Germany Journal

Document Type : Original Article


Bandar Abbas Education Department, Hormozgan, Iran


One of the main problems of our schools is not helping the problem students. Unfortunately, instead of being ready to help those who are retarded or in a state of maladaptation, most of them turn away from them and show a repulsive attitude. In the face of seemingly weak students, they are unloved and inadvertently abandoned and repressed. In most of the above cases, these problems are related to students' anxiety and threaten their mental health now and in the future. One of the variables related to mental health is anxiety. So that the results of some studies have shown that anxiety affects their health and has a negative effect on their body, anxiety and function, and by reducing and increasing anxiety, mental health symptoms and its sub-branches are affected. Anxiety is now a social issue and one of the fundamental foundations of mental health. Researchers and physicians have shown great interest in studying children's anxiety for a variety of reasons, as childhood anxiety is a dangerous and important factor in the development of behaviors such as delinquency, dropout, and violence in adolescence and adulthood. Almost half of the antisocial children in adolescence continue to behave similarly. Also, half of the antisocial adolescents engage in antisocial behaviors in adulthood.

Graphical Abstract

Investigating the Effect of Anxiety Management Skills Training on Students' Health



Anxiety in the early years of life, many problems including poor self-esteem (1), rejection by peers (2) lead to poor academic performance, irritability and hyperactivity. In addition, anxiety confronts its victims with negative consequences such as depression, anxiety, loneliness, and low self-esteem (3). Aggressive behavior is also associated with physical ailments such as cardiovascular disease and tension headaches (4). Training in anxiety and anxiety management skills, which provide appropriate methods for expressing and managing emotions, can be effective in reducing aggressive behavior. Using calm and positive dialogue and self-control can increase feelings of self-efficacy and social skills. In our society, anxiety must be controlled and controlled so as not to cause irreparable damage to the family and society (5-7).

In the social dimension, this issue is also of special importance because if the family, which is the smallest social unit, is transformed and damaged, it will affect the whole society and endanger the health of the society. This is very important for our country and especially in the current situation (Golchin, 2002). In this regard, the present study seeks to investigate anxiety control skills on anxiety and academic performance of students in Bandar Abbas.

Research background

A study entitled "Study of the effect of anxiety on employee performance", which was written in 1997 by Gholam Babapour Miandoab. Findings from this study on two research hypotheses have shown that: 1- Anxiety in easy tasks has no effect on performance. 2- Anxiety in difficult tasks weakens performance. The most important side effect of this study, which is proposed to be further studied in the future, is the positive effect or direct relationship of anxiety with the quantity of tasks and responsibilities, as well as its inverse relationship with the quality of work.

A study entitled "The effect of cognitive behavior therapy in reducing anxiety in adolescent girls with generalized anxiety disorder" written in 2009 by Marjan Alirezaei Motlagh. This study was performed to evaluate the effect of cognitive-behavioral therapy on reducing anxiety in adolescent girls with generalized anxiety disorder. The subjects were 62 17-year-old girls with generalized anxiety disorder who were selected through a pan-state anxiety questionnaire and a diagnostic interview by a psychiatrist and were randomly divided into experimental and control groups. A study entitled "Effectiveness of problem solving and training of emotion management skills in reducing anxiety and aggression in adolescents", written in 2012 by Elnaz Karami. The purpose of this study was to evaluate the effectiveness of life skills training programs (problem solving and emotion management skills) in reducing anxiety and aggression in middle school adolescents using a quasi-experimental pretest-posttest method with a control group. The sample consisted of 40 female middle school students who were randomly selected from female middle school students in Tehran and randomly assigned to experimental and control groups (8-10).

The experimental group learned problem-solving and emotion management skills training in ten 90-minute sessions. The results of analysis of covariance of pre-test-post-test data showed that problem-solving skills and emotion management are significantly effective in reducing students' anxiety and aggression.

