Exam experience and some reactions to exam stress

The aim of this study was to assess the effects of previous exam experience on some psychophysiological reactions before, during and after repeated exams. A sample of 15 first year psychology students took part in the study. While the subjects were expecting a oral exam for the first time, their levels of exam apprehension, high activation and state anxiety were measured a day before, an hour before the exam and the following day. Furthermore, subjects’ cardiac R-R intervals were continuously recorded from five minutes before the exam to five minutes after the exam. Four, out of 15 subjects, passed the exams at first sitting, while the rest of them failed and had to repeat it. These 11 students underwent the same procedure for the second time. The levels of exam apprehension, high activation and anxiety did not show any differences between the first and the second exam sittings. R-R interval parameters indicated a higher stress before and after the second exam sitting, while the stress level was more or less the same during both exams.     

Head-down bed rest impairs vagal baroreflex responses and provokes orthostatic hypotension

We studied vagally mediated carotid baroreceptor-cardiac reflexes in 11 healthy men before, during, and after 30 days of 6 degrees head-down bed rest to test the hypothesis that baroreflex malfunction contributes to orthostatic hypotension in this model of simulated microgravity. Sigmoidal baroreflex response relationships were provoked with ramped neck pressure-suction sequences comprising pressure elevations to 40 mmHg followed by serial R-wave-triggered 15-mmHg reductions to -65 mmHg. Each R-R interval was plotted as a function of systolic pressure minus the neck chamber pressure applied during the interval. Compared with control measurements, base-line R-R intervals and the minimum, maximum, range, and maximum slope of the R-R interval-carotid pressure relationships were reduced (P less than 0.05) from bed rest day 12 through recovery day 5. Baroreflex slopes were reduced more in four subjects who fainted during standing after bed rest than in six subjects who did not faint (-1.8 +/- 0.7 vs. -0.3 +/- 0.3 ms/mmHg, P less than 0.05). There was a significant linear correlation (r = 0.70, P less than 0.05) between changes of baroreflex slopes from before bed rest to bed rest day 25 and changes of systolic blood pressure during standing after bed rest. Although plasma volume declined by approximately 15% (P less than 0.05), there was no significant correlation between reductions of plasma volume and changes of baroreflex responses. There were no significant changes of before and after plasma norepinephrine or epinephrine levels before and after bed rest during supine rest or sitting.(ABSTRACT TRUNCATED AT 250 WORDS)     

Investigating the Effects of Exam Length on Performance and Cognitive Fatigue

This study examined the effects of exam length on student performance and cognitive fatigue in an undergraduate biology classroom. Exams tested higher order thinking skills. To test our hypothesis, we administered standard- and extended-length high-level exams to two populations of non-majors biology students. We gathered exam performance data between conditions as well as performance on the first and second half of exams within conditions. We showed that lengthier exams led to better performance on assessment items shared between conditions, possibly lending support to the spreading activation theory. It also led to greater performance on the final exam, lending support to the testing effect in creative problem solving. Lengthier exams did not result in lower performance due to fatiguing conditions, although students perceived subjective fatigue. Implications of these findings are discussed with respect to assessment practices.     

Endogenous monoamine oxidase inhibitory activity and HPA activation in the pig

Previously we have shown that an increase in endogenous monoamine oxidase A inhibitory activity (MAO-AI), measured in human saliva, both precedes and predicts psychological stress-induced activation of the hypothalamic pituitary adrenal (HPA) axis, as determined by the cortisol response. We now report the relationship between endogenous MAO-AI and the cortisol response in the plasma of prepubertal pigs (n=5 or 6) under two experimental paradigms of HPA activation. In the first condition, pigs were physically restrained (snaring) for 15 minutes. Blood samples were taken from indwelling catheters at intervals before and after snaring (a sampling period of about 1 hour), and at the same time intervals on a separate day to provide baseline measures. Both cortisol concentration and percentage MAO-AI were determined in each plasma sample. There was a pronounced cortisol response on the snaring day (cortisol peaked 30 minutes after the start of the snaring). There was also a significant MAO-AI response to snaring which peaked 15 minutes after the start of the stress challenge. In the second experimental paradigm, bacterial endotoxin (LPS: 20microg/pig) was used to induce HPA activation and plasma cortisol and MAO-AI were determined. This time, however, the cortisol response was not preceded by any change in MAO-AI. We conclude that generation of MAO-AI, which is associated with HPA activation induced by psychological stress, is not a component of the pathways involved in immunological stimulation of the HPA axis.     

