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[Digital mental health interventions for test anxiety. Supporting Students Under Pressure: A Systematic Review of
1Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary;
Introduction:
Test anxiety impacts approximately 25-50% of university students' psychological wellbeing and academic achievement, yet support options remain limited. Despite rising demand for mental health services, many students face barriers in accessing help. Digital mental health interventