2013. Vol.4, No.6A1, 18-24
Published Online June 2013 in SciRes (
Copyright © 2013 SciRes.
Test Anxiety, Depression and Academic Performance:
Assessment and Management Using Relaxation
and Cognitive Restructuring Techniques
Esther F. Akinsola, Augustina Dubem Nwajei
Department of Psychology, Faculty of Social Sciences, University of Lagos, Lagos, Nigeria
Received April 15th, 2013; revised May 17th, 2013; accepted June 14th, 2013
Copyright © 2013 Esther F. Akinsola, Augustina Dubem Nwajei. This is an open access article distributed under
the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any
medium, provided the original work is properly cited.
Examination as a word evokes varying degrees of anxiety in students depending on the importance of the
examination, perceived difficulty level of the subject, and degree of preparedness for the examination. A
perceived difficult subject would elicit higher anxiety levels, and test anxiety as a psychological condition
can adversely affect people in every field of life (Cohen, 2004), and especially it adversely affects stu-
dents who face different examinations. The suspicion is that test anxiety may not exist alone but co-exist
with other forms of psychological distress such as depression, and psychological intervention such as
cognitive therapy is expected to reduce students’ anxieties and any other psychological distress and con-
sequently improve their academic performance. In an attempt to verify our suspicion and confirm the ex-
pectation, 420 senior secondary school students made up of 210 males and 210 females aged between 13
and 19 years responded to test anxiety, trait anxiety, and depressive symptoms inventories. 72 of the stu-
dents whose test anxiety scores were higher than the group’s average score were divided into three groups
and treated under three conditions of “no treatment”, “relaxation treatment alone”, and combined “relaxa-
tion and cognitive restructuring treatment”. Results obtained show that test anxiety, trait anxiety, and de-
pression co-exist and are positively related, and they are negatively related to academic performance. In
addition the combination of relaxation and cognitive restructuring treatment reduced anxiety and depres-
sion better than relaxation treatment alone or no treatment and improved test performance of the students
much more than any of the other two conditions. The findings thus confirm the effectiveness and efficacy
of cognitive therapy in managing anxiety and depression and improving academic performance, and when
combined with relaxation technique, the combination optimizes academic performance.
Keywords: Test Anxiety; Academic Performance; Relaxation & Cognitive Restructuring
“We live in a test conscious and test giving culture in which
the lives of people are in part determined by their test perform-
ance” (Sarason, Davidson, & Lighthall, 1960: p. 26). As it was
then in 1960 even so it is now in 2013. Tests and examinations
at every educational level have become a global and very pow-
erful strategy for decision making about people at all ages and
all strata. All over the world people are evaluated in terms of
their skills, abilities and achievements and such evaluations are
determined by their test performance (Rana & Mahmood,
One of the challenges in the educational sector is examina-
tion problem. The word “examination” though familiar to all
students, it evokes varying degrees of anxiety in them depend-
ing on the importance attached to the examination and their
level of preparedness for the examination. Furthermore the se-
verity of such anxiety increases as the examination approaches,
and peaks on the night preceding the examination (Tooran-
poshti, 2011).
Test Anxiety and Academic Performance
Test anxiety is a psychological condition in which people
experience extreme distress and anxiety in testing situations.
While many people experience some degree of stress and anxi-
ety before and during examinations, test anxiety can actually
impair learning and hurt test performance. Test anxiety is an
overwhelming feeling of disturbance and distress among stu-
dents globally and can be a devastating problem for them be-
cause it may impair their performance and their well being later
in life in the long run (Farooqi, Ghani, & Spielberger, 2012;
Rafiq, Ghazai, & Farooqi, 2007). According to (Cohen, 2004),
test anxiety can adversely affect people in every field of life
whenever and wherever people of all ages and strata have to be
evaluated, assessed and graded in terms of their abilities,
achievements or interests.
Zeidner (1998) outlined three components of test anxiety to
be cognitive, affective, and behavioural. The cognitive compo-
nent involves worry or negative thoughts, depreciating self
statements that occur during assessments and performance in-
hibiting difficulties that may arise from anxiety (e.g. problem in
recalling facts, difficulty in reading and understanding ques-
tions). The affective component includes the person’s appraisal
of his/her physiological state such as tension, tight muscles and
trembling. The behaviour component includes poor study skills,
avoidance and procrastination of work.