Neuroendocrine Response to School Load in Prepubertal Children: Focus on Trait Anxiety

At the time of school-age, the most frequent stress stimuli are related to school environment and educational process. Anxiety may play a big role in coping with stressful situations associated with school load. To approach this issue, we performed a real-life study at school during the classwork. The sample consisted of 36 healthy children aged 10 years, which were divided to low and high trait anxiety group based on the median value of the anxiety score. The investigations were carried out in the classroom during a stress condition (final exams) and non-stress condition (without any exam). In the whole sample, the condition with exam was associated with higher cortisol and lower testosterone concentrations in saliva compared to the condition without exam. The activity of salivary alpha-amylase increased at the end of the exam. Anxious children showed higher concentrations of aldosterone and lower activity of alpha-amylase compared to children with low trait anxiety. Cortisol levels were higher in anxious children in the first morning samples before starting the lessons. Children with high and low trait anxiety did not differ in extraversion, neuroticism, as well as non-verbal intelligence and school success. Thus, the anxious children at school showed a more rapid decrease of anticipatory stress-induced cortisol concentrations, higher aldosterone levels, and lower alpha-amylase activities compared to non-anxious children. These changes, particularly high concentrations of aldosterone in children with high trait anxiety, may have an impact on their psychophysiological development.     

Alterations of postawakening cortisol parameters during a prolonged stress period: Results of a prospective controlled study

Though postawakening cortisol is considered to be altered under chronic stress prospective studies proving this assumption is missing, so far. Furthermore, there is some uncertainty which aspects of postawakening cortisol alterations are strongest related to stress. The present study thus analyzed the cortisol concentration at awakening itself (0 min), the cortisol awakening response (CAR; i.e. the increase within 30 min after awakening), the area under the curve of the first hour after awakening (AUC_G60) and the mean of samples taken 0 min and 30 min after awakening (AUC_G30) in 12 exam students, participating in a major exam and 12 matched control students not participating in any exam. Saliva samples were taken on two consecutive days at 0, 15, 30, 45, and 60 min after awakening, respectively, at four time points (T1-T4): on the verge of exams, when students anticipated and prepared the exam (T1), in the middle of exams (T2), and shortly after (T3). T4 (weeks after exams) represents a reference measure. Repeated measures analyses of covariance revealed a significantly higher AUC_G30 (p = 0.007) and AUC_G60 (p = 0.011) and higher cortisol concentrations at awakening (p = 0.016) in exam students and a significant time by group interaction for concentration at awakening (p = 0.031). No effects were found for the CAR. The results of this prospective controlled study support notions that chronic stress induces increases of overall postawakening cortisol. They further indicate that the CAR is not affected by chronic stress and that the awakening concentration responds later than the AUC_G to conditions of chronic stress as analyzed here.     

Moderate anxiety, whether acute or chronic, is not associated with ovarian suppression in healthy, well-nourished, Western women

The relationship between psychological stress and reduced fecundity has been a matter of speculation and investigation for decades. Most previous studies have been compromised, however, by a number of problems including ambiguous direction of causation, poorly operationalized variables, and the confounding of psychological with energetic stress. We present a two-part study of the relationship between moderate anxiety, both acute and chronic, and daily measures of ovarian steroid and corticosteroid levels in saliva. Anxiety, as a particular form of psychosocial stress, was measured by the Spielberger Stait-Trait Anxiety Inventory as well as by a self-reported daily stress score. In the first part, 23 college juniors taking the Medical College Admissions Test (MCAT) were studied the month before and the month after the test, and again several months later, and compared at the same time points with 27 controls. In the second part, chronic anxiety levels were assessed in 95 women between 27 and 41 years of age and analyzed in relation to daily levels of salivary ovarian and corticosteroids over one menstrual cycle. The sample sizes are sufficient to allow for confidence in negative results. No statistically significant differences in ovarian or corticosteroid levels were observed whether between the MCAT and control subjects in part one, between the MCAT subjects before and after the MCAT test in part one, or between high and low anxiety subjects in part two. The results indicate that moderate levels of anxiety, whether acute or chronic, are not associated with suppressed ovarian function in healthy women.     

Stress-related changes of benzodiazepine binding inhibitory activity (B.B.I.A.) in humans

The presence of benzodiazepine binding inhibitory activity (B.B.I.A.) in sera from 44 psychiatric patients and from 14 healthy volunteers, prompted us to investigate whether or not this activity underwent changes in stressful situations. We measured the inhibitory units (IU) of deproteinized sera of 12 subjects, immediately before and 2 weeks after sitting for a difficult university exam. Our results showed significantly higher IU values (i.e., higher B.B.I.A. concentrations) in the samples taken just before the exam. This preliminary finding clearly suggests the involvement of B.B.I.A. in anxiety mechanisms.     

