follows-
Generalized anxiety disorders (GAD) is very common among the patients and as a part of this
GAD people generally face extreme anxiety or concern, for at least 6 months regarding
different types of things such as social interactions, work, personal health, and circumstances
in normal routine life . The anxiety and fear can cause major problems in different areas of
their life, such as school, social interactions, and work. In this type of anxiety disorder people
generally face various problems such as feeling restless, issue of fatigue, muscle tension,

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difficulties in managing worries and feelings, sleeping disorders. In some cases, it is also
reported that the patients of GAD may face symptoms like poor concentration and become
irritated easily (National Institute of Mental Health, 2020).
Panic disorder is another type of anxiety disorders that is characterized by sudden panic
attacks. A panic attack refers to the conditions in which the individuals may face unexpected
phases of strong fear which come on rapidly and arrive their highest level within a short
period of times eventually within minutes. Such panic attacks can happen surprisingly or can
happen due to onset of some trigger, such as a fearful situation or scary object (National
Institute of Mental Health, 2020). The study findings of Cruz et al. (2015), reported that
during the panic attack one individual may face various problems such as sweating,
palpation, higher heart rate that is tachycardia, symptoms of shaking or trembling. Along with
this, in some cases the problems of chocking, breath shortness are also reported by the
individuals. Along with this, it is also reported that the individuals suffering from the
problems of panic disorders have also the fear of next attack and as a result the issues of
panic are also enhanced among them. In this regard it can be mentioned that those persons
should avoid those places in order to prevent the repetition of panic attack in their life
(National Institute of Mental Health, 2020).
Phobia related disorder is another form of anxiety disorder. A phobia refers to that particular
condition in which the individual is suffering from an intense fear related to a specific
subjects or situations. However, it is quite obvious sometimes the situation demands attention
as they are truly fearful. Therefore, such conditions are associated with the enhancement of
the phobia disorder. Among the specific phobia related disorder a few specific names can be
mentioned and they are mainly flying related phobia, phobia related to the heights, phobia for
receiving injections and observing blood (National Institute of Mental Health, 2020).

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Social anxiety disorder is another type of anxiety disorder that is characterized by problem of
social anxiety among the people and in such conditions people generally face issue of intense
fear and anxiety towards their social performances (National Institute of Mental Health,
2020). According to the study of Leary & Jongman-Sereno (2014), it is stated that the people
feel anxious during interacting with other people. The study also reported that people with the
problem of anxiety disorders believe that their conditions will be evaluated negatively by
other people and it can cause embarrassment of them in front of the society. As a result, in
most of the cases, those people generally avoid any type of social interactions and sometimes
such kind behaviours can affect the their work performances and educational performances in
case of students as poor interaction with other hampers their life (National Institute of Mental
Health, 2020).
Separation anxiety disorder is another anxiety disorder which is caused due to the fear of
separation and in most of the cases, it is stated that the mostly the children are affected by this
problem. However, in recent times adults are also diagnosed with the problems separation
anxiety. People who are suffering from separation anxiety disorder may have fears regarding
being separated from individuals to whom they are close. They frequently concern that
different types of harm or some unwanted thing will occur to those individuals to whom they
are attached closely while they are detached from them. This fear of being separated causes
more fear among them to dodge being detached from their connection figures and to dodge
being alone. People suffering from separation anxiety may face nightmares regarding
separation from the close persons or may experience physical indications when separation
happens or is expected by them (National Institute of Mental Health, 2020).
Test Anxiety
The idea of test anxiety denotes the concerned actions that are mostly observed
among the students, and it is displayed through physiological, cognitive emotional and

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behavioural mechanisms. Cognitive portions of test anxiety usually include negative feelings,
doubts that restrict an individual’s concentration during or before the test, and it causes the
cognitive inadequacies connected to recovery, recall or attentions take place. For many years,
it is stated that the problem of test anxiety disorder has become an emerging issue around the
world and in this regard, it can be stated that in school and colleges a huge number of
students are now have the problem of test anxiety disorder and it is also affecting their
academic performances along with their personal life (Lissek et al., 2014). In a study, it is
observed that the rate of test anxiety disorder among the students is quite high and has
become a serious area of concern for the students and for their parents as well. As per the
findings of Cherry (2019), it is observed that in recent time, most of the students are facing
issues such as stress and anxiety before their examination. However, there are contradictory
viewpoints as well provided by different researchers. In this context, it can be observed that a
little amount of nervousness or tension is actually beneficial for the examination and it can
help in the overall improvement of the performances in the examinations.
Symptoms
While discussing about the symptoms of the test anxiety disorders, it can be stated
that the symptoms of this condition may vary one person to another person. In terms of
severity it can be mild to severe and some students face mild symptoms and some other may
face severe symptoms of this disease. In this regard, it can be reported that students with mild
symptoms of the disease still able to perform well in their examination. As a part of their
anxiety disorder symptoms the students may face panic attacks during or before the
examination (Cherry, 2019). As per the Anxiety and Depression Association of US, the
symptoms of test anxiety disorders can be physical, behavioural, cognitive and emotional. As
a part of the physical symptoms of the test anxiety disorder of the disease, it can be
mentioned that the sweating, faster heartbeat, shaking, dry mouth, nausea and fainting are

