Student Mental Health Resources

Test anxiety is “worry or fear caused by having to take tests.” Students may describe symptoms of test anxiety in several ways. For example, some students describe test anxiety as “mental distraction” in which they are unable to concentrate, because they are distracted by a variety of external factors. Some students experience test anxiety as physical symptoms, such as “butterflies” in the stomach, a quickened heart rate, rapid or shallow breathing, nausea, sweaty palms, headache, etc. Students also have characterized test anxiety as a “mental block” during which they are unable to focus on the assignments (exams, oral quizzes, etc.) that they are confronting.

There is no magic cure for “test anxiety.” However, students who develop an understanding of what test anxiety is and who acquire and practice techniques to allay the potential debilitating aspects of test anxiety are better able to prepare themselves for a successful educational experience.

The material in this section was adapted from About Test Anxiety, Channing Libete Co., Inc., 1987.

Many students face anxiety when approaching an exam. However, for certain students, this anxiety may become severe enough that it affects how they function during the exam. Some students become quite anxious because they have failed exams in the past and they fear that they will experience this failure again. Students experiencing “test anxiety” may remark that they studied and believe they mastered and comprehend the material; yet, because of the anxiety, they may not perform adequately on the exam.

Test anxiety may result from “pressure, past experience, and fear of failure” (p. 4). Suggestions for managing test anxiety include the following:

1. Give yourself permission to believe that one test will not influence all future educational and career endeavors.

2. Learn about stress and develop relaxation techniques. Practice the techniques daily and use them when you’re experiencing anxiety.

3. Believe that active study procedures yield positive results.

4. Remember that the important people in your life (parents, friends, significant other, etc.) will still care about you despite your test score.

5. Develop appropriate study strategies to curb or eliminate test anxiety.

6. Remember that studying is an individual process. Each student establishes study strategies that are effective for him/her. A study approach that works for your best friend may not be the one that is most beneficial to you.

7. Acquiring relaxation techniques might help in testing situations in which anxiety is so high that test answers are forgotten during the exam but recalled minutes after handing in the test.

1. Select an appropriate place to study that is free from distractions. Attempt to study in the same location on a daily basis. Be alert and rested when you are studying.

2. Look over class notes as soon as possible after each class. Incorporate review time each 2-3 days to re-review your class notes.

3. Schedule your time so that you are aware of test dates, review periods, and social/recreational time. Consider studying in shorter blocks of time (such as 30 minute sessions) rather than one 4-hour period.

4. Determine study strategies that are effective for you. For example, some students learn well with note cards. Others find that notes in the margins of their class notes or brief outlines enable them the most effective learning.

5. Acquire good eating and sleeping patterns so that your mind and body are functioning well. Make a concerted effort to practice study strategies so that “cramming” is eliminated.

1. Plan your time. Check to see how many points each question is worth. Spend more time on the questions that are worth more points.

2. Determine which questions are the easiest and do those first.

3. Budget time to review your answers before handing the test in.

4. Try not to panic when confronting a difficult question. Place a mark beside the questions and continue. Go back later, and try to answer the hard questions.

5. Be alert to words such as “always,” “never,” “after,” etc.

6. Take time to assure yourself that you understand what the questions is asking in a multiple-choice exam.

7. If there is no penalty for guessing, take time to go back and answer any questions that were skipped earlier in the test.

1. Seek assistance from an academic support counselor or other qualified professional on the University campus. Tips on how to combat test anxiety and other study strategies are usually available.

2. Talk to your friends and classmates. Perhaps they have experienced similar concerns and can provide some ideas that may help you.

3. Visit the class instructor if you are encountering difficulty with course material or with comprehending lectures.

4. Discuss your feelings with the important persons in your life (parents, spouse, girl/boyfriend, etc.) Receiving their support and concern may help in calming your fears.

Active Minds is a nonprofit organization supporting mental health awareness and education for students. Active Minds is opening up the conversation about mental health and creating lasting change in the way mental health is talked about, cared for and valued in the United States.

See general information about Active Minds here.

