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Dr. Alicia Tom Hayes specializes in adolescent and adult psychology. A systematic review found that adolescents with anxiety disorders face social and academic challenges. While academic performance varied, many experienced school refusal and lower entry into higher education. Tailored interventions should address diverse challenges and different types of anxiety disorders. College students may face increased anxiety due to new environments and living away from home. Another study explored how personality traits, particularly high neuroticism and moderate extroversion, impact stress responses in female students during exams. Those with high neuroticism showed higher levels of perceived stress and anxiety, potentially affecting academic performance. Students with low neuroticism may still experience anxiety-related issues during exams, but their response to anxiety may differ. Welcome to the Developmental Diaries, a psychology podcast. My name is Tess Kelley. I'm your host, and today I'm happy to introduce Dr. Alicia Tom Hayes, who specializes in adolescent and adult psychology. Her areas of specialty include mood and anxiety disorders, parent training for children with attention deficit hyperactivity disorders, as well as behavioral difficulties. Dr. Tom received her B.A. in psychology and sociology from Rutgers University and then went on to receive her M.A. and doctorate in clinical and school psychology from Keene University. Today, I am so happy to be discussing with her the topic of anxiety in respect to how it influences academic performance. Once again, thank you so much for joining us, Dr. Tom, today. My first question is in regards to a study that I had researched called Social and Academic Functioning in Adolescents with Anxiety Disorders, and this was a systematic review. In examining the impact of anxiety disorders on adolescents, a systematic review explored the relationship between clinical anxiety and social, as well as academic functioning. So researchers looked at a bunch of studies until about October of 2017, and out of those, 19 studies showed that teenagers dealing with anxiety disorders faced problems such as negativity in relationships and increased loneliness and vulnerability to victimization. And while many felt impaired at school, the academic performance did actually vary. So although these adolescents faced a higher risk of school refusal and lower entry into higher education, limitations included a focus on specific anxiety disorders and methodological diversity. So my question for you is, how might tailored interventions for adolescents with anxiety disorders be designed to effectively address the diverse challenges identified in both social and academic functioning, while also considering the various differences observed across several types and numbers of anxiety disorders? Yeah. So, you know, kind of like the studies kind of show, right, adolescents who have different types of anxiety disorders. So I know that it was a little bit, the studies was a little bit limited because it wasn't looking at specific anxiety disorders, so like social anxiety or generalized anxiety. But I think the function is mostly the same when we look at it in terms of that anxiety getting in the way of us being able to focus on anything else, right? So anxiety is very much, as much as it is a behavioral kind of somatic kind of disorder, it also is very much thought-based as well, too. And if you are having your thoughts consumed with whatever anxious pieces that you're focused in on, there is no way that you're going to be able to take on the academic pieces, right? School in and of itself is a very hard thing, right, when we think about it, just having to focus in the newer adolescence and we're teenagers, we've got lots of hard things that we're studying, geometry, algebra, and all the things that we are like, I'm never going to use this in real life, right? That takes a lot of brain power. And if half of our brain power is always going to all of these things that we're anxious about, it's going to be hard for us to pay attention in school. And then when we get not-so-good grades and we aren't able to pay attention in school, then we're not going to want to go. That's why we see those high levels of school refusal. And then if we're looking at the specific types of anxiety, if it is social anxiety or something along the lines of that, then we could see why kids would have school refusal, right? They're there, there's lots of it. I was looking at some of the separation anxiety component. Now we're nervous about whoever we're separating from, whether it be mom or dad or something bad happening there as well, too, so I could definitely see how the two could be correlated in terms of not wishing to be at school while we're kind of having these struggles with anxiety and how it could impair our academic functioning as well, too. Yeah, I completely agree with you. I also found with my own experience of being an adolescent, I definitely was getting anxiety in classes, and especially as a college student, that really spiked for me because, you know, I'm on campus 24-7, which is extremely different from when I was in high school and I had the ability to go home and have my alone