Zeidner (1998) cited Carver & Scheier (1984) as arguing that
test anxious persons are likely to have strong and chronic
doubts about either producing adequate performance on ex-
aminations, being evaluated favourably by significant others, or
being able to control their feelings so that they would not be
overwhelmed by them.
Speilberger & Vagg (1995) regarded test anxiety as a situa-
tion specific or state anxiety which is a temporary emotional
state. This according to Speilberger, Gorsuch, & Lushene (1970)
is different from trait anxiety which is a constant personality
characteristic. According to Speilberger & Vagg (1995), test
anxious individuals are more prone to react with excessive
anxiety such as worry, negative thoughts, nervousness and phy-
siological arousal across testing situations. This proneness pre-
disposes them to experiencing more intense levels of state
anxiety which is considered as the emotional component of test
anxiety in evaluative situations. The high level of state anxiety
among test anxious people activates worry conditions stored up
in memory and these conditions interfere with test performance
(Zeidner, 1998). A positive relationship between trait and test
anxiety is therefore expected.
Hebb’s Theory of Arousal (1972)
Hebb’s theory which is useful in explaining the relationship
between test anxiety and academic performance was an adapta-
tion of Yerke’s Dodson law (1908). The theory states that hu-
man beings seek out an optimal level of arousal such that too
low arousal brings about boredom while too high arousal leads
to stress. This theory predicts a U-shaped function between
arousal (anxiety) and performance. It assumes that both low and
high levels of arousal (anxiety) produce minimum performance
while a moderate level results in maximum performance. Arou-
sal can be high at times of excitement or panic.
Numerous studies have been carried out to determine the re-
lationship between test anxiety and performance. In one study,
Cassady and Johnson (2002) found that cognitive test anxiety
exerts a significant stable and negative impact on students’
academic performance. In another study, Kassim, Hanafi, &
Hancock (2008) investigated the consequences of test anxiety
on academic performance among university students, and found
test anxiety to be negatively related to academic performance.
Hancock (2001) studied the effects of students’ test anxiety and
teacher’s evaluation practices on students’ achievement and
motivation at post secondary level and found that students with
high anxiety level performed poorly and were less motivated to
learn. Ndirangu, Muola, Kithuka, & Nassluma (2009) in their
own study on the relationship between test anxiety and aca-
demic performance found that secondary school students exhib-
ited higher anxiety levels before the examination in all subjects.
Chapell, Blanding, Takahashi, Silverstein, Newman, Gubi, and
McCann (2005) explored the relationship between test anxiety
and academic performance using graduate and undergraduate
students as participants. They found a negative relationship be-
tween test anxiety and academic achievement. In a more recent
study, Rana & Mahmood (2010) investigated the relationship
between test anxiety and academic achievement. They found a
negative relationship between test anxiety and achievement.
They also found that a cognitive factor (worry) contributes
more in test anxiety than affective (emotional) factor. In another
study, Marzieh Gholami tooranposhti (2011) examined the ef-
fect of self regulation education on test anxiety, academic
achievement and meta-cognition and found that self regulation
education reduces test anxiety. Farooqi, Ghanl, & Spielberger
(2012) in their own study examined gender differences in test
anxiety and academic performance and found that female me-
dical students reported higher test anxiety levels than male
medical students. They also found a negative relationship be-
tween test anxiety and academic performance.
Depressi on and Academic Performance
Depression as a mood disorder affects a person’s ability to
perform life activities including academic performance (Hy-
senbegasi, Hass, & Rowland, 2005). It is common for people
who suffer from depression to engage in self blame, experience
confusion and a feeling of hopelessness. The major components
of depression are loss of interest in activities that were once
found pleasurable and a depressed mood (Schwartz & Schwartz,
1993). It has been found that loss of interest aspect of depres-
sion is associated with lower grade point averages and students
who suffer from both anxiety and depression had poor aca-
demic performance (Eisenberg, 2009).
Beck’s Cognitive Behavioural Theory of Depression
Beck proposed that negative automatic thoughts generated by
dysfunctional beliefs were the cause of depressive symptoms.
He hypothesized that depressed patients have a negative view
of themselves, their environment and their future. Depressives
distort reality by harbouring negative feelings about anything
and everything and they develop thoughts of worthlessness and
inferiority (Papalia & Olds, 1988; Schwartz & Schwartz, 1993).
Beck maintained that depression-prone individuals are more
likely to notice and remember situations in which they have
failed or did not live up to some personal standard while ignor-
ing successful situations. As such they maintain their negative
sense of self leading to depression (McGinn, 2000).