A study entitled "The effect of social skills training on girls' anxiety and adjustment" written in 1993 by Fatemeh Nasrabadi. The aim of this study was to investigate the effect of social skills training on anxiety and adjustment of seventh grade high school students in Tehran. The research design was quasi-experimental and post-test was pretest with the control group. The statistical population of this study was all seventh-grade female students of Tehran High School who were studying in the 92-93 academic year in which the cluster was purposefully selected. Spence Anxiety Questionnaire (children's version). And Singh and Sina High School Students Adjustment Questionnaire (1993). Students who scored high in the Spence Anxiety Questionnaire as well as in the Adjustment Questionnaire were selected as the sample group. The independent variable in this study was social skills training that was performed for 10 sessions of 90 minutes for the experimental group. Analysis of covariance was used to analyze the data. The findings showed that social skills training significantly reduces anxiety and adjustment in students (11-13). A study entitled "The effect of Gestalt therapy on general anxiety and students' test anxiety" written in 2016 by Hossein Keshavarz Afshar. The aim of this study was to identify the effect of Gestalt therapy on general anxiety and test anxiety in students. This study examined the treatment process of five cases in a clinical research method based on a multistage design. According to the results, Gestalt therapy is effective in reducing general anxiety and improving test anxiety in students. The data were analyzed in a multivariate curve and the results showed that in four of the five students treated, the level of test anxiety and general anxiety decreased. Accordingly, the results indicate the effect of Gestalt therapy in reducing general anxiety and improving test anxiety in students (14).

A study entitled "The effectiveness of problem-solving training on test anxiety and social anxiety in elementary students", which was written in 1995 by Hamid Kazemi et al. The purpose of this study was to investigate the effect of problem solving training on test anxiety and social anxiety in knowledge It was elementary school students. The statistical population of the present study included all male high school students in Najafabad in the 2014-2015 academic year, of which 30 were selected by cluster random sampling and randomly assigned to both experimental and control groups (15-17). A study entitled "Study of the effect of life skills training on academic performance and test anxiety of male students of the third high school of Kaboudar Ahang city in the academic year of 1995-96" which was written in 2017 by Mehdi Rasaei. The aim of this study was to investigate the effect of life skills training on academic performance and test anxiety of male high school students in Kaboudar Ahang High School in the 2016-2017 academic year. The present study is a quasi-experimental study (design of unbalanced control groups). The statistical population of this study was all third grade male high school students in Kaboudar Ahang city in the academic year 2016-2017, from which 40 people were selected by available sampling method and randomly divided into experiments and controls. Groups. The experimental group received 12 life skills training sessions, while the control group did not receive training in this course. Participants completed the exam anxiety scale before and after training, and their GPA was used to assess students' academic performance. Descriptive statistics as well as independent t-test and analysis of covariance were used to analyze the data. The results of covariance analysis showed that life skills training reduces students 'anxiety but does not have a significant effect on increasing students' academic performance. Therefore, based on these findings, it seems useful to use life skills training to reduce students' test anxiety.

A study entitled "The effect of cognitive-behavioral intervention on improving the perception of anxiety control and anxiety sensitivity in men with anxiety symptoms" written in 1996 by Mehdi Taghavi. The aim of this study was to investigate the effect of cognitive-behavioral interventions on improving the perception of anxiety control and anxiety sensitivity in men with anxiety symptoms. The statistical population of this study was all men living in Tehran. Using a quasi-experimental design and sampling method among male volunteers referred to a counseling center, 30 people with a standard deviation higher than the average anxiety score (Beck) based on the inclusion criteria, selected and selected. They were randomly divided into two. Experimental groups and controls. A study entitled "The effectiveness of cognitive-behavioral play therapy on anxiety and rumination in children with general anxiety disorder aged 6 to 12 years referred to counseling and psychotherapy clinics in Yasuj" written in 2018 by Hesam Norouzian Nasrabad Sofla. The aim of this study was to evaluate the effectiveness of cognitive-behavioral play therapy on anxiety and rumination in children with general anxiety disorder aged 6 to 12 years referred to counseling and psychotherapy clinics in Yasuj. The sample included 40 children with anxiety and rumination to counseling and psychotherapy clinics in Yasuj, which were available by "available" non-random sampling method. Findings showed that cognitive-behavioral play therapy has an effect on anxiety and rumination in children with generalized anxiety disorder (18-20). A study entitled "The effect of group gestalt therapy on social anxiety and test anxiety of female students" written in 2019 by Fatemeh Mohammadi Shahraji. The aim of this study was to investigate the effect of group gestalt therapy on social anxiety and test anxiety of female students. This research is a quasi-experimental study with a pretest-posttest design with two experimental and control groups. The statistical population of this research consists of all female undergraduate students of Sari Azad University in the academic year of 1995-96. The statistical sample consisted of 50 students who were randomly selected and then they were given the Connor anxiety inventory, Sarason exam anxiety inventory and were pre-tested. From these people, 20 people who had more anxiety were selected and then therapeutic intervention (8 sessions of 90 minutes) was performed on the experimental group and after the sessions, students in both groups underwent post-test. Data were analyzed using analysis of covariance. According to the mean scores, it can be concluded that group gestalt therapy has a significant effect on reducing students' social anxiety. Also, according to the mean scores, it can be concluded that group gestalt therapy has an effect on reducing students' anxiety.