A Randomized Cross-over Exploratory Study of the Effect of Visiting Therapy Dogs on College Student Stress Before Final Exams

This exploratory study investigated the effect of visiting therapy dogs on college-student perceived and physiological stress the week prior to final exams. Students (n = 78) were randomly assigned to order of a therapydog intervention and attention-control condition, each 15 minutes long. Students completed the Perceived Stress Scale (PSS), a stress visual analog scale (SVAS), and provided saliva for measuring nerve growth factor (sNGF) and alpha amylase (sAA), prior to randomization. Saliva samples and SVAS were again collected after each condition. There was no effect of group order on demographics, PSS, or initial SVAS. Repeated measures models were used to analyze the complete data sets of 57 students. There were no significant differences in sAA between or within students completing the intervention and control conditions. sNGF was not subjected to analysis as most levels were undetectable. Significant differences in SVAS scores were found between the intervention and control condition, with large effect sizes. SVAS scores were lower following the intervention, regardless of condition order (intervention first, p = 0.0001, d = 1.87; intervention second, p = 0.0004, d = 1.63). No SVAS differences were found for the control condition. Based on these findings, campus events with visiting therapy dogs represent a costeffective, easily accessible activity to reduce perceived, but not physiological, stress for college students prior to final exams.     

Adrenergic response to intense muscular activity in sedentary subjects as a function of emotivity and training]

Seven male sedentary human subjects were studied during intense muscular work (80% of maximal oxygen uptake) performed either for 15 min or until exhaustion (mean duration: 47 +/- 2 min). Plasma catecholamines were estimated before and after the experiment by means of an original fluorimetric assay. Epinephrine or norepinephrine were individually isolated from plasma and assayed in single extracts by a highly sensitive fluorimetric method. Epinephrine and norepinephrine levels as low as 15 ng per liter were detectable by this procedure in human plasma. The adrenergic pattern was found to be greatly different from one subject to another and related to emotivity: the effect of this factor was revealed by the predominance of epinephrine in plasma at rest or under exercise (ratio NA/A less than 1). In nonemotive subjects (ratio NA/A greater than 1 at rest) plasma epinephrine and norepinephrine increased progressively during exercise. Increments after exercise were higher for norepinephrine changes; however, the fact that epinephrine concentrations correlated significantly with norepinephrine suggests a simulataneous and coordinated stimulation of adrenal glands and orthosympathetic nervous system. In emotive subjects (ratio NA/A less than 1 at rest) the apprehension of muscular work promoted a difference in catecholamine responses: norepinephrine release was not affected by subject's anxiety, while epinephrine secretion, already elevated before the test, reached a high degree of magnitude in the first minutes of muscular work, remaining nearly constant until exhaustion. Physical training of nonemotive subjects, during 2 months with two intense exercises by a week, reduced strongly norepinephrine release after exhaustive muscular work. In the same conditions, the adrenal-medullary response was not significantly modified when compared with untrained subjects. Our results suggest that the adrenergic behaviour during exercise is a function of effort intensity to be supplied; catecholamines seem to be important factors in regulating body homeostasy during muscular work in man. In addition, emotive subjects exhibit amplified adrenal-medullary response, which may be related to psychological stimuli.     

EEG Based Evaluation of Examination Stress and Test Anxiety Among College Students