Some groups of people have been identified as having higher
chances of developing depression. Such people include the poor,
the unemployed, women and students (Wetzel, 1984). Some
studies have focused on adolescent’s depression while some
focused on the relationship between depression and academic
In one of such studies on adolescent’s depression, Moilanen
(1995) found that the student’s depression was often associated
with dysfunctional beliefs and negative future attitudes. She
suggested that the cognitive theory has reasonable validity for
describing the systems of depression for non-referred adoles-
cents. In an earlier study (Moilanen, 1993) evaluated depression
in college students and found that students’ current depressive
states were consistently related to their negative processing of
personal information (Moilanen, 1993: p. 345). She found that
the students’ cognitive thoughts were affecting them and mak-
ing them develop symptoms of depression and thereby sug-
gested a cognitive treatment for students’ depression. Studies
that focused on the relationship between depression and aca-
Copyright © 2013 SciRes. 19
demic performance include those carried out by Hysenbegasi et
al. (2005), DeRoma, Leach, & Leverett (2009), Busari (2012),
and Owens, Stevenson, Hadwin, & Morgate (2012).
Hysenbegasi et al. (2005), studied the impact of depression
on the academic productivity of university students and found
that depressed students reported a pattern of increasing inter-
ference of depression symptoms with academic performance
peaking in the month of diagnosis and decreasing thereafter
with the lowest levels reported in 4 to 6 months post diagnosis.
DeRoma et al. (2009) in their own study examined the associa-
tion between self reported depressive symptomology and col-
lege academic performance. They found a significant and nega-
tive relationship between depression and academic performance.
In addition they found that students who reported moderate
levels of depressive symptoms demonstrated lower perform-
ance within academic environments when compared to those
with normal and minimal levels of depression. In another study,
Busari (2012) evaluated the relationship between gender, age
depression and academic performance among adolescents. She
found that depression and academic performance were signifi-
cantly and negatively correlated, age and academic perform-
ance were significantly and positively correlated and females
performed significantly better than males. Owens et al. (2012)
in their own study investigated the relationship between nega-
tive affect, worry, working memory and academic performance.
They found that higher levels of anxiety and depression were
associated with lower academic performance and concluded
that academic performance is reduced in young people with
high levels of anxiety or depression as a function of increased
test-specific worry that impinges on working memory central
executive processes. If worry and negative thoughts are the
cognitive component of anxiety (Zeidner, 1998; Speilberger &
Vagg, 1995), and negative automatic thoughts generated by dys-
functional beliefs (cognitive components) are the cause of de-
pressive symptoms (Beck, 1976, 1983) then an appropriate treat-
ment for anxiety and depression must involve cognitive ther-
Beck’s Cogni t i ve Beh aviour Therap y- C og niti ve
In treating depression Beck emphasized understanding and
changing the patient’s core beliefs. By restructuring destructive
thinking he believed that positive changes could be brought in
the patient (Loveleena Rajeev, 2013). The therapist is expected
to involve the patient in setting realistic goals and taking re-
sponsibilities for action and thought. By changing thought and
perception a change in behaviour and emotional responses can
result. The patient is educated on the concept of faulty thinking
and new ways and ideas are generated to develop a positive
outlook of self experiences and environment (Loveleena Rajeev,
2013). In therapy the patient learns to apply cognitive restruc-
turing techniques so that negatively distorted thoughts underly-
ing depression can be corrected and replaced with more logical
and adaptive thinking. Many studies have been conducted to
ascertain the efficacy of cognitive therapy for depression. In
one of such studies, Rush, Beck, Kovacs, & Hollon (1977)
compared the use of therapy with the use of tricyclic antide-
pressant therapy (pharmacotherapy) using patients suffering
from clinical depression. They found that cognitive therapy was
more effective than tricyclic anti-depressant therapy and relapse
rates were lower among patients who received cognitive ther-
In another study, Blackburn, Bishop, Glen, Whalley, &
Christie (1981) investigated the efficacy of cognitive therapy
and pharmacotherapy each alone and in combination in the
treatment of depression. They found that cognitive therapy was
superior to drug treatment in general practice, the antidepres-
sant drug group did less well in both hospital and general prac-
tice, and the combination treatment was superior to drug treat-