time and be in the comfort of my family. Yeah, you're absolutely right, right? College is a huge life change. Many people, like our traditional college students, those of us who are coming straight from high school into college, these are 17-, 18-year-old kids, right? And this is the first time a lot of people are living away from home, away from their safety blanket. Some of us are moving far out, right? We're moving or leaving our home states and going far out for the first time. And like you said, one big piece is that college is, you're there all the time, but when you're not in class, you don't get that off switch of that safety of I'm at home with my family and the people that know me best where I can kind of shut down, turn off, and just be me, right? Now we're living in a situation with a roommate that we may or may not know, right? And now we have to be on and we have to figure out how to navigate how am I speaking to this person, how am I telling them I need them to be quiet when I have to go to sleep or I can't have a guest here. All of these kinds of things are triggering, right? And if we're already anxious in and of itself, it's going to be that much more triggering as well. It definitely makes sense with the higher education piece as well too. Okay. So shifting the focus from sort of in adolescence, we're going to move on to the topic of the stress responses and specifically females. This is something that I kind of, when I started my research project, I was like, I really want to look specifically at how it affects females in general, right? And especially, you know, students, female students during exams to kind of explore another facet of the relationship between mental health and academic experiences. Question two was a study called Female Students' Personality and Stress Response to an Academic Examination, Anxiety, Stress, and Coping in International Journal. And in the study, researchers explored how women's psychological and hormonal responses to stress during real life examinations are influenced by their personality traits. They categorized female students into two groups based on personality clusters, one with high neuroticism and moderate extroversion, and another with low neuroticism and high extroversion. So the HNME group showed higher levels of perceived stress, emotional dysregulation, and negative effect. They also exhibited elevated state anxiety levels before and after the examination compared to the LNHE group. Additionally, cortisol levels were higher on the examination day for all women with a potential link between cortisol release and personality clusters. So the question I had for you about this study was, how do personality traits, particularly high neuroticism and moderate extroversion, impact the relationship between stress responses and academic performance in female students? Gotcha. So when it comes to those of us who have high neuroticism, we want to think about, look, what does that mean? So now we're super focused, we're very anally retentive in that kind of way, so we're going to want to be perfect. And now when we're trying to get the grades that we want to get, we're going to go above and beyond to try to get those grades. Now we might be up all night studying, we might be cramming, we might be doing all of these things and putting way too much pressure on ourselves so that when we get to that examination, our anxiety level is going to be through the roof. And like we said before, anxiety, as much as it is a thematic response, it's very thought-related as well, too. It's very thought-based. So if we have that much level of anxiety, are we going to be able to recall anything that we just studied? It's going to be like a whole block there, and now we're going to be even more anxious because I can't remember anything. Our anxiety we're going to feel in our body, that's going to go up and then it's just going to be a horrible cycle, whereas some people, you might see people start crying during examinations or people running out of a room, and that's typically the pattern that's happening if we aren't able to calm ourselves down in that moment, take a few deep breaths, clear our thoughts a little bit, and try to recall what we've been doing, then we're just going to be kind of stuck. So I can see how that personality style can kind of be linked to those high levels of anxiety when we're test-taking as well, too. Is it possible, obviously, in the study it said, compared to the LNHE group, so low neuroticism levels, is it possible to have low neuroticism levels but still deal with anxiety-related issues that causes, you know, problem-solving issues like during the exams? At least I find that when I, if I read like the first question of exam and I don't know it, it just sets me off, and like for the rest of the questions, I'm like, I don't know the answer to that, but in reality, when I get the test back later, I'm like, I did know all these questions. Mm-hmm. Mm-hmm. Got you. So that's actually a wonderful question, right? So when we have lower levels of neuroticism, right, that anxiety doesn't necessarily, the anxiety itself doesn't change. We're so anxious about that test is still something that's important to us. What changes is how we are responding to that anxiety, right? So if