Email Bailey Keller at bkeller5@pennstatehealth.psu.edu for details about the College of Medicine chapter of Active Minds.

When you're studying, distracting thoughts will slow you down (e.g., less efficient/study longer). Even worse, you are practicing distracted thinking while you study.

What you practice, you perform. Research indicates that when people are stressed (like at the time of a test), it is more challenging to think critically. Stressed individuals typically resort to automatic thinking (or thinking that has been practiced repeatedly). If you are studying in a distracted state, you are practicing distraction and this may manifest on the exam. To enhance your concentration and decrease distraction while studying:

• As you read or review the study material, attend actively to your "running dialogue." Your running dialogue is your thoughts, attitudes, or feelings about what you are reviewing or may be distracting thoughts.

• Examples of distracting thinking include:

  • Reading the same paragraph or page three times and you still cannot recall what you've read.

  • Thinking about another assignment, test or project while you are studying.

  • Thinking about non-academic-related activities (e.g., what's for lunch? I wonder what so-and-so is doing now, etc.)

  • Thinking about what you reviewed 10 minutes ago or what you are going to review 10 minutes from now.

• Remind yourself that all of the things that intrude in your thinking (i.e., distracters) are likely important, just not at this time.

• Write out distracting thoughts on paper as they come to you.

• Say to yourself, "These things are important, just not at this time."

• Re-direct your focus to your study material.

• During each study break, allow yourself to actively worry about what you have written down as a distraction.

  • Intentional worrying tends to be more productive than intrusive worry.

  • The distracters likely have some significance if they called your attention away from the material.

• Remind yourself: You are preparing not only by learning the content, but also by training the state of mind you hope to have when you take the exam (i.e., high concentration/low distractibility). If you practice this enhanced concentration, this state of mind will most likely occur automatically at the time of the exam.

Preparing for Step 1 and Step 2 exams adds significant stress to an already demanding curriculum. To help you stay calm, confident, and focused during this critical time, the Office of Professional Mental Health has put together a list of practical tips and strategies to support your mental health.

Download PDF version of the guide

Negative thinking is much like distracting thinking, only worse. With negative thoughts, not only are you distracted, but also you practice critical or self-debasing thinking.

The more you practice negative thinking, the better you get at it, and the more it becomes automatic in your thinking.

When individuals are stressed (like at the time of an exam), they tend to not think clearly and use automatic thinking more often. If you've rehearsed negative thinking, you will most likely think negatively automatically at the time of an exam.

To decrease negative thinking and practice more functional thinking while preparing for an exam:

• As you read or review the study material, attend actively to your "running dialogue." Your running dialogue is your thoughts, attitudes, or feelings about what you are reviewing or may be distracting thoughts.

• Examples of negative thoughts include:

  • "I should know this by now."

  • "I am never going to get through all this material."

  • "I may know this stuff now, but I'll surely forget it by the time the test occurs."

• Remind yourself that you do not want to have such negative thoughts become rehearsed and to occur automatically at the time of an exam.

• Write out negative thoughts on paper as they come to you.

• After writing, take the opportunity to reframe the negative thought and make it more functional or positive. This must be done in a realistic, non-fluff way. Your reframed thought (the thought you hope will become automatic) is something that you have to believe.

Examples of reframed negative thoughts include:

• "I should know this by now" ... "I learn different content areas at different paces. Some info will be remembered easily and some will be more challenging" OR "If I continue to follow my study plan, I will remember and be able to verbally recall more and more" OR "It doesn't serve me to be frustrated right now. I need to 'stay the course' and continue to focus until the break."

• "I am never going to get through all this material" ... "Although there is a lot to go through, I'm going to prioritize the study material and focus upon the most important information first."

• "I may know this now, but I'll likely forget it on the test" ... "I have recalled important details on previous tests" OR "If I relax, concentrate, and take one section at a time, I'll succeed" OR "A relaxed mind recalls much more information than a stressed mind."

Although initially reframing negative thinking is time consuming, the more you do it, the more proficient (or automatic) you do it. As you become more proficient, you’ll reframe negative thinking automatically.