ment. Some other researches that involve meta-analyses of the
effects of cognitive therapy in treating depression (e.g. Dobson,
1989; Wampold, Mnami, Baskin, & Callen Tiemey, 2002; Glo-
aguen, Cottraux, Cucherat, & Blackburn, 1998) found that cog-
nitive therapy was superior to no treatment or placebo; cogni-
tive therapy is as effective as interpersonal or brief psycho-
dynamic therapy in managing depression. They also found that
cognitive therapy is as effective and even more effective than
pharmacotherapy in managing mild to moderate unipolar de-
In a review of studies on cognitive therapy and depression,
Stuart J. Rupke, David Blecke, & Marjorie Renfrow (2006)
confirmed that cognitive therapy is an effective treatment for
depression and is as effective as antidepressants or interper-
sonal or psychodynamic therapy. Their review also confirmed
the effectiveness of the combination of cognitive therapy with
other forms of therapy. They also affirmed that some studies
have shown that cognitive therapy is effective for managing
adolescents with depression. Some studies have also shown that
relaxation techniques can be used to manage some mental
health conditions including anxiety and depression. In the re-
view of studies on anxiety, e.g. Sultanoff & Zalaquett (2000)
found that drug and behaviour treatments have similar short-
term effect but behavioural treatment had better long-term ef-
fects than drug treatment of anxiety disorders. In another study
Biabangard (2003) compared the effectiveness of Lazarus mul-
timodal therapy, Ellis Rational Emotive therapy, relaxation and
placebo in decreasing students’ test anxiety. The findings re-
vealed that the four therapeutic methods were more effective in
reducing anxiety than the control group. Lazarus multimodal
therapy was found to be more effective in reducing anxiety than
relaxation, placebo and control groups.
Based on the above reviewed literature it is reasonable to
expect a relationship between trait anxiety and test anxiety, test
anxiety and depression, gender and test anxiety. It is equally
reasonable to propose that cognitive therapy and relaxation
techniques would be effective in reducing anxiety and depres-
sion in secondary school adolescents and consequently im-
proving their performance. This study attempted to verify this
expectation with the following hypotheses as guides
1) There would be a positive relationship between trait anxi-
ety, test anxiety and depression.
2) Female participants would report higher levels of test
anxiety than males.
3) Cognitive restructuring and relaxation techniques would
be effective in reducing anxiety and depression and improving
test performance in the students such that post treatment per-
formance would be better than pre-treatment performance in
mathematics test.
4) Students who received cognitive restructuring and deep
breathing relaxation therapy would perform better than those
Copyright © 2013 SciRes.
who received only deep breathing relaxation therapy and the
control group that received no therapy.
420 senior secondary school students consisting of 210 males
and 210 females aged between 13 and 19 years participated in
the assessment phase of the study. The participants were non-
clinical and non referred students randomly selected from
classes I, II and III of three different secondary schools. 140
students were selected from each class respectively. Out of the
420 students that participated in the assessment phase 72 of
them whose test anxiety scores were higher than the sample’s
mean score took part in the treatment phase.
The instruments administered to the students were state-trait
anxiety inventory (STAI), test anxiety inventory (TAI), symp-
toms distress checklist (SCL-90) and mathematics test.
S tate-T rait Anxiety Inventory (ST AI Y-2)
This inventory developed by (Spielberger, 1970) measures
general anxiety. It consists of two forms Y-1 and Y-2. Y-1
measures state anxiety which is the present state anxiety level
of the individual while Y-2 measures trait anxiety which is the
relatively stable predisposition of a person to being anxious.
The form Y-2 was used in this study to measure the students’
predisposition to being anxious and the test anxiety inventory
was used to measure their situational anxiety level. Form Y-2
consists of 20 items and the responses to them vary from “al-
most never” to “almost always” with a minimum score of 20
and maximum of 80. Spielberger provided reliability coeffi-
cients of 0.90 and 0.91 for the two forms. For the present sam-
ple the reliability coefficients for Y-2 are: Cronbach alpha =
0.80, split half = 0.72 and one week test retest = 0.85.
Test Anxiety Inventory (TAI)
This inventory also developed by (Spielberger, 1980) meas-
ures anxiety proneness to examinations and evaluative situa-
tions. The inventory consists of 20 items that assesses two
components of test anxiety namely worry (W) and emotionality
(E). Responses to the items vary from “almost never” to “al-
most always” with a minimum score of 20 and maximum of 80.