External background

Eric Rashba (2009), in an article entitled "Anxiety Management Can Save Your Life," found that anxiety management significantly prevents heart attacks and increases people's efficiency in their lives and workplaces.

Smith et al. (2012) in a study "Comparison of perfectionism, anxiety and coping styles of maladapted students and normal students" showed that maladaptive perfectionism, anxiety and dysfunctional coping styles are associated with intensifying incompatibility. And acknowledged that these results explain the role of personality variables in exacerbating incompatibility.

Elliott et al. (2015) conducted a study to investigate the effect of yoga on reducing anxiety in high school students on Qeshm Island. The research method was quasi-experimental with experimental group and control group. Yoga training sessions were performed in 10 sessions twice a week for 90 minutes each time. The method of analysis included analysis of covariance. The results showed that the mean of aggression and its dimensions in the two experimental groups decreased significantly compared to the control group. Conclusion: Yoga exercise can be effective in reducing the anxiety of high school students in Qeshm Island.

Smith and Saina (2017) in a study entitled "Evaluation of the effectiveness of anxiety management training on reducing anxiety and increasing adaptation and treatment with gradual detoxification with biofeedback" This study aims to investigate the long-term effects of gradual detoxification with thermal biofeedback and drug therapy has been used in the treatment of migraine and has provided practical guidelines and application by therapists to consider personality components in the choice of migraine treatment method and has concluded that the treatment method in the treatment of incompatibility, The results show that "the effectiveness of gradual anxiety management training and de-stressing with thermal biofeedback" is much more effective than drug therapy in reducing anxiety and its duration and severity, and this superior pain remains in the short-term follow-up period.

The results of Mivald et al.'s (2018) study on "The effect of anxiety management training on anxiety and self-esteem of 12-15-year-old male students" with a sample of 34 students indicated that training in anxiety management skills as an effective method for Reduce anxiety and increase self-esteem (21-23).

The results of research by Elson et al. (2019) entitled "The effectiveness of cognitive-behavioral group therapy and play therapy on the treatment of anxiety disorders, depression and hope in children" with a sample size of 20 people; Cognitive-behavioral group therapy sessions have a positive effect on reducing anxiety and depression and increasing hope.

The psychoanalytic manifestation of anxiety

Freud's latest writings distinguish between three types of anxiety. Freud believes that the first experience of anxiety occurs at birth. From the safe environment of the uterus, the baby enters a new and unfamiliar situation and suddenly realizes that the needs of the immediate institution may not be met.

Therefore, this initial anxiety becomes a model for other anxieties. We return to the second type of anxiety mentioned by Freud: anxiety is the fear of self-punishment that results from not following the natural standards of actual or potential behavior ordered by the institution. This type of anxiety manifests itself in feelings of guilt and shame. The third type, neurotic anxiety, arises as a result of the institution threatening to oppress and subsequently expressing aggressive or hedonistic behavior that is not socially acceptable. As he tries to alleviate the pressure of the reduced rate, these pervasive anxieties can be attributed to things in the real world. Fear goes back to some other things that are a symbol of unconscious conflict, so it creates a sick mood. (4).

Freudian New Theory of Anxiety

These theories have been developed in recent decades. And uncle, mainly as a result of opposing Freud's overemphasis on the importance of biological motivations, especially sexual motivations and the threat that these motivations pose to the individual. Neo-Freudians consider the development of human personality to be primarily a social influence. They believe that primary anxiety does not occur at birth, but only when the child realizes that his or her parents are dependent on it. The child depends not only on meeting basic physiological needs but also on the support of his or her parents. Anxiety stems from the actual potential failure of these dependency needs. If the child misbehaves, the parents may withhold their love and support. This threat forces the child to follow the parents' expectations.

