The effectiveness of mindfulness-based stress reduction intervention on cognitive avoidance of students with test anxiety

Document Type : Original Article


1 M.S in Clinical Psychology, Department of Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.

2 ) M.S in general Psychology, Department of Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.

3 Full Professor, Department of Psychology, Department of Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.

4 M.S Clinical Psychology, Department of Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.


This study aimed to determine the effectiveness of mindfulness-based stress reduction intervention on cognitive avoidance of students with test anxiety. The research method was quasi-experimental with a pretest-post-test design ad a control group. The statistical population included all Meshkinshahr students who were referred to school counseling centers. Among them, 30 people with test anxiety were selected by purposive sampling. Data collection tools were test anxiety questionnaires (Abolghasemi et al., 1996) and cognitive avoidance (Sexton and Dogas, 2008). The experimental group received a mindfulness-based stress reduction program (John Kabat-Zayn) for 8 weeks (one week of a 2-hour session). The collected data were analyzed using multivariate analysis of covariance. The results showed that mindfulness-based stress reduction intervention significantly reduced cognitive avoidance in students with test anxiety (P <0.001). According to the present study, the use of mindfulness-based stress reduction intervention in the pre-exam period can be effective in reducing the cognitive avoidance of students with test anxiety.


Abolghasemi,A;Asadi mogdam,A; Najarian, B and Shokrkan, H (1375) .. Construction and validation of a scale for measuring exam anxiety in third grade students of Ahvaz middle school. Journal of Educational Sciences and Psychology, Shahid Chamran University of Ahvaz, (3 and 4), 61-73. (Persian)
Ahmadi Z ;; Mirzaeian B and Madah, M (2016) The effectiveness of mindfulness-based cognitive therapy on anxiety and cognitive avoidance in anxiety students. Quarterly Journal of New Psychological Ideas. 1 (1): 1-10. (Persian)
Atia, M. M., & Sallam, L. E. (2020). The effectiveness of mindfulness training techniques on stress anxiety and depression of depressed patient. AmJNurs8, 103-113.
Baer, R. A. (2006). Mindfulness-based treatment approaches: Clinicians guide to evidence
base and application. USA: Academic Press is an Imprint of Elsevier.
BasakNejad,s; Moeini, N., Mehrabizadeh Honarmand, M. (1389). The relationship between post-event processing and cognitive avoidance with social anxiety in students. Journal of Behavioral Sciences, Volume 4, Number 4, 340-335. . (Persian)
Beauchemin, J., Hutchins, T. L., & Patterson, F. (2019). Mindfulness meditation may lesson anxiety, promote social skills, and improve academic performance among adolescents with learning disabilities. Complementary Health Practice Review, 13,34-45.
Brown, L. A., Forman, E. M., Herbert, J. D., Hoffman, K. L., Yuen, E. K., & Goetter, E. M. (2019). A randomized controlled trial of acceptance-based behavior therapy and cognitive therapy for test anxiety: A pilot study. Behavior modification35(1), 31-53.
Burton, B. N., & Baxter, M. F. (2019). The Effects of the Leisure Activity of Coloring on Post-Test Anxiety in Graduate Level Occupational Therapy Students. The Open Journal of Occupational Therapy, 7(1): 7-15.
Carsley, D., & Heath, N. L. (2020). Effectiveness of mindfulness-based coloring for university students’ test anxiety. Journal of American College Health68(5), 518-527.
Cheraghian, b;Ferydoni mogdam, M; Baraz Pardanjani, Sh and Bavarsad, N (2008). Examination of exam anxiety and its relationship with academic performance in nursing students. Journal of Knowledge and Health, 3 (3-4), 25-29. (Persian)
Clark, D. A., Crandall, J. R., & Robinson, D. H. (2018). Incentives and test anxiety may moderate the effect of retrieval on learning. Learning and Individual Differences. 63, 70-77.
Dahl, C. J., Lutz, A., & Davidson, R. J. (2015). Reconstructing and deconstructing the self: cognitive mechanisms in meditation practice. Trends in Cognitive Sciences, 19(9), 515-523.
Delavar,A. (1396). Research Methods in Psychology and Educational Sciences, 36th Edition, Tehran: Viraish Publications.
Dickson, K. S., Ciesla, J. A., & Reilly, L. C. (2012). Rumination, worry, cognitive avoidance, and behavioral avoidance: Examination of temporal effects. Behavior therapy43(3), 629-640.
‏Gosselin, P., Langlois, F., Freeston, M. H., Ladouceur, R., Dugas, M. J., & Pelletier, O. (2002). The Cognitive Avoidance Questionnaire (CAQ): Development and validation among adult and adolescent samples. Journal de Therapie Comportementale et Cognitive12(1), 24-37.