Worry (W) was defined as excessive pre-occupation and con-
cern about the outcome of examinations, especially the conse-
quences of failure. Worry is a cognitive component of test anxi-
ety (Zeidner, 1998). Emotionality was defined as an individ-
ual’s behavioural reactions and feelings aroused by test situa-
tions. The test anxiety composite score was defined as the over-
all cognitive, affective and behavioural reactions to examina-
tion situations. Spielberger (1980) reported reliability coeffi-
cient of 0.08 for the inventory. The reliability coefficients for
the present sample are: Cronbach alpha = 0.77, split half = 0.78,
and one week interval test retest = 0.87.
Symptoms Distress Checklist (SCL-90)
This checklist was developed by Derogatis, Lipman, & Covi
(1977). It consists of 10 subscales that measure 10 categories of
symptoms associated with stress. Subscale D designed to assess
depression was used to determine the depression status of the
students. This subscale consists of 13 items and the responses
to them vary from “not at all” to “extremely” with the mini-
mum score being zero and the maximum 52. Derogates et al.
reported Cronbach alpha and test retest reliability coefficients
of 0.90 and 0.90 for the subscale respectively. For the present
sample the reliability coefficients are: Cronbach alpha = 0.70,
split half = 0.63, one week test retest = 0.88
Mathema tics Te st
The mathematics test was constructed by the researchers in
line with the taught syllabus of each class and using the con-
tents in the relevant sections of the mathematics textbooks of
their respective classes. The test contains multiple choice an-
swer questions considered appropriate for their respective
classes. The mathematics test was given to the 72 students in
the treatment groups. Mathematics examination has the poten-
tial of evoking high level of anxiety in secondary school stu-
dents. This is because for them to go beyond secondary school
level to tertiary institutions a minimum of grade C (Credit) in
Mathematics and English language are required and many stu-
dents don’t like mathematics because of the calculations in-
volved. As such it was expected that the students would per-
form poorly in the mathematics test and the application of cog-
nitive therapy and relaxation techniques would reduce their
anxiety and depression levels and consequently improve their
performance in the test when taken again after therapy.
In the assessment stage the three instruments measuring trait
anxiety, test anxiety and depression were administered to the
420 students to determine the base line for selecting those who
would participate in the treatment phase. It was ensured that the
students were comfortably seated in a well ventilated and bright
room before the administration of the tests.
In the treatment phase 72 students whose scores on test anxi-
ety were above the sample’s mean score were randomly se-
lected and divided into three groups of 24 participants per
group and 8 participants from each of the three classes in each
group. Each group was made up of 15 males and 9 females.
The treatment involved the use of deep breathing as a relaxa-
tion technique and cognitive restructuring as cognitive therapy
technique. The first group (Group 1) served as the control
group and did not receive any treatment. The second group
(Group 2) served as the experimental group I and received only
deep breathing relaxation as treatment. The third group (Group
3) served as experimental group II and received both deep
breathing relaxation and cognitive restructuring as treatment.
The experimental group I received (8) ten minutes sessions of
deep breathing relaxation while the experimental group II re-
ceived (8) ten minutes sessions of deep breathing and (6)
twenty minutes sessions of cognitive restructuring. In the course
of the cognitive therapy the students were encouraged to exam-
ine their attitudes toward examinations and construct positive
self affirmations by creating personal words and phrases that
carry the meaning of success in examinations to describe them-
selves. They were also encouraged to visualize themselves
Copyright © 2013 SciRes. 21
succeeding and rehearsing forthcoming examination situations.
After the treatment sessions parallel forms of the mathematics
tests were given to three groups under the same conditions as
the pre-treatment
Hypothesis 1
There would be a positive relationship between trait anxiety,
test anxiety and depression.
The mean scores of the students in the three measures re-
corded in Table 1 above represent the norms for the three scales
and indicate that the students’ proneness to anxiety is high and
thinking about approaching test can aggravate their anxiety
levels. The participants’ mean scores are: 42.58, 42.43, & 14.39
for trait anxiety, test anxiety and depression respectively. In
Tab le 2 the correlation coefficients of 0.422, 0.319 and 0.284
indicate positive and significant relationships between trait
anxiety, test anxiety and depression. The implication is that the
higher the students’ predisposition to anxiety the higher the test
anxiety and depression they reported. These results lend sup-
port to the first hypothesis.
Hypotheis 2
Female participants would report higher levels of test anxiety
than males.