7TEST ANXIETY DISORDERS- EFFECT ON COLLEGE STUDENTS
common symptoms of test anxiety disorder. On the other hand the cognitive and behavioural
symptoms include outright avoidance of testing themselves (Cherry, 2019). According to the
study of Opialla et al. (2015), it is stated that the severity of test anxiety disorder can
encourage the students to drop out from the schools or colleges as a part of their avoidance to
the source of fear. Along with this cases of substance abuse are reported by the students.
Many students with the problem of substance abuse often keep their answer sheet blank
during their test out of fear in spite of knowing all the answers.
On the other hand, the emotional symptoms of the condition include the symptoms
like lower self-esteem, depression, anger, restlessness, and feeling of hopelessness.
Causes
While discussing about the cause of test anxiety disorders among the students, it can
be stated that there are mainly two types of causes and they are biological causes and mental
causes. In case of biological cause, the role of adrenaline is very crucial. According to the
study of Zeidner (2014), the secretion of adrenaline in the human body is responsible for fight
or flight response that is the response helps to combat with that particular situation or helps to
escape from that situation. In this context, it can be stated that the secretion of adrenaline is
mostly helpful for the individuals and it helps to cope up with a particular situation in a better
manner. According to Cherry (2019), some students this system works as negative manner
and thus it becomes impossible for them to cope up with that situation that is examination for
the students in this particular situation. In case of mental causes of test anxiety disorder, it can
be stated that it is associated with the perceptions of the individuals. In this context, it is quite
obvious that if the student believe that he or she will not perform well in the examination,
then it will affect the mental conditions of that students in a negative manner and thus it is
very crucial to keep positive perceptions regarding the examination and to avoid this type of

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anxiety disorder one individual should have positive believe regarding his or her examination
(Zeidner, 2014).
Treatment
As a part of the treatment of the anxiety disorder of the students, it can be stated that
the students should prepare well for their examination so that they can be confident enough to
give the examination in a proper manner and it will also help the students to gain confidence
about getting scores in their examination (Dan, Bar Ilan, & Kurman, 2014). According to the
study of Wells and Carter (2014), practicing good and positive thoughts is very helpful for
getting rid of test anxiety disorders and the study also reported that negative thoughts and
behaviours are highly associated with the onset of test anxiety disorders among the students.
In another study by Valerio, Kim and Sexton-Radek (2016), sleep is identified as a crucial
factor for improving the condition of test anxiety disorders of the students. The study
concluded that practicing a healthy and good sleeping pattern can help the students in their
memory process and thus an adequate amount of sleep can help the students to keep their
learning in their memory and as a result they can easily deliver those learning in their
examination as well.
In another study of Khng (2017), it is recommended that one should take deep
breathing when they feel anxious and such exercises also can help the students to overcome
their anxiety before their examination. Not only this, but in some cases the health care
professionals may recommend cognitive behavioural therapy or CBT and anti-anxiety
medications. However, in some cases the combination of both these things is also
recommended by the health care professionals. According to the study of Ewing et al. (2015),
it is stated that the application of the CBT in case of anxiety patients are quite effective and it
has been proven to be successful in improving the anxiety conditions of the patients. In this
present study, it was reported that the anxiety of the patients in the intervention groups