we have higher levels of neuroticism and we've got all of these things happening in our brain and we aren't able to turn it off or manage it in a way where we can say, okay, let me push through, then we're going to see people, like we said, people crying, crying at a test. Right. Those of us who might have a, will be lower on that characteristic may be able to shift it a little bit, to feel all that anxiety and say, okay, let me take a deep breath. I might not know this first question, but let me go to the second question and see. Let's be able to kind of regulate ourselves enough to be able to get through it. Not saying we don't feel anxious still the same way, but we might be able to know how to manage it a little bit better, and that is always the key when we're dealing with anxiety, right? So there's anxiety when we have it, either we're going to do something that's going to blow it out of proportion or we're going to do something that makes it more manageable. So it all depends on how we're dealing with that anxiety that makes it bigger or smaller as well too. Right. Exactly. I guess an additional question that I have that just kind of popped into my head is, is there a biological or genetic factor that plays a role into children's academic performance? In doing my own research and speaking to my parents, my dad, when he was in school, had lower levels of neuroticism comparatively to my mom, who was more similar to me. Her and I definitely in our discussions have similar academic anxiety, you know? And in doing my research, I thought about the term nature-nurture and wondered if it played a role in academic anxieties. I think that that goes to the classic nature-nurture debate, right? So which kind of plays a bigger role? And in reality, I think that it's 50-50, right? I think that there may be some biological genetic factors that may have been passed down from one parent or the other in terms of anxiety that makes us a little bit more if we're going to be anxious, okay, we may have a little bit more ability to be anxious if we are connected to these parents who have these genetic factors, right? But I believe like the nurture part is the piece that's going to play another big piece of the role as well too, right? So if we already have that genetic factor and we have that ability to say, okay, I might be a little bit anxious, how we respond in that environment is going to make it bigger or smaller, if that makes sense. So for example, if a person kind of sees a parent or something like that, and they see the way that they respond to anxious moments, right? We might just automatically kind of start to respond in that way as well too, because that's something that we're witnessing in our environment and now we take on that trait as well too. So I think it might be a little bit mix of both of them that kind of sprinkles down on children. Just like in the other way, we can kind of see how a parent responds to anxiety, I don't like that. I'm not going to do that as well too, right? And that goes for any kind of trait as well too. So I think it's kind of a mix between both, you know, the biological factors and the genetic factors that makes us a little bit more predisposed to having anxiety. But I think an environmental piece, right, and how we're what we see within our environment helps to kind of bring out that anxiety and how we respond to it as well too. Right. And kind of one way that I've been able to cope with my anxiety in regards to test taking is receiving extra time and taking it in a reduced environment. So this is actually leading on to my next question. So this study surveyed the impact of depression and anxiety on speed of academic performance and retrieval fluency in post-secondary students. And it evaluated the functional effects of severe mental health symptoms on academic performance. Researchers analyzed data from 1,476 students. The focus was on individuals with mental health diagnoses, particularly anxiety and or depression who reported high symptom levels. Surprisingly, these students did not differ from clinical controls on timed academic measures, suggesting that they typically perform tasks within a normal timeframe. And on the other hand, students with reading disabilities were noted as the slowest in academic performance. They concluded that students with mental health diagnoses may not need required increase of time for speeded academic tasks, but alternative accommodations may be necessary for their equal participation in post-secondary programs. Now I thought going into my research about anxiety on academic performance that I would find several studies supporting the fact that people who do have higher levels of anxiety need extra time and have the opportunity to take it in a reduced environment. I was really surprised to find this study, which went against that statement. So my question for you is, how can teachers and counselors help students with anxiety or depression, especially since the study shows that they usually complete academic tasks within a regular timeframe? And what does this mean for things like giving extra time on assignments? Is it not useful? Well, I actually have some questions about the study in and of itself, just what it sounds like. So when we are screening for, for example, learning