Case Study: Exam-related stress and anxiety among adolescent students


This study examined students coming out of 12th grade and entering professional college in the age range of 18 to 21 years. The transition from school to professional college in itself is a hectic process, involving the need for students to study day and night in order to perform well on the required entrance exams.

As the students’ studying becomes more complicated and vast, it requires more time and concentration. Each student has to prepare himself for the change. Often as the exam approaches, students’ levels of concentration and the study time involved increase. This, in turn, leads to more stress, and some students even develop anxious feelings in the form of palpitation, fine tremors, sweating, abdomen or chest pain, loose motion, etc. I had to deal with some students who went absolutely blank at the exam center, and when I took their history, I found that in the last 24-48 hours, they had slept for only one hour. In order to stay awake, they frequently consumed coffee. Very few students were also found to have amphetamines in their possession.

Inclusion criteria:

  1. Age range 18-21 years
  2. Both male and female included

Exclusion criteria:

  1. Prior history of psychiatric illness
  2. Prior history of drug abuse, particularly amphetamines
  3. Pregnancy


I was working in an institute hospital where 1500 students were staying in a hostel. I would see them for any medical problems and, besides this, the rest of my patients were faculty and employees of the company. I used to see students approaching me with problems of anxiety, and it was more frequent during exam time. I thought to evaluate them more deeply by understanding how they react to the stress of exams. I came across two categories of students: those who were studious throughout the year, consistently receiving good grades, and those who were only more active towards their studies during exam time, with grades varying from below average to good. The component of anxiety was present in both categories of students, but far less in studious students who maintained a good grade year-round. I even consulted the students’ teachers and received feedback on their performance in the classroom. We matched their signs and symptoms of anxiety to the proximity of exam times. Sometimes I would call the students’ parents and discuss with them their child’s academic performance and behavior in school and at home. This gave us a clearer idea of why such phenomenon is occurring, and then we planned our treatment strategies accordingly. Most of the students would compete with each other; if one were studying throughout the night, the other would try to follow him and go to sleep early in the morning. This may start a week before the exam....

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