Test anxiety is defined as a multidimensional phenomenon integrating cognitive, emotional, and physiological components that emerge during evaluative situations. The field underwent a significant shift with the introduction of Cognitive Interference Theory, which suggests that impaired performance is not a result of a lack of intelligence, but rather an attention split: the learner's cognitive resources are diverted toward managing intrusive thoughts ("worry") instead of focusing on the task at hand.
Meta-analyses spanning decades of research consistently show a significant negative correlation between high anxiety levels and academic performance. At the same time, they highlight the Yerkes-Dodson Law, which posits that a moderate level of arousal is actually essential for optimal performance.
Recent neuropsychological studies further demonstrate that interventions combining emotional regulation with effective learning strategies can significantly reduce amygdala activity in real-time. This allows working memory to function at its full capacity, thereby narrowing the gap between existing knowledge and actual performance.
The research on test anxiety in our clinic is led by Prof. Eshkol Rafaeli, a senior faculty member in the psychology department.
Publications
Prinz, J., *Bar-Kalifa, E., Rafaeli, E., & Lutz, W. (2016). Imagery Rescripting und psychophysiologische Zusammenhänge anhand eines ImRs-Behandlungskonzepts für Prüfungsangst: Überblick und erste Erfahrungen / Imagery Rescripting and psychophysical relations based on the ImRs-therapy concept used for test anxiety: Review and first experience. Psychotherapie - Psychosomatik - Medizinische Psychologie, 66, 481-485.
Prinz, J.N., Bar-Kalifa, E., Rafaeli, E., *Sened, H., Lutz, W. (2019). Imagery-based treatment for test anxiety: a multiple baseline open trial. Journal of Affective Disorders, 244, 187-195.
Prinz, J.N., Rafaeli, E., Reuter, J., Bar-Kalifa, E., & Lutz, W. (2022). Physiological activation and co-activation in an imagery-based treatment for test anxiety. Psychotherapy Research, 32, 238-248.. https://doi.org/10.1080/10503307.2021.1918353
Uhl, J., Eberhardt, S., Schwartz, B., Rafaeli, E., & Lutz, W. (2024). Emotion Dynamics of Clients with Test Anxiety Before and After an Imagery-Based Treatment. Journal of Behavioral Therapy and Experimental Psychiatry, 82, 101909. https://doi.org/10.1016/j.jbtep.2023.101909
Uhl, J., Altmann, U., Rafaeli, E., *Bungart, P., &
Maurer, O., & Rafaeli, E. (2020). Current life imagery. In G. Heath & H. Startup (Eds.). Creative Methods in Schema Therapy: Advances and Innovation in Clinical Practice. Routledge.
Prinz, J., Rafaeli, E., Wasserheß, J., & Lutz, W. (2021). Clients’ Emotional Experiences Tied to Therapist-Led (but Not Client-Led) Physiological Synchrony during Imagery Rescripting. Entropy, 23, 1556. https://doi.org/10.3390/e23121556
Sened, H., *Gorst-Kaduri, K., *Nathan-Gamliel, H., Rafaeli, E., Zilcha-Mano, S., Shamay-Tsoory, S. G. (2025). Inter-Brain Plasticity as a Mechanism of Change in Psychotherapy: A Proof of Concept Focusing on Test Anxiety. Psychotherapy Research.
Uhl, J., Lutz, W., & Rafaeli, E. (2025). The Physiological Signature of Imagery Rescripting: Associations between Heart Rate and Session-Level Outcomes. Behaviour Research and Therapy,104879. https://doi.org/10.1016/j.brat.2025.104879