disorders, dyslexia, math issues, whatever it may be, there are tests that we do. So we have a battery of tests that we do that kind of shows that this person has this disability based on this set of tests. It sounds like most of the anxiety or depression measures that we're giving are self-reports. So when we are using self-reports, if we're doing research on self-reports themselves, it kind of reflects that people sometimes embellish or they undersell how they're doing on self-reports as well too. So if we're comparing self-reports of students with anxiety and depression saying, okay, this is how I'm feeling, check, check, check, versus actual cognitive tests, that's kind of a little bit more reliable in that way. Yeah. Then that piece, I'm kind of looking like, who is the population that you guys really like looked at to kind of really compare these two things as well to really kind of say, yes, these kids with anxiety and depression don't need as much time as these kids with, you know, learning disabilities as well too. So that part's a little bit like, yeah, for me, but let's just say that, let's just say for the sake of this, that they're kind of saying that your question was what, sorry, I got thrown off. No, I just thought it was, I thought it was an interesting study because obviously, you know, that I do receive extra time as somebody who does have anxiety. And I feel like that over the years has really improved my growth mindset because I'm not sitting in a classroom comparing myself to other students as they're getting up and like have already finished the exam. Right, right, right. Like my, my question was, how can teachers and counselors say if this doesn't help all students with anxiety and depression receiving extra time, how can they help college students with anxiety or depression in regards to improving their academic performance if extra time is not the answer? The extra time is one piece, like you said. So the extra time gives us a little bit of that flexibility, like you said, in terms of, okay, I don't have this hour. And we know a lot of the times when someone is, like we said, that anxiety-based, thought-based kind of cognitive-based disorder, that when we sit there, the first five minutes, we could be kind of like frantic, right? And if we give ourselves the minutes to calm down, then we're able to kind of get through the test and realize, okay, maybe I do know some of this stuff, but now we've just wasted some portion of our time trying to manage our anxiety before taking it. So I do think that the extra time can be helpful for sure, depending on the kids. Some kids, you know, it might not be so depressed, right? I think that one thing that you touched upon that I think that could be useful is us having it in a whole separate room. Even if we didn't have the extra time and we said, okay, you'll be taking it separate in this room, I think that might be helpful only because, like you said, now I'm not comparing myself to the other students that's gotten up. Now I have a space where I'm nice and quiet, and it's just me, and it's just like if I'm in my dorm room studying, right? So I think that that piece might be helpful as well, too, even if it's like we're not going to give you the extra time. It's going to be the same hour and 20 minutes everyone gets, but you'll be able to kind of take it in a separate room. That might be helpful as well, too. Another study that I did was co-developmental trajectories of specific anxiety symptoms from middle childhood to early adolescence. So, you know, younger children, obviously, I wanted to do like younger children up until college graduates. Yeah. So the study investigates the co-developmental trajectories of specific anxiety symptoms in children transitioning into adolescence and their associations with psychological well-being and academic achievement. And the research conducted with 715 Chinese elementary school students over three years identifies five distinct anxiety trajectories, congruent low, which is like the lower group, moderately low with predominant social anxiety, and moderately low with predominant school anxiety, moderately high with predominant generalized and social anxiety, and congruent high. So these findings revealed varying levels of psychological well-being and academic achievement based on the trajectory group, emphasizing the importance of considering individual differences in designing intervention programs for optimal outcomes. So my question was, how did the identified patterns of anxiety development in this study shed light on the connection between students' perception of their anxiety and their actual academic achievement? Gotcha. Gotcha. Okay. So firstly, the individualized portion, right, I think is super, duper important, right? And, you know, just working with all of my patients that I work with, that's always what I look for. Even if somebody has, two people have the same diagnosis, that's great, but they're two different people who do two different things, right? And have different levels of the same thing. So I always think that taking an individualized approach is always going to be useful to helping that person in particular with whatever it is that they're struggling with, whether it be in therapy or in school or