However, the child still needs to suppress these motivations, cause failure, and then express aggression does not lead to rejection and initial anxiety, so he must use defense mechanisms to suppress it. Secondary anxiety occurs in later years of a person's life, when these well-established defense mechanisms are challenged early in life to suppress primary anxiety.

Behavioral theory of anxiety

Weston Varanier pioneered research on fear based on behavioral theory. They proved that fear can be created through the classical conditioning process. This bar with a classic example. Little Akbert shows the best picture. They conducted an experiment in which Akbert hit a steel bar with a hammer every time he wanted to play with a white mouse. It was not unexpected that the sound of the response evoked fear in Eckbert, who, after repeating this several times, was accompanied by a white mouse, and Eckbert was terrified of the white mouse. Therefore, the fear response to a previously non-existent rat corresponded to this process of time and distance conditioning. (4).

However, this experiment is a turning point in the history of graphic behavior. It should be noted that other attempts to prove the acquisition of fear by these methods have been less successful. Although classical conditioning may be part of this process, caution is that in the real world, the fear response is seldom repeated with a stimulus unrelated to the stimulus, and fear arises with such a stimulus, and in proposing a two-factor theory in This study has contributed to the growth and survival of panic. As mentioned, fear is created through classical conditioning, and one learns to alternately reduce this fear through avoidance. This second type of learning is called device ventilation. And the reason is that the person learns the answer of avoidance and maintains it. This means that this response reduces anxiety if it is considered a booster. Seligman's theory of readiness also helps us understand how fear is conditioned because it has been shown that those stimuli for which we are biologically ready become conditioned faster than those for which we are not very ready. Pervasive anxiety disorders are thought to develop in a manner similar to panic attacks. A neutral stimulus is accompanied by an unpleasant experience and then the person shows a conditioned emotional response. However, because it is very difficult to identify panic symptoms or they are very effective because of such symptoms. It becomes impossible for a person to escape from fear. Thus, panic can be considered as a conditional avoidance response while pervasive anxiety disorder has become a conditioned emotional response.

Behavioral aspects

Social anxiety is a persistent fear of one or more situations in which a person is exposed to the supervision of others, and the fear of misbehavior or misbehavior is consequently humiliating or embarrassing. This goes beyond the usual shyness, which in many cases leads to the avoidance of important social and professional situations. Anxious situations can involve almost any social relationship, especially attending small groups, parties, talking to strangers, hotels, and the like. Physical symptoms can include dizziness, palpitations, hot flashes, and upset heart. Panic is usually controlled by escape or avoidance behaviors. For example, a student may leave the classroom (escape) or refuse to give an oral report (avoid it) because he or she has already experienced severe anxiety or anxiety attacks while speaking in front of a group. Some small avoidance behaviors are seen when a person avoids eye contact with others. For example, a person chooses a place to sit that does not have face-to-face contact with others. In more severe cases, the person avoids facing any social situation that causes anxiety. Such avoidant behaviors in the affected person cause a severe decline in quality of life in the person and cause the worsening and progression of this disorder, so sufferers should seriously avoid avoidant behaviors.

Physiological aspects

Physiological reactions, like other anxiety disorders, are seen in social anxiety. When children are in an anxious state, they may show symptoms such as mood swings, crying, clinging to parents, or silence. In adults, there are tears in the eyes, excessive sweating, palpitations, tremors, and palpitations that result from a physiological response to stress. Redness is also commonly seen in these people. These visible reactions increase a person's anxiety. Recent research shows that a part of the brain called the amygdala, which is part of the limbic system, is more normal in people with social anxiety when faced with angry faces or scary situations. This study shows that the severity of this reaction is directly related to the severity of social anxiety.

Types of anxieties and fears

1- Generalized Anxiety Disorder: If you have anxiety throughout the day, no matter where you are or what you do, and if it lasts six months or more, you have generalized anxiety disorder, which often affects people. It occurs between 20 and 40 years. Men and women are equally popular.

