Examination as a word evokes varying degrees of anxiety in students depending on the importance of the examination, perceived difficulty level of the subject, and degree of preparedness for the examination. A perceived difficult subject would elicit higher anxiety levels, and test anxiety as a psychological condition can adversely affect people in every field of life (Cohen, 2004), and especially it adversely affects students who face different examinations. The suspicion is that test anxiety may not exist alone but co-exist with other forms of psychological distress such as depression, and psychological intervention such as cognitive therapy is expected to reduce students' anxieties and any other psychological distress and consequently improve their academic performance. In an attempt to verify our suspicion and confirm the expectation, 420 senior secondary school students made up of 210 males and 210 females aged between 13 and 19 years responded to test anxiety, trait anxiety, and depressive symptoms inventories. 72 of the students whose test anxiety scores were higher than the group's average score were divided into three groups and treated under three conditions of "no treatment", "relaxation treatment alone", and combined "relaxation and cognitive restructuring treatment". Results obtained show that test anxiety, trait anxiety, and depression co-exist and are positively related, and they are negatively related to academic performance. In addition the combination of relaxation and cognitive restructuring treatment reduced anxiety and depression better than relaxation treatment alone or no treatment and improved test performance of the students much more than any of the other two conditions. The findings thus confirm the effectiveness and efficacy of cognitive therapy in managing anxiety and depression and improving academic performance, and when combined with relaxation technique, the combination optimizes academic performance.

Background Previous studies have suggested that culture impacts the experience of psychosis. The current study set out to extend these findings by examining cultural variation in subclinical positive psychotic experiences in students from The Netherlands, Nigeria, and Norway. Positive psychotic experiences were hypothesized to (i) be more frequently endorsed by, and (ii) cause less distress in Nigerian vs. Dutch and Norwegian students. Methods Psychology students, aged 18 to 30 years, from universities in the Netherlands ( n = 245), Nigeria ( n = 478), and Norway ( n = 162) were assessed cross-sectionally with regard to the frequency of subclinical positive psychotic experiences and related distress, using the Community Assessment of Psychic Experiences (CAPE-42). Multi-group confirmatory factor analysis and multivariate analysis of covariance were performed to assess measurement invariance of the positive symptom dimension (CAPE- Pos ) and compare mean frequency and associated distress of positive psychotic experiences across study samples. Results Only CAPE- Pos items pertaining to the dimensions ‘strange experiences’ and ‘paranoia’ met assumptions for (partial) measurement invariance. Frequencies of these experiences were higher in the Nigerian sample, compared to both the Dutch and Norwegian samples, which were similar. In addition, levels of experience-related distress were similar or higher in the Nigerian sample compared to respectively the Dutch and Norwegian samples. Conclusion Although positive psychotic experiences may be more commonly endorsed in non-Western societies, our findings do not support the notion that they represent a more benign, and hence less distressing aspect of human experience. Rather, the experience of psychotic phenomena may be just as, if not more, distressing in African than in European culture. However, observed differences in CAPE- Pos frequency and distress between samples from different cultural settings may partly reflect differences in the measure rather than in the latent trait. Future studies may therefore consider further cross-cultural adaptation of CAPE-42, in addition to explicitly examining cultural acceptance of psychotic phenomena, and environmental and other known risk factors for psychosis, when comparing and interpreting subclinical psychotic phenomena across cultural groups.

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