whatever support that they kind of need as well, too. I just wanted to say that part because I think that that's really useful. But now I forgot the question, sorry. No. So how did the identified patterns of anxiety development in this study shed light on the connection between students' perceptions of their anxiety and their actual academic achievements? Gotcha. Gotcha. So basically what the question is asking is the way that the students saw their anxiety kind of plays a role in how they performed academically. The way that we are kind of looking at our anxiety, if we think about it, right, it makes rational sense, right? If we're thinking, oh, I've got so much anxiety, I can't focus, I can't do this. And of course, we're not going to be able to focus on anything else but that because that's where all of our attention is going. We're not going to have any room to focus on anything else, right? So if we kind of perceive it as, oh, I've got all this anxiety, but now I'm getting meds, I'm going to therapy, I'm getting medication, whatever it may be, even with those things helping on a higher level, just on a regular placebo kind of level, it's going to make us feel a little bit different just knowing that there's some intervention, some help, some reprieve that I can get versus those of us where we feel like my anxiety is so high and there's nothing I can do about it, right? When we just feel like there's nothing we can do about it, that's that learned helplessness kind of feeling, and we're going to feel stuff. We're going to feel like nothing matters. Why do I need to go to school? Why do I need to learn? I don't have the space to learn this. I'm busy managing this big anxiety. So if we think about it, it definitely makes sense how our perception of our anxiety would definitely affect, you know, our academic ability as well, too. Yeah, when I was in high school, a way that my school kind of kept us from feeling anxious was we couldn't see our overall grades. So we would have to go to an advisor and ask them to see our grades. And I actually, I thought that was a really smart idea because, you know, I feel like in at least my generation, we have like an app where you can just pull up your grades and you can see like all of the assignments left, like what percentage is worth, like what grade is worth what. And I guess I thought it was a really good idea. And I don't know if, you know, people should implement that into schools. And if that's just a self thing, if I just thought that was helpful, or if that might actually be a good thing for students, because obviously, you know, people have anxiety in regards to academic performance when taking exams. But I think an interesting thing to like note is that people can also have anxiety by their grades. Even seeing their grades, like seeing a B, like freaking out because you have a B or a C. I guess I was just wondering what your take on that was. I think that, like we said, that individualized piece is going to be important, because for different people, it's going to work in different ways. For some people, it can be a motivation, right? So if I see my grades, and I know I have to do this, this, and that to kind of get there, and that's great. But then we have, you know, those kids who are constantly checking, who are on, you know, that app just going and going and looking and refreshing and what is this and what is that. And that can be very anxiety provoking as well, too. So I think a happy medium, something that could be useful, is whatever apps we use out there. I know there's lots of different ones for different schools. But it having some kind of like restriction on it, where it's like you only can check your full grade or whatever it may be, maybe once a day or something like that, right? Like some kind of limit so that kids are not there every day. But they can kind of take a glimpse and say, okay, what do I need to do if I, you know, need to get a higher grade? Or, okay, that grade is kind of low. I need to do something to pass it up. I think that could be useful in kids being able to take responsibility for their grades and learning that that's on you to make sure you get your assignments done and that you have the grades that you want to have. But I think having some kind of restriction or some kind of limit to how much we can access it is going to be helpful in terms of those overly anxious kids that are just looking all day trying to figure out what do I piece this piece together to get this grade and kind of causing that piece as well, too. Yeah. Right. I completely agree with that. So another topic I found interesting in doing my research was the effects of a growth mindset on academic performance. I thought it would be interesting to include the phrase growth mindset in this term because we did learn about it in my psychology course this semester. And just to reiterate, a growth mindset is the belief that abilities can be developed through hard work in contrast to a fixed mindset where abilities are seen as fixed. This mindset has important effects on academic performance. So this study explores how childhood adversity, particularly threats and deprivation, relates to academic achievement and mental health in 408 youth between ages 10 to 18. It found that both threats and