Intrusions in test anxiety

  • 202 Accesses


Test anxiety constitutes a widespread phenomenon among students and is associated with a reduced academic performance and a stressful life. Intrusive experiences represent a significant symptom and lead to additional psychological strain (Pekrun and Götz 2006). A deeper understanding of intrusions has contributed to the development of effective therapeutic approaches within the context of anxiety disorders. The current study investigates the prevalence and content of intrusions as well as subsequent coping strategies in the context of test anxiety in 202 German-speaking students. An online survey, which covered the manifestation of test anxiety and aspects of the intrusive experiencing, was completed by the participants. Based on their statements, category systems were constructed using qualitative content analysis according to Mayring (2015) and a frequency analysis was carried out. Results indicate that approximately a third of all students suffer from intrusions, of which up to nine different intrusions are reported. Preeminently, physiological as well as visual intrusions occur. Content-related, negative cognitions are particularly reported. The engaged coping strategies are largely to be assessed as functional and encompass aspects such as social interactions or physical activation. The content of intrusions, cognitions, emotions, and coping strategies can be identified and used in treatment.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Subscribe to journal

Immediate online access to all issues from 2019. Subscription will auto renew annually.

US$ 99

This is the net price. Taxes to be calculated in checkout.


  1. Arntz, A. (2012). Imagery rescripting as a therapeutic technique: Review of clinical trials, basic studies, and research agenda. Journal of Experimental Psychopathology, 3, jep.024211.

  2. Ashcraft, M. H., & Kirk, E. P. (2001). The relationships among working memory, math anxiety, and performance. Journal of Experimental Psychology: General, 130, 224–237.

  3. Beck, A. T., Laude, R., & Bohnert, M. (1974). Ideational components of anxiety neurosis. Archives of General Psychiatry, 31, 319–325.

  4. Bögels, S. M., Alden, L., Beidel, D. C., Clark, L. A., Pine, D. S., Stein, M. B., & Voncken, M. (2010). Social anxiety disorder: Questions and answers for the DSM-V. Depression and Anxiety, 27, 168–189.

  5. Bohus, M., & Huppertz, M. (2006). Wirkmechanismen achtsamkeitsbasierter Psychotherapie.

  6. Bortz, J., & Schuster, C. (2010). Statistik für Human- und Sozialwissenschaftler. Berlin: Springer.

  7. Brewin, C. R., Gregory, J. D., Lipton, M., & Burgess, N. (2010). Intrusive images in psychological disorders: Characteristics, neural mechanisms, and treatment implications. Psychological Review, 117, 210–232.

  8. Cassady, J., & Johnson, R. (2002). Cognitive test anxiety and academic performance. Contemporary Educational Psychology, 27, 270–295.

  9. Cicchetti, D. V., & Sparrow, S. A. (1981). Developing criteria for establishing interrater reliability of specific items. Applications to assessment of adaptive behavior. American Journal of Mental Deficiency, 86(2), 127–137 Accessed 16 July 2018.

  10. Çili, S., & Stopa, L. (2015). Intrusive mental imagery in psychological disorders: Is the self the key to understanding maintenance? Frontiers in Psychiatry, 6.

  11. Cizek, G. J., & Burg, S. S. (2006). Addressing test anxiety in high-stakes environment: Strategies for classrooms. Thousand Oaks: Corwin Press.

  12. Clark, D. A., & Purdon, C. L. (1995). The assessment of unwanted intrusive thoughts: A review and critique of the literature. Behaviour Research and Therapy, 33, 967–976.

  13. Crocq, M., Macher, J., Barros-Beck, J., Rosenberg, S. J., & Duval, F. (1993). Posttraumatic stress disorder in world war II prisoners of war from Alsace-Lorraine who survived captivity in the USSR. In J.- P. Wilson & B. Raphael (Eds.), International handbook of traumatic stress syndromes (pp. 253–262). New York: Plenum Press.

  14. Day, S. J., Holmes, E. A., & Hackmann, A. (2004). Occurrence of imagery and its link with early memories in agoraphobia. Memory, 12, 416–427.

  15. Fehm, L., & Fydrich, T. (2011). Prüfungsangst. Göttingen: Hogrefe.

  16. Freeston, M. H., Ladouceur, R., Thibodeau, N., & Gagnon, F. (1991). Cognitive intrusions in a non-clinical population. I. Response style, subjective experience, and appraisal. Behaviour Research and Therapy, 29, 585–597.

  17. Freeston, M. H., Ladouceur, R., Provencher, M., & Blais, F. (1995). Strategies used with intrusive thoughts: Context, appraisal, mood, and efficacy. Journal of Anxiety Disorders, 9(3), 201–215.

  18. Hackmann, A., Clark, D. M., & McManus, F. (2000). Recurrent images and early memories in social phobia. Behaviour Research and Therapy, 38, 601–610.

  19. Hancock, D. R. (2001). Effects of test anxiety and evaluative threat on students’ achievement and motivation. The Journal of Educational Research, 94, 284–290.

  20. Hedl, J. J. (1972). Test anxiety: A state or trait concept? Proceedings of the Annual Convention of the American Psychological Association, 7(Pt. 1), 503–504.

  21. Hirsch, C. R., Meynen, T., & Clark, D. M. (2004). Negative self-imagery in social anxiety contaminates social interactions. Memory, 12, 496–506.