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showed better improvement regarding the problems of anxiety than that of the patients of the
control group who only receives medications of anxiety. In another study by Triscari et al.
(2015), the effectiveness of the combination therapy of CBT and medications was reported
and the study result showed that the patients of the intervention had better condition
compared to the control group who only received CBT therapy and on the other hand the
patients of the intervention group received combination of drugs and CBT therapy during the
study period.
College Accommodation
While discussing about the accommodation issues of the college students having
anxiety disorders, it has been found that the students face a very unique type of problems and
as a part of this they have to seek medical assistances in the college campuses. In US, most of
the campuses although have this facilities till it is not the ultimate solutions for the students
with anxiety disorders. In this regard, it can be stated that students with such kind of
problems generally needs special support from their professors and it is not possible for their
professors to meet their needs. According to Accardo, Kuder and Woodruff (2019), it was
reported that due to lack of assistance from their professors, the students’ academic
performances are greatly affected.
The Effect of test anxiety on community college students GPA
The study findings of Dawood et al. (2016) the relationship between anxiety and academic
performances were examined. In this descriptive cross sectional study the authors included
277 undergraduate college students for examining the association in between academic
performances and test anxiety disorders. In this study, the participants were asked to fill their
personal information regarding age, gender, academic performances including GPA,
academic level, medical history and history of mental illness. Test anxiety inventory was
used to evaluate the primary outcome variable of the study. The students provided responses

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regarding their feelings before the examination by using a four point Likert Scale. The study
result showed that test anxiety scores of the patients were within the range of 20 to 74 and
among the students 14.4 per cent of the students reported about severe level of test anxiety
disorder and on the other hand 50.9 per cent of the students had the problems of moderate
level of test anxiety disorder. Along with this, more than one quarter of the total study
participants had experienced mild test anxiety disorder.
In spite of having a huge number of test anxiety disorder patients among the study
participants, it can be mentioned that there was a significant negative relationship in between
the test anxiety scores and academic levels. Along with this, no significant relationship was
found among the test anxiety scores and undergraduate students’ Grade Point Average
(GPA). Therefore, the study concluded that although no statistically significant relationship
was found among the students’ anxiety disorder and GPA, still a good number of students
experienced test anxiety disorders.
Government financial assistant and Importance of GPA
While discussing about the government’s role in the life of college students, it can be stated
that students have the opportunity to have assistance from the government regarding their
education. In this context, it can be stated that in US government provides assistance to the
students for completing their education and as a result the students have to perform well in
their examination in order to gain those academic scholarships as most of them are dependent
on the GPA of the students. Therefore, from the above literature study, it can be stated that a
huge amount of students are facing the problems of test anxiety disorders and it can hamper
the GPA of the students. As per the rule of US government, it is reported that in order to get
the Gates Millennium Scholarship, the students have to secure at least 3.3 and for the
economically weak students such type of scholarships are very useful (College
Scholarships.org, 2020). Therefore, it can be stated that poor academic performances due to

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test anxiety disorder before their examination can restrict them to get those scholarships. In
case of the scholarship given by American Indian Science and Engineering Society along
with the partnership with Google, a scholarship of $10,000 is given to the students and in
order to get this scholarship the student have to secure a GPA of 3.0 and on the other hand
Hispanic Scholarship Fund also provides support to the economically weaker students. As a
part of this they also provided 10 thousand US dollar to each of the students who are eligible
in terms of economic status and educational qualification that is securing at least 3.0 GPA in
their examination (College Scholarships.org, 2020).
Summary
From this above literature review it has been found that both the environmental and
genetic risk factors are highly correlated with the problems of the anxiety disorders among
the people. It has been also found that if an individual is exposed to stressful life condition
and negative life situation, then there is a high chances of getting affected by the issue of
anxiety disorders. Generalized anxiety disorders (GAD), Panic disorder, Phobia, Social
anxiety and Separation anxiety are the major associated conditions of anxiety disorders
(Opialla et al., 2015). Test anxiety disorder results from the stress level and the anxious state
of mind of a student driven by the fear of failure. Cognitive portions of test anxiety usually
include negative feelings, doubts that restrict an individual’s concentration during or before
the test, and it causes the cognitive inadequacies connected to recovery, recall or attentions
take place. It has been also found that test anxiety disorders can be physical, behavioral,
cognitive and emotional. Practicing good and positive thoughts, cognitive behavioural
therapy or CBT, counselling, physical activity and in critical cases medication can help to
reduce the anxiety issues within the students. From this literature review it can be said that
when it comes to financial deficiency and lack of resources for preparation government has
major role to minimize the education associated anxiety within the students (Dawood et al.,

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2016). In this literature review numerous articles has been found on relationship between
anxiety and academic performances. In several studies it has been found that anxiety because
of lack of resources for preparation is a major cause of test anxiety within students. Most of
the studies in this literature review addressed the underlying factors of test anxiety within the
students that are associated with environmental factors neglecting the other personal and
neurological aspects that can contribute to anxiety issues. It is the major limitation of this
literature review.

13TEST ANXIETY DISORDERS- EFFECT ON COLLEGE STUDENTS
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