健康与遗传心理学研究室知识库

鉴于考试焦虑的高发率，以及它对学生学业成绩和心理健康具有广泛和深远的负面影响，预防和干预考试焦虑一直是教育学和心理学研究的热点。国内考试焦虑干预的研究虽起步较晚，但发展迅速。此前的元分析文章未综合大量研究进行分析，且未涉及干预在降低我国学生考试焦虑的长期效果及提高学业成绩的效果。面对国内庞大的学生群体，考试焦虑干预的需求量大，从已有研究中探索对我国学生最有效的干预方法和影响效果的因素以辅助干预方案设计， 具有十分现实的实践意义。近年来，网络分析方法为探索心理障碍产生、维持和发展提供了新的视角。通过计算症状间的关系，估计考试焦虑的网络结构，探索对考试焦虑发病及缓解影响最大的症状，可为设计最有效的干预方案提供新的思路。

本研究分为两个部分。第一部分通过检索和筛选中英文数据库，纳入随机对照研究共 84 篇，涉及 102 个独立效应量，4083 名被试。采用元分析，以考试焦虑的即时效果、持续效果及学业成绩为结果变量，考察干预效果及影响因素。第二部分运用网络分析技术，对 1309 名初中生的考试焦虑进行网络模型估计，节点中心性指标计算及减轻和加重症状的模拟干预，识别考试焦虑的中心症状以及干预和预防的目标症状。

研究一结果显示：(1)干预对考试焦虑的即时效果(g = -1.59)和持续效果(g = -1.09)均达到显著的大效果，对学业成绩提高达到显著的小到中等的效果(g = 0.35)。(2)对于即时效果的亚组分析表明：对中学生的干预效果显著优于对大学 生的干预效果(|g|: 1.70 > 1.25, p < 0.01)，均为大效应量；被试仅基于一个考试焦虑量表筛选的干预效果显著优于经多种量表筛选(|g|: 1.77 > 1.32, p < 0.01)；干预疗法显著影响即时效果(Qb = 36.43, p < 0.001)；一次干预时长在 30 分钟到 60 分钟之内效果优于其它时长(g = -1.88, Qb = 10.36, p < 0.05)；干预频率一周一次效果最好(g = -1.70, Qb = 17.76, p < 0.001)。干预形式、干预方案是否参考或形成手册、对照组类型、文献来源和测量工具对即时效果均无显著影响。

研究二结果显示：(1)考试焦虑的伊森网络症状间连接稠密，中心症状为 “考前紧张不安”和“开考前感到恐慌”。(2)模拟干预结果显示，“开考前感 到恐慌”症状减轻，总分降幅最大，从 10.86 下降到7.63；而“考试时手抖得 厉害”症状加剧，总分上升最大，从10.81 到13.15。减轻和加重症状效果最大的绝大多数症状属于考试焦虑的情感-生理维度。

研究结论：在干预方案的干预设置中，学习阶段、筛选被试使用的量表种类、干预疗法、一次干预时长和干预频率等均是影响干预考试焦虑即时效果的调节变量；干预方案中应将“考前紧张不安”和“开考前感到恐慌”作为核心干预症状；“开考前感到恐慌”可作为干预方案的目标症状；“考试时手抖得厉害”可作为预防方案的目标症状。针对我国学生的考试焦虑，应尽早进行预防和干预，防重于治；预防和干预均以考试焦虑的情感-生理症状为主；干预设置在每周一次，每次30 到 60 分钟为宜。

Given the widespread and profound negative impact of test anxiety on students' academic performance and mental health, as well as its high prevalence, the intervention and prevention of test anxiety have always been hot topics in educational and psychological research. Although the research on test anxiety intervention in China started late, it has developed rapidly. Previous meta-analytic reviews were difficult to comprehensively analyze a large number of studies, and the long-term effect of the intervention on reducing test anxiety and improving academic performance of Chinese students were not involved. In the face of a huge number of students in China, there is a large demand for the intervention of test anxiety. It is of great practical significance to explore the most efficient intervention method and the factors affecting the effect from the existing researches to assist the design of intervention programs. In recent years, network analysis has provided a new perspective for exploring the generation, maintenance and development of psychological disorders. By calculating the relationship between the symptoms, estimating the network structure and exploring the symptoms that have the greatest impact on test anxiety, it can provide a new idea for the design of the most effective intervention program.

This study was divided into two parts. In the first part, 84 randomized controlled trials (RCTS) with 102 independent effect sizes and 4083 participants were included by searching Chinese and English databases. Using meta-analysis, the part examines the effects of interventions for test anxiety among Chinese students at post-treatment and follow-up , with test anxiety and academic performance as outcome variables. In the second part, using the network analysis technologies, the test anxiety network structure of 1309 junior middle school students was estimated, node centrality indices were calculated, and the simulated alleviating and aggravating interventions were carried out, so as to identify the central symptoms of test anxiety and the target symptoms for intervention and prevention.

Results of study one showed that: (1) The interventions had significant large effects on reducing test anxiety at post-treatment (g = -1.59) and follow-up (g = -1.09), and a significant small to moderate effect on academic performance improving (g = 0.35). (2) Subgroup analysis of post-treatment effect showed that the interventions effect on middle school students was significantly better than that on college students (|g|: 1.70 > 1.25, p < 0.01), both being large effect sizes. Interventions based on screening participants with only one test anxiety scale had significantly better effects than those using multiple scales (|g|: 1.77 > 1.32, p < 0.01). The type of intervention therapy significantly affected the post-treatment effect (Qb = 36.43, p < 0.001); Interventions lasting between 30 to 60 minutes per session were more effective than other durations (g = -1.88, Qb = 10.36, p < 0.05). Intervention frequency of once a week yielded the best effect (g = -1.70, Qb = 17.76, p < 0.001). Intervention form, whether the intervention program referred to or formed a manual, control group type, literature source, and measurement tools had no significant impact on the post-treatment effects.

Results of study two showed that: (1) The symptoms' connectivity of Ising network was dense. The central symptoms were "nervousness before tests" and "feeling panic just before taking tests". (2) Simulation intervention results indicated that reducing the severity of the symptom "feeling panic just before taking tests" led to the largest decrease in predicted total score, dropping from 10.86 to 7.63; exacerbating the symptom "hand shakes during tests" led to the largest increase in predicted total score, rising from 10.81 to 13.15. The top five symptoms with the greatest effect on alleviating and aggravating all belonged to the affective- physiological dimension of test anxiety.

Conclusion: In the settings of intervention programs, learning stage, the type of screening scales, intervention therapy, duration of each intervention session, and intervention frequency are all moderating variables that influence the effect of intervention for test anxiety at post-treatment. The central symptoms in the intervention program should be: "nervousness before tests" and "feeling panic just before taking tests". "Feeling panic just before taking tests" can be used as the target symptom of intervention programs. "Hand shakes during tests" can be a target symptom for prevention programs. For test anxiety among Chinese students, it is advisable to conduct prevention and intervention as early as possible, with prevention being more important than intervention; both prevention and intervention should focus on the affective-physiological symptoms of test anxiety; intervention settings are preferably once a week, 30 to 60 minutes per session.