deprivation were linked to a lower belief in a malleable intelligence with threat being more significant. A lower growth mindset was associated with poorer academic performance and more symptoms of anxiety and depression. The study suggests that fostering a growth mindset may be a promising approach to alleviate the impact of childhood adversity on academic and mental health outcomes. What are the potential long-term consequences that you believe of undertreated or untreated anxiety on students' future educational and career trajectories? Right. So that's a big one, right? Because we have, you know, individuals, and for me specifically, I work with mostly my children, my teenagers, my young adults, right? And I chose that population for a reason, right? Because the earlier we get into there, right, early intervention is always key. The earlier we get in there to help us first acknowledge that we're feeling anxiety and then being able to use the proper coping skills, you know, to manage that anxiety is going to help us in the long run. Even if when we're adults we have to get back into therapy here and there to refresh some things, having that ability to kind of say, I know what I'm working with and I know how to manage that is going to be so crucial in us to be able to manage all the other areas of life as well too. But if we have this kind of anxiety that's been untreated, and for a lot of people who've had anxiety that's been untreated, a lot of the time people are also undermining their anxiety as well too, telling them, oh, you'll be okay or it's not that serious. And when we kind of have that, that also takes impacts on our self-esteem, which is then going to hurt us in the long run in terms of if I am in school and I am trying to get good grades and the grades is not, you know, meeting the criteria of what I think is okay because I'm so anxious, now that takes another impact on our self-esteem. When we have lower self-esteem, not only does it hurt us, but then it hurts our social, you know, our social connections as well too. We need to be able to be sociable and have that kind of connections as well too, just as humans. And then we kind of need that just for our future function at work, with people. All of those things are all wrapped up to intertwine with one another. So there is such a huge impact of us not being able to treat anxiety or any kind of mental health issue or concern that we're having and kind of like pushing it to the side of pretending it's not there. That's never going to be helpful, right? And the earlier that we're able to do it, it's going to be the most impactful in us being able to manage it, you know, for the duration of our life as well too. Yeah, I just thought, do you think that, say that, you know, you go throughout high school with it undertreated or undertreated, do you think that that will, as a young adult, that will just like hinder your growth in general with careers? Like, say if you never go to therapy and then, or you don't do anything to treat it, and then you're like 25 and realizing that you can, does that mean that, you know, does it just mean that it's going to be harder to obviously contain that anxiety and treat it? Or will they just always have severe anxiety? No, I think the former for sure, right? That it's just going to be a little bit harder for us to be able to now undo or unlearn all the things that we've kind of, you know, learned about our anxiety or what we perceive of our anxiety for 25 years or for 30 years or for 40 years or whatever it may be. So the later we wait, it is going to be a little bit harder because we form certain patterns that it's going to take that much more work to undo those patterns. But it's not that they aren't going to be able to do it. They can definitely do it. It'll be a lot of work. And because it's a lot of work, some people don't stick with it. And then they find themselves in a place where they're stuck, right? But for those of us who do kind of stick with it and get through the hard part of the pattern, then they'll be able to find, you know, that they're able to kind of see those changes and manage their anxiety a lot better as well too. So it's definitely doable, but it's just going to take a lot of work and it's going to take a lot of dedication for us to be able to push through that as well too. Yeah, I completely agree. Even within myself, I need to refresh on therapy every few months after even going to therapy for eight years just to make sure that I'm not going back into my old ways, specifically in regards to anxiety. I think it's really important to continue putting in the hard work to have and maintain your fixed mindset. I definitely notice sometimes, especially when I transitioned from the summertime back into school, that I need to refresh upon my coping mechanisms and maintaining my anxiety during academic exams. I think it's really important for every individual, regardless of who you are, to every once in a while, check back in with your therapist and review the coping mechanisms that you've gained in therapy and just refresh them. Anyway, we are unfortunately all out of time today. Dr. Tom, thank you so much for joining us. Once again, I'm your host, Tess Kelley, and thank you for tuning in to The Developmental Diaries.