2- Social fear or fear of people: This type of fear is very common. The person is afraid that people will make fun of him, belittle him or hurt him and that he will be attacked and harassed by others.

3- Fear or simple fear: This type of fear such as fear of heights, fear of animals, fear of flying or plane, fear of elevator or escalator, fear of lightning, fear of driving, fear of darkness, burial alive or Fear of death.

4- Panic disorder: Panic is a predominant and severe anxiety disorder that often lasts for a short time. During an anxiety attack, a person often experiences dizziness, distraction, rapid heartbeat, increased pulse rate, a feeling of tightness in the throat, a feeling of suffocation, shortness of breath, and a burning sensation in the body.

5- Panic disorder: Severe, recurrent and unpredictable seizures, following at least one seizure for a month or more, one of the symptoms of anxiety about the effects and consequences of seizures, constant thoughts about recurrent seizures, obvious behavioral changes Related to seizures. If these attacks are not due to the direct effect of the drug or medical illness or other mental disorders.

6- Common anxiety disorder: Severe anxiety on most days’ symptoms such as restlessness, premature fatigue, muscle tension, sleep disorders and difficulty concentrating, at least 3 of them are associated with anxiety.


The most important issue that can be deduced from social anxiety studies is the significant importance of timely diagnosis and treatment because over time, the cognitive, psychological and physical aspects of this disorder are strengthened and it will be much more difficult to overcome. However, most people with this disease come for treatment very late and after dealing with many problems in life. Because the disorder is not well known in many parts of the world and is thought to be caused by personality disorders, people with anxiety often seek self-medication. Another factor that affects this issue is the avoidance of patients to see a doctor because of the disorder itself. These issues increase the risk of drug addiction, psychotropic drugs and dangerous drug interactions. Research has shown the effectiveness of two types of treatment in social emergencies: drug therapy and short-term psychotherapy, such as cognitive-behavioral methods, the main element of which is the gradual placement in social situations. (2).

Academic Performance

Academic performance means achieving the expected level of education and bringing the education organization closer to its predetermined goals. Academic performance means increasing the level of learning, increasing the level of grades and acceptance of students in courses and levels of education, and in another definition, it can be said if a person's learning is commensurate with his ability and talent and no difference between his potential and actual ability. If not learning, it can be said that the student has achieved academic progress (5).

Many unsuccessful students reflect the difference between academic performance and intellectual capacity before any psychological pathology, social or cultural factors. These factors basically lead to low and unexpected grades by creating low motivation for academic success with limited possibilities to achieve it. Although little research has been done on the social and cultural roots of low academic motivation, there is ample evidence that beliefs of non-academic values and goals are nurtured by family, school, peer group, and gender roles (9).

According to some researchers, the determinants of academic performance are: intelligence, family environment, parental literacy level, peer relationships, motivation, self-concept and psychological adjustment. Socioeconomic, peer relationships, and school characteristics were examined, and each was somehow related to academic achievement. When a student is qualified in the school environment during the first few years and the same successful experiences are repeated in the next four or five years, a kind of immunity against mental illness is created for an indefinite period. Such a person will be able to easily cope with the pressures and crises of life and believe that failing the exam in any case will affect children and adolescents. Broken people experience depression, sadness, maladaptation and restlessness. One of the main reasons for failing the test is students' unfamiliarity with the conditions and method of the test. Students' fear of failing the exam also leads to cheating (4).

The importance of the effect of academic performance on students' mental health is such that some experts have considered it at least until the second half of adolescence as a basic criterion for diagnosing healthy performance. According to him, adolescents who, despite having a normal IQ, do not perform well in school, show significant psychological problems and have evaluated academic performance as evidence for students' mental health.

Factors hindering academic performance

In the etiology of this issue, the issue of fear of exams, which in psychology is called exam anxiety, exam anxiety as a common and important educational phenomenon, is closely related to academic performance and performance. Children and adolescents, like adults, not only do not have the wide range of anxiety during their development when they are rational and natural, but as a constructive force, they force the individual to act more effectively in different life situations.