  22. Hodapp, V. (1991). Das Prüfungsängstlichkeitsinventar TAI-G: Eine erweiterte und modifizierte Version mit vier Komponenten. Zeitschrift Für Pädagogische Psychologie, 5, 121–130.

  23. Hodapp, V., Rohrmann, S., & Ringeisen, T. (2011). Prüfungsangstfragebogen. Göttingen: Hogrefe.

  24. Homer, S. R., & Deeprose, C. (2017). Voluntary and involuntary imagery in social anxiety. Behavioural and Cognitive Psychotherapy, 45, 285–299.

  25. Kent, G., & Jambunathan, P. (1989). A longitudinal study of the intrusiveness of cognitions in test anxiety. Behaviour Research and Therapy, 27, 43–50.

  26. Kraemer, K. M., Luberto, C. M., O’Bryan, E. M., Mysinger, E., & Cotton, S. (2016). Mind- body skills training to improve distress tolerance in medical students: A pilot study. Teaching and Learning in Medicine, 28(2), 219–228.

  27. Krippendorff, K. (1980). Content analysis. An introduction to its methodology. London: Sage.

  28. Mayring, P. (2015). Qualitative Inhaltsanalyse Grundlagen und Techniken (12th ed.). Weinheim: Beltz.

  29. Muse, K., McManus, F., Hackmann, A., Williams, M., & Williams, M. (2010). Intrusive imagery in severe health anxiety: Prevalence, nature and links with memories and maintenance cycles. Behaviour Research and Therapy, 48, 792–798.

  30. Patel, A., Knapp, M., Henderson, J., & Baldwin, D. (2002). The economic consequences of social phobia. Journal of Affective Disorders, 68, 221–233.

  31. Pekrun, R. (1992). The impact of emotions on learning and achievement: Towards a theory of cognitive/motivational mediators. Applied Psychologie: An International Review, 41, 359–376.

  32. Pekrun, R., & Götz, T. (2006). Emotionsregulation: Vom Umgang mit Prüfungsangst. In H. Mandl (Ed.), Handbuch Lernstrategien (pp. 248–258). Göttingen: Hogrefe.

  33. Price, K., Veale, D., & Brewin, C. R. (2012). Intrusive imagery in people with a specific phobia of vomiting. Journal of Behavior Therapy and Experimental Psychiatry, 43, 672–678.

  34. Rachmann, S. (1981). Part I. Unwanted intrusive cognitions. Advances in Behaviour Research and Therapy, 3, 89–99.

  35. Reimer, S. G., & Moscovitch, D. A. (2015). The impact of imagery rescripting on memory appraisals and core beliefs in social anxiety disorder. Behaviour Research and Therapy, 75, 48–59.

  36. Reiss, N., Warnecke, I., Tolgou, T., Krampen, D., Luka-Krausgrill, U., &Rohrmann, S. (2016). Effects of cognitive behavioral therapy with relaxation vs. imagery rescripting on test anxiety: A randomized controlled trial. Journal of Affective Disorders.

  37. Salkovskis, P. M. (1991). The importance of behaviour in the maintenance of anxiety and panic: A cognitive account. Behavioural Psychotherapy, 19, 6.

  38. Sarason, I. G. (Ed.). (1980). Test anxiety: Theory, research, and applications. Hillsdale: Lawrence Erlbaum Associates, Inc.

  39. Scholz, M., Neumann, C., Wild, K., Garreis, F., Hammer, C. M., Ropohl, A., Paulsen, F., & Burger, P. H. M. (2016). Teaching to relax : Development of a program to potentiate stress - results of a feasibility study with medical undergraduate students. Applied Psychophysiology and Biofeedback, 41, 275–281.

  40. Somerville, K., Cooper, M., & Hackmann, A. (2007). Spontaneous imagery in women with bulimia nervosa : An investigation into content , characteristics and links to childhood memories. Journal of Behavior Therapy and Experimental Psychiatry, 38, 435–446.

  41. Southwick, S. M., Krystal, J. H., Morgan, C. A., Johnson, D., Nagy, L. M., Nicolaou, A., et al. (1993). Abnormal noradrenergic function in posttraumatic stress disorder. Archives of General Psychiatry, 50, 266.

  42. Speckens, A. E. M., Hackmann, A., Ehlers, A., & Cuthbert, B. (2007). Imagery special issue: Intrusive images and memories of earlier adverse events in patients with obsessive compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 38, 411–422.

  43. Stavemann, H. H. (2010). Einführung in die KVT: Die Therapie emotionaler Turbulenzen. Weinheim: Beltz.

  44. Thwaites, R., & Freeston, M. (2005). Safety-seeking behaviours: Fact or function ? How can we clinically differentiate between safety behaviours and adaptive coping strategies across anxiety disorders? Behavioural and Cognitive Psychotherapy, 33, 177–188.

Download references


We are very grateful to all participants in this study.

Author information

Correspondence to Kristina Klug.

Ethics declarations

Conflicts of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Klug, K., Tolgou, T., Schilbach, M. et al. Intrusions in test anxiety. Curr Psychol (2019).

Download citation


  • Test anxiety
  • Intrusive imagery
  • Cognitions
  • Emotions
  • Coping strategies
  • Qualitative content analysis