BackgroundAdolescence is a crucial chapter in life and the presence of stress, depression, and anxiety at this stage is a great concern. Prolonged stress is one of the risk factors that may induce suicidal thoughts, destructive ideation, abuse of alcohol, and drugs in adulthood. Based on a record from National Crime Records Bureau, In India over 2320 children were committed suicide per year because of failure in examinations. This raised number implies the severity of this issue and its major impact on society.ObjectivesThe main objective of this paper is to analyze the cognitive stress in students during examination period using EEG biomarkers.Methods and ResultsEEG signal was acquired in two different test conditions such as before examination with 12 minutes and after examination with 3 minutes from 14 subjects with eight electrodes located using wireless Enobio device (Neuro electrics) with 10-20 international lead system. The three brain waves such as theta, alpha, beta relative band energies were considered, and EEG band ratios such as heart rate, neural activity, arousal index, vigilance index and cognitive performance attentional resource index extracted between before and after examination condition using db4 wavelet family with 6 level decomposition. The statistical results suggest that after examination the relative sub-band energies α, β, and θ were decreased significantly (p < 0.05) as compared to before examination. Also, the EEG band ratio such as heart rate and vigilance index shows significant (p < 0.05) decrease after the examination as compared to before examination. It was found that there was a significant (p < 0.05) rise in the arousal index, Cognitive performance attentional resource index (CPARI), and neural activity after the examination as compared to before examination.ConclusionThe experimental results found that the memory and concentration were high before examination, which concludes that adolescence group examination stress was high before examination period as compared to after examination. In the case of gender group comparison, theta energy band for male students was found high compared to female students in before examination state such that it concludes that male students were highly stressed (before examination) than female students. Overall, our results suggest that after examination male students with lower heart rate index than female students which implies the male students control their stress levels as compared to females in the same stress situation.     

Scent attractiveness and endocrine status in male students before and during a stress situation

Scent attractiveness of sweat samples collected from male students before and during theoretical exams was assessed by female students. Five-rank scale was used for subjective assessment of the scent samples in term unpleasant/pleasant. Scent attractiveness depended on physiological conditions of both recipients and donors. Male students with low basal concentration of salivary cortisol smelt better than students with high level of cortisol. High level of salivary testosterone also was associated with low scent attractiveness of the male students, but only for the recipients in non-receptive phase of menstrual cycle. In all, the females who were in receptive phase of menstrual cycle assessed scent attractiveness of male students higher then the females in non-receptive phase. Exam stress coincided with increase of the salivary cortisol resulting in decline of scent attractiveness in male students. The negative effect of exam was most prominent in students that failed exam and in student who aspired to be the best but failed. So, the exam stress and basal variation of stress-related physiological indexes, such as salivary cortisol, are mirrored in male chemical signals, which are recognized by females.     

Spectral EEG characteristics in students with different anxiety profile during tests

EEG spectral power was calculated in 39 students at the age of 19-21 years in two experimental conditions: during the common educational process and immediately before an examination (stress condition). During the education process, in subjects with high anxiety (tested by Spielberger) the relative spectral power of the delta activity was higher than in the other group in the occipital, parietal, central, and right frontal brain areas, whereas the power of the EEG alpha in these areas was lower. Before examination tests, in subjects with high activity the delta power bilaterally increased in the temporal areas, whereas in subjects with low anxiety there was a decrease in the alpha rhythm power, especially in the right frontal area. In stress condition, the relative power of the delta activity in both occipital and temporal, right parietal and central areas was higher in subjects with low anxiety, whereas their alpha power was lower in both frontal and in occipital, parietal, and temporal areas of the left hemisphere.     

Introducing Computer-Based Testing in High-Stakes Exams in Higher Education: Results of a Field Experiment

The introduction of computer-based testing in high-stakes examining in higher education is developing rather slowly due to institutional barriers (the need of extra facilities, ensuring test security) and teacher and student acceptance. From the existing literature it is unclear whether computer-based exams will result in similar results as paper-based exams and whether student acceptance can change as a result of administering computer-based exams. In this study, we compared results from a computer-based and paper-based exam in a sample of psychology students and found no differences in total scores across the two modes. Furthermore, we investigated student acceptance and change in acceptance of computer-based examining. After taking the computer-based exam, fifty percent of the students preferred paper-and-pencil exams over computer-based exams and about a quarter preferred a computer-based exam. We conclude that computer-based exam total scores are similar as paper-based exam scores, but that for the acceptance of high-stakes computer-based exams it is important that students practice and get familiar with this new mode of test administration.     