For example, the average anxiety of an employee causes him to be on time at his office every day. This will make the job last longer and more productive, and ultimately more successful. Student anxiety forces him to try harder to take courses. Therefore, natural anxiety is one of the positive factors of personality and an integral part of psychological life. But when the anxiety exceeds what is necessary, we encounter abnormal behavior. A person with test anxiety vaguely feels anxious and restless. He has caused excessive sleep and fatigue. Such a person is constantly worried about possible problems that lead to a decrease in his mental concentration, thus making it difficult for him to make a decision. For example, in the case of a student who is very anxious when answering exam questions, this concern may cause him or her to be unable to focus on the question (the problem of concentration) and to doubt his or her ability to answer the question while a series of adverse physiological reactions (such as increased heart rate, dry mouth, increased sweating, etc.) caused by anxiety, this puts extra strain on the student and all of the above factors prevent the proper processing of learned information and reminders of things that has learned.

Reasons for dropping out

Studies on dropout characteristics show that they have a more ambiguous identity and image than graduates. They also have more emotional problems and less self-confidence. They also have more stubbornness, anger and disgust with authority than any other. In addition, they suffer from a sense of futility that they are trying to escape, they also do not have long-term goals, they want to live in the present, plan less and participate in purposeful activities.

These people see the world as unpredictable, deceptive, hostile, and belligerent, in addition to the fact that long-term goals are meaningless to them, and their plans are likely to go wrong and doomed to failure. For them, too, human relationships are fragile, random, unplanned, devoid of warmth, intimacy, and exploitation. In addition, various factors affect dropout and dropout, some of which are mentioned here. Economic and social factors - Absence of one of the parents, especially the mother - Lack of a suitable place to study - Rejection - Lack of learning - Lack of motivation Emotional incompatibility - Lack of love - Student personality and resentment - Factors within the family such as dissatisfaction Parents from marriage - Very strict or easy disciplinary standards - Excessive parental support - Their guilt - Long periods or periods of child separation from parents and weak family relationships - Poverty, unemployment - Alcohol - Addiction - Family disputes - Disorder and Lack of interest in education and training of parents.


It is of special importance in any society to study the problems and difficulties of students in the field of education and personality and to identify the factors that can hinder their individual and social development. Every year, a large number of students in our country, despite having sufficient ability, suffer from academic failure due to various factors, and some also drop out of school and are attracted to the false labor market. Not only does this endanger their mental health, but it also thwarts the effort to train skilled and specialized people in the community. It is associated with feelings of stress, anxiety and depression that reduce natural activities and social interactions. By teaching them anxiety management skills, they can be helped to continue living well. Therefore, encouraging students, creating successful behavioral patterns, strengthening anxiety management skills, avoiding any punitive and degrading behavior, and teaching them the correct ways to overcome life adversity are the most important steps that can be taken to help students. Anxiety as a part of every human life, in all societies, is considered as an appropriate and compatible response. Lack of anxiety or pathological anxiety can cause us many problems and dangers. Anxiety in a balanced and constructive way forces us to try to do our work on time and properly, thus making our lives more stable and productive. It is rare for anxiety crises to go unnoticed during puberty, sometimes appearing suddenly and sometimes gradually. Sometimes it is pervasive and sometimes it ends in a few hours.

Therefore, anxiety as a part of children and adolescents' lives is one of the factors in their personality structure. Therefore, some anxieties of childhood and adolescence can be considered natural and their positive impact on the development process can be accepted, because it provides an opportunity for people to develop their adaptive mechanisms to deal with stressful and anxious sources. Conversely, there is pathological anxiety, which is the source of inadequacy and incompatibility, and ranges from cognitive and physical disorders to unwarranted fears and panic, and deprives the individual of many possibilities. In general, every student in situations different schools, such as exams, fear of ridicule from others, and the like, experience varying degrees of anxiety. Although a limited amount of anxiety is necessary for human development, a large amount of it causes behavioral disorders and often forces a person to display nervous behaviors. If school anxiety exceeds a certain level, it can disrupt the educational process and psychological and social adjustment of students. Anxiety and anxiety have unintended psychological, social, family and even educational consequences for adults. These consequences often conflict with their personal goals. Adolescents are motivated to express aggressive behaviors, to escape unpleasant situations such as rejection, failure, abuse, etc., but the result of their aggressive behavior is often to create another unpleasant situation for themselves and others, which in turn creates a vicious circle.

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