‏ Hallion, L. S., Tolin, D. F., & Diefenbach, G. J. (2019). Enhanced cognitive control over task-irrelevant emotional distractors in generalized anxiety disorder versus obsessive-compulsive disorder. Journal of anxiety disorders, 64, 71-78.
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. ( 2017). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of consulting and clinical psychology, 78(2), 169.
Hosseinzadeh Firouzabad, Y., Bassak Nejad, S., & Davoudi, I. (2018). Prediction of subscale test anxiety considering behavioral procrastination, decisional procrastination and cognitive avoidance in university students. Iranian Journal of Psychiatry and Clinical Psychology23(4), 424-437.
Kabat-Zinn, J. (1990). Full catastrophe living: How to cope with stress, pain and illness using mindfulness meditation. Dell
 Kabat-Zinn, J. (1994). Catalyzing movement towards a more contemplative/sacred-appreciating/non-dualistic society. In: Meeting of the working group. The Nathan Cummings Foundation and Fetzer Institute.
Kabat-Zinn J.(2005) Coming to our senses: Healing ourselves and the world through Mindfulness.
 NewYork: Hyperion;
Karl, J. A. & Fischer, R. (2020). Revisiting the five-facet structure of mindfulness. Measurement Instruments for the Social Sciences, 2(7), 1-16.
khorrami, F., saif, A., Kiamanesh, A., dortaj, F. (2019). The Effectiveness of Mindfulness training in Test Anxiety and Attitudes Towards School in 11th grade Students. Educational Psychology, 14(50), 25-54.  (Persian)
Knoll, R. W., Valentiner, D. P., & Holzman, J. B. (2019). Development and initial test of the safety behaviors in test anxiety Questionnaire: Superstitious behavior, reassurance seeking, test anxiety, and test performance. Assessment26(2), 271-280.
Lewis, E. M., Gilroy, S. P., Buckner, J. D., & Heimberg, R. G. (2020). The Impact of Brief Mindfulness Training on Postevent Processing Among Individuals With Clinically Elevated Social Anxiety. Behavior Therapy.
Lu, S., Huang, C. C., & Rios, J. (2017). Mindfulness and academic performance: An example of migrant children in China. Children and Youth Services Review, 82, 53-59.    
Ludwig, D. S. & Kabat-Zinn, J. (2008). Mindfulness in medicine. Jama, 300(11), 1350-1352.
Mahmoud Alilou, M, Shahjui, T, Hashemi, Z. (1389). Comparison of uncertainty tolerance, cognitive avoidance, negative orientation to problem and positive beliefs about anxiety between patients with generalized anxiety disorder and normal people. Journal of Modern Psychological Research, 5 (20), 169-187. (Persian)
Mahmoudzadeh, R., & MOHAMMADKHANI, S. (2016). The mediating role of cognitive avoidance and anxiety in the relationship between negative perfectionism and procrastination. (Persian)
McManus, F., Muse, K., Surawy, C., Hackmann, A., & Williams, J. M. G. (2017). Relating differently to intrusive images: The impact of mindfulness-based cognitive therapy (MBCT) on intrusive images in patients with severe health anxiety (hypochondriasis). Mindfulness6(4), 788-796.
Owan, V. J., Bassey, B. A., & Etuk, I. S. (2020). Interactive effect of gender, test anxiety, and test items sequencing on academic performance of ss3 students in mathematics in calabar education zone, Cross River State, Nigeria. American Journal of Creative Education, 3(1): 21-31
Paterniti, A. (2018). Comparing the efficacy of a mindfulness-based program to a skillstraining program in the treatment of test anxiety. Unpublished Doctoral Dissertation, Island, England: University of Islan.
Schaefer, A., Matthess, H., Pfitzer, G., & Köhle, K. (2017). Mental health and performance of medical students with high and low test anxiety. Psychotherapie, Psychosomatik, Medizinische Psychologie57(7), 289-297.
Saadipour, E., Soltanizadeh, H., & Ebrahim Ghavam, S. (2020). The effect of mindfulness training on academic procrastination in students with high and low test anxiety. Quarterly Journal of Child Mental Health6(4), 221-230. (Persian)
Sexton, KA. Dugas MJ.(2008). The cognitive avoidance questionare: Vlidetion of the English translation. Journal of Anxiety Disorder; 22(3):355–70.
Sexton, K. A., & Dugas, M. J. (2009). An investigation of factors associated with cognitive avoidance in worry. Cognitive Therapy and Research33(2), 150-162.
Thurston, M. D., Goldin, P., Heimberg, R., & Gross, J. J. (2017). Self-views in social anxiety disorder: The impact of CBT versus MBSR. Journal of Anxiety Disorders.
Veer, S. D., Brouwers, A., Evers, W., Tomic, W. (2019). A pilot study of the psychological impact of the mindfulness-based stress reduction program on persons who stutter, European Psychotherapy, 9 (1): 39-56.