QTc Interval (Cardiac Repolarization): Lengthening After Meals

NAGY, DAVID, RONALD DeMEERSMAN, DYMPNA GALLAGHER, ANGELO PIETROBELLI, ADRIENNE S ZION, DEBORAH DALY, STEVEN B HEYMSFIELD. QTc interval (cardiac repolarization): lengthening after meals. Weight reduction, either by dietary or surgical means, is associated with prolongation of the heart rate corrected QT interval (QTc=QT/R-R^0–5 and, on occasion, sudden death. Screening subjects with obesity before weight loss for prolonged QTc intervals is an accepted practice, although at present, there are no guidelines for whether subjects should be fasting before electrocardiogram (EKG) evaluation. The aim of this study was to test the hypothesis that EKG QTc interval duration is independent of meal ingestion. The hypothesis was tested in 11 healthy subjects who ingested a 500-kcal formula meal. A small decrease in absolute QT interval and a steady decline in R-R interval were observed for up to 60 minutes after formula ingestion. The QTc interval increased above baseline at 15 minutes (p<0. 007) after meal, a change that persisted for the 1-hour postmeal observation period. Spectral analysis of EKG R-R intervals (low-/high-frequency amplitude ratio) indicated a change in cardiac autonomic flow after meal ingestion. The QTc interval did not lengthen and R-R low-/highfrequency amplitude ratio remained unchanged in eight subjects evaluated in a similar manner but in whom isovolumic amounts of water replaced the meal. These observations suggest that (1) cardiac repolarization changes with fasting and feeding, (2) the QTc interval is influenced by meal intake, and (3) the autonomic nervous system may play a role in meal-related QTc changes. These findings have implications for the evaluation of patients with obesity before starting and during weight loss treatment.     

Relaxation and immunity enhancement effects of gamma-aminobutyric acid (GABA) administration in humans

The effect of orally administrated gamma-aminobutyric acid (GABA) on relaxation and immunity during stress has been investigated in humans. Two studies were conducted. The first evaluated the effect of GABA intake by 13 subjects on their brain waves. Electroencephalograms (EEG) were obtained after 3 tests on each volunteer as follows: intake only water, GABA, or L-theanine. After 60 minutes of administration, GABA significantly increases alpha waves and decreases beta waves compared to water or L-theanine. These findings denote that GABA not only induces relaxation but also reduces anxiety. The second study was conducted to see the role of relaxant and anxiolytic effects of GABA intake on immunity in stressed volunteers. Eight acrophobic subjects were divided into 2 groups (placebo and GABA). All subjects were crossing a suspended bridge as a stressful stimulus. Immunoglobulin A (IgA) levels in their saliva were monitored during bridge crossing. Placebo group showed marked decrease of their IgA levels, while GABA group showed significantly higher levels. In conclusion, GABA could work effectively as a natural relaxant and its effects could be seen within 1 hour of its administration to induce relaxation and diminish anxiety. Moreover, GABA administration could enhance immunity under stress conditions.     

RETRACTED ARTICLE: Changes in parameters of biochemical and oxidative stress in university students during and after examinations

The study aimed to evaluate the parameters of lipid peroxidation and antioxidant protection, biochemical parameters, and cortisol and adrenaline content in the blood of students depending on the effect of exam stress. A total of 135 healthy students (72 female (53.3%) and 63 male (46.7%)) aged from 19 to 21 years (mean age 20.16 ± 0.42 years) of the experimental group underwent detailed medical screening and examination before the inclusion in the study. The control group consisted of 30 healthy students (17 female (56.7%) and 13 male (43.3%)) of corresponding age (mean age 20.23 ± 0.54 years), whose medical examination was performed during breaks in the absence of any stress factors. The blood parameters of the experimental group were investigated 1 h before, 1 h after, and 24 h after the exam. The cortisol content in the blood of experimental group students significantly increased 1.37 times (p < 0.05) an hour before the exam and 1.32 times (p < 0.05) an hour after; adrenalin content in blood increased 1.76 times (p < 0.05) and 1.49 times (p < 0.05), respectively. Compared to the control group, intensification of lipid peroxidation processes with a 1.51-fold (p < 0.05) increase in erythrocyte malonic aldehyde content in blood 1 h before and 1.42-fold (p < 0.05) increase an hour after the exam was observed in students due to the effect of exam stress.. Changes in hormonal homeostasis, activation of lipoperoxidation processes with the development of oxidative stress, and the disintegration of antioxidant protection factors are typical for academic stress in students.     

Effects of paced respiration on anxiety reduction in a clinical population

The purpose of this study was to examine the effects of paced respiration on autonomic and self-report indices of affect within a clinical population. Thirty-six alcohol-dependent inpatients scoring high in trait anxiety were randomly assigned to either a pacing or attention control group. The paced subjects received 10 minutes of slow-breathing training during the first experimental session, while control subjects simply counted the pacing tones. In a second session, paced subjects were asked to breathe at the same lowered rate (10 cycles per minute) on their own, while the remaining subjects were instructed to relax. Prior to and following each session, self-ratings of tension level and state anxiety were collected. As expected, paced subjects evidenced greater reductions in self-rated tension, state anxiety, and skin conductance levels compared to the control subjects. It was concluded that respiratory pacing is an easily learned self-control strategy and potentially may be a useful therapeutic tool.