Looking at Tab le 3 above the difference between the mean
scores of males and females in test anxiety is not significant
Table 1.
Mean and Std. Dev of participants’ scores on anxiety and depression
Measures N Mean Std. Dev.
Trait anxiety 420 42.58 7.44
Test anxiety 420 42.43 8.83
Depression 420 14.39 7.59
Table 2.
Correlation matrix of anxiety and depression variables.
Test anxiety Trait anxiety Depression
Test anxiety
Trait anxiety 0.422*
Depression 0.319** 0.284**
Table 3.
Mean and Std. Dev. of participants’ scores on test anxiety according to
Variable Group N Mean Std.
Dev. Df Calculated
t P
Anxiety Male 210 42.71 8.86 418 0.65 1.98 P > 0.05 NS
Female 210 42.15 8.81 − −
indicating that males and females reported similar levels of test
anxiety. The mean scores for males and females are 42.71 and
42.15 respectively. These results do not support hypothesis 2.
Hypothesis 3
Cognitive restructuring and relaxation techniques would be
effective in reducing anxiety and depression and improving test
performance in the students such that post treatment perform-
ance would be better than pre-treatment performance in mathe-
matics test.
From Ta b l e 4 it can be seen that groups I and group II that
received relaxation alone and combined relaxation and cogni-
tive restructuring performed significantly better after treatment
than before treatment. This means that the treatment given re-
duced the anxiety and depression levels of the students and this
reduction in turn led to their improved performance on the test.
The mean scores on the test are: control group: 5.83 vs 6.08;
relaxation only group: 5.87 vs 8.04; therapy combination group:
5.83 vs 9.45. These results support the third hypothesis.
Hypothesis 4
Students who received cognitive restructuring and deep brea-
thing relaxation therapy would perform better than those who
received only deep breathing relaxation therapy and the control
group that received no therapy.
A look at Ta bl e 5 above shows that the group that received
the combination of relaxation and cognitive restructuring
treatment had the highest test performance mean score followed
by the group that received relaxation treatment alone. The con-
trol group had the least performance mean score. The mean
scores for the test are: 6.08, 8.04, & 9.45. These results indicate
that the combined treatment reduced anxiety and depression in
the students more than relaxation alone or no treatment and this
made the students to perform best in the test. From Table 6 it is
Table 4.
Comparisons of participants’ pre and post therapy test performance
mean scores using “t” test statistic.
Group NMean Df Cal t Crit t P
Before Therapy245.83
After Therapy246.08
46 0.488 1.658 P > 0.05 NS
Before Therapy245.87
Group I
After Therapy248.04
46 4.735 1.658 P < 0.05
Before Therapy245.83
Group II
After Therapy249.45
46 6.033 1.658 P < 0.05
Note: table t value is 1.658 P 0.05.
Table 5.
Mean and Std. Dev. of participants’ post therapy test performance
scores according to groups.
Groups No Means Std. Deviation
Control Group24 6.083 2.02
Group I 24 8.04 1.78
Group II 24 9.45 2.57
Copyright © 2013 SciRes.
Table 6.
Summary of analysis of variance of the groups’ post therapy test per-
formance scores.
Source Sum of Squares df Mean Square F P
Between group 137.86 2 68.93 14.92P < 0.05
Within group 318.75 69 4.62
Total 456.61 71
Note: table value of F is 3.07 P < 0.05.
evident that the differences in the mean scores in Tabl e 5 are
significant with the value of F being F = 14.92, and P < 0.05.
These results lend support to hypothesis 4.
Major Findings
1) A positive and significant relationship was found between
test anxiety, trait anxiety, and depression.
2) The test anxiety levels of males and females were not sig-
nificantly different.
3) Deep breathing relaxation and cognitive restructuring
techniques significantly reduced anxiety and depression in the
students and significantly improved their post treatment test
4) Students who received the combination of relaxation and
cognitive restructuring had the best post treatment performance
followed by the performance of those who received relaxation
therapy alone. The control group that received no treatment had
the least improvement in their performance.
Concerning test anxiety, a positive relationship exists be-
tween trait and test anxiety in such a way that as test anxiety
increased, trait anxiety also increased. Students who suffer from
test anxiety also reported suffering from depression thereby
confirming depression as a correlate of test anxiety. When the
anxiety levels of the students were reduced though therapy their
performance in the test improved tremendously, suggesting a
negative relationship between anxiety and test performance.
This finding agrees with the findings of Kassim et al. (2008),
Chapell et al. (2005), & Farooqi et al. (2012), that found test
anxiety to be negatively related to academic performance.
As the anxiety levels of the students reduced through therapy
their depression levels also reduced and this facilitated im-
proved performance. This finding confirms the negative rela-
tionship between depression and academic performance, and
agrees with the findings of Busari (2012), & Owen et al. (2012),
who also found depression to be negatively and significantly re-
lated to academic performance. The fact that the students’ per-
formance improved significantly after relaxation and cognitive
therapy affirms their efficacy in managing test anxiety and de-
pression and improving test performance. Rush et al. (1977),
Blackburn et al. (1981), & Wampold et al. (2002) found cogni-
tive therapy to be an effective therapy, and even superior to
other forms of therapy, in managing clinical depression. The
present findings further confirm its efficacy and effectiveness in
managing both clinical and nonclinical depression and anxiety.
The combined therapy that resulted in improved performance
highlights the benefit of addressing the cognitive and emotional
components of anxiety in therapy, as well as the added advan-
tage of combining cognitive therapy with other forms of ther-
apy to ensure maximum and enduring therapeutic benefits.
Ordinarily test anxiety in students may not degenerate to
clinical levels, but the fact that excessive anxiety has been
linked to poor academic performance (Mandler & Sarason,
1952; Sarason, 1975; Owen et al., 2012), and examination be-
ing a global phenomenon, it is necessary for examination bod-
ies and institutions to make provisions for intervention centres
where students can be helped to reduce their test anxiety levels
and optimize their performance.
Beck, A.T. (1976). Cognitive therapy and the emotional disorders.
New York: International University Press.
Beck, A.T. (1983). Cognitive therapy of depression: New perspectives.
In P. J. Clayton, & J. E. Barett (Eds.), Treatment of depression. Old
controversies and new approaches (pp 265-284). New York: Raven
Biabangard, E. (2003). Effectiveness of Lazarus multimodal therapy,
Ellis rational emotional therapy and relaxation on decreasing stu-
dents test anxiety. Iranian Journal of Psychiatry and Clinical Psy-
chology, 8, 36-42.
Blackburn, I. M., Bishop, S., Glen, A. I., Whalley, L. J., & Christie, J. E.
(1981). The efficacy of cognitive therapy in depression: A treatment
trial using cognitive therapy and pharmacotherapy, each alone and in
combination. British Journ al of psychiatry, 139, 181, 189.
Busari, A. O. (2012). Evaluating the relationship between gender age
depression and academic performance among adolescents. Scholarly
Journal of Education, 1, 6-12.
Cassady, J. C., & Johnson, R. E. (2002) Cognitive test anxiety and aca-
demic performance. Contemporary educational Psychology, 27, 270-
295. http://www.idealibrary.comon
Chapell, M. S., Blanding, Z. B., Takahashi, M., Silverstein, M. E.,
Newman, B., Gubi, A., & Mccann, N. (2005). Test anxiety and aca-
demic performance in undergraduate and graduate students. Journal
of Educational Psychology, 97, 268-274.
Cohen, A. (2004). Tests anxiety and its effect on the personality of stu-
dents with learning disabilities.
Derogatis, L. R., Lipman, R. S., & Covi, L. (1977) Manual for the
symptoms distress checklist 90 (SCL-90). Baltimore: John Hopkins
University School of Medicine, Clinical Psychometrics Research
DeRoma, V. M., Leach, J. B., & Leverett, J. P. (2009) The relationship
between depression and college academic performance. College Stu-
dent Journal, 43, 325-334.
Dobson, K. S. (1989). A meta-analysis of the efficacy of cognitive
therapy for depression. Journal of Consulting Clinical Psychology,
57, 414-419. doi:10.1037/0022-006X.57.3.414
Elsenberg, D. (2009). College students—Depression and academic per-
formance. Depression Forums Web Page.
Farooqi, Y. N., Ghanl, R., & Spielberger, C. D. (2012) Gender differ-
ences in test anxiety and academic performance of medical students.
International Journal of Psychology and behavioural Sciences, 2,
Gloaguen, V., Cottraux, J., Cucherat, M., & Blackburn, I. M. (1998). A
meta-analysis of the effects of cognitive therapy in depressed patients.
Journal of Affective D isorders, 49, 59-72.
Hebb, D. O. (1972) Text book of psychology (3rd ed.). Philadelphia:
Hysenbegasi, A., Hass, S. L., & Rowland, C. R. (2005) The impact of
depression on the academic productivity of university Students. Jour-
nal of Mental Health Policy E conomic, 8, 145-151.
Kassim, M. A., Hanafi, R. M., & Hancock, D. R. (2008). Test anxiety
and its consequences on academics performance among university
students. Advance in P sy c h ol o g y Research, 53, 75-95.
Copyright © 2013 SciRes. 23
Copyright © 2013 SciRes.
Loveleena Rejeev (2013). Aaron Beck’s cognitive behaviour theory.
Mandler, G., & Sarason, I. G. (1952). A study of anxiety and learning,
Journal of Abnormal and Social Psychology, 87, 166-173.
McGinn, L. K. (2000). Cognitive behavioral therapy of depression:
Theory, treatment and empirical status. Amenean Journal of Psycho-
therapy, 54, 254-260.
Moilanen, D. L. (1995). Validity of Beck’s cognitive theory of depres-
sion with non-referred adolescents. Journal of Counselling and De-
velopment, 73, 438-442.
Moilanen, D. L. (1993). Depressive information processing among non-
clinic, non-referred college students. Journal of Counselling Psy-
chology, 40, 340-347. doi:10.1037/0022-0167.40.3.340
Ndirangu, G. W., Muola, J. M., Kithuka, M. R., & Nassiuma, D. K.
(2009). An investigation of the relationship between test anxiety and
academic performance in secondary schools in Nyeri District, Kenya.
Global Journal of educational Research, 8, 1-7.
Owens, M., Stevenson, J., Hadwin, J. A., & Morgate, R. (2012). Anxi-
ety and depression in academic performance. An exploration of the
mediating factors of worry and working memory. School Psychology
International. doi:10.1177/0143034311427433
Papalia, D. E., & Olds, S. W. (1988). Psychology. New York: McGraw-
Hill Book Company.
Rafiq, R., Ghazal, S., & Farooqi, Y. N. (2007). Test anxiety in students:
Semester vs annual system. Journal of Behavioural Sciences, 17, 79-
Rana, R. A., & Mahmood, N. (2010). The relationship between test
anxiety and academic achievement. Bulletin of Education and Re-
search, 32, 63-74.
Rush, A. J., Beck, A. T., Kovacs, M., & Hollon, S. (1977). Compara-
tive efficacy of cognitive therapy and pharmacotherapy in the treat-
ment of depressed outpatients. Cognitive Therapy Research, 1, 17-
37. doi:10.1007/BF01173502
Sarason, I. G. (1975). Test anxiety, attention and the general problem of
anxiety. In C. D. Spielberger, & I. G. Sarason (Eds.), Stress and
anxiety. Washington DC: Hemisphere.
Sarason, S. B., Davidson, K. S., & Lighthall, F. F. (1960). Anxiety in
elementary school children. New York: Wiley.
Schwartz, A., & Schwartz, R. (1993). Depression: Theories & treat-
ments. New York: Columbia University Press.
Spielberger, C. D., & Vagg, R. P. (1995). Test anxiety. Bristol: Taylor
& Francis.
Spielberger, C. D. (1980). The test anxiety inventory. Palo Alto, CA:
Consulting Psychologist Press Inc.
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). STAI
manual. Palo Alto: Consulting Psychologists Press Inc.
Stuart, J., Rupke, M. D., David Blecke, M., Div, M. S. W., & Majorie
Renfrow, M. D. (2006). Cognitive therapy for depression. American
Family Physician, 73, 83-86.
Sultanoff, B., & Zalaquett, C. (2000). Relaxation therapies. In D.
Novey (Ed.), Clinician’s complete reference to complementary & al-
ternative Medicine (pp. 114-129). New York: Mosby.
Tooransposhti, M. G. (2011). A new approach for test anxiety treatment,
academic achievement and met cognition. International Journal of
Information and Education Technology, 1, 221-229.
Wampold, B. E., Mnami, T., Baskin, T. W., & Callen Tiemey, S.
(2002). A meta-(re) analysis of the effects of cognitive therapy ver-
sus “other therapies” for depression. Journal of affective disorders,
68, 159-165. doi:10.1016/S0165-0327(00)00287-1
Wetzel, J. W. (1984). Clinical handbook of depression. New York:
Gardner Press.
Zeidner, M. (1998). Test anxiety: The state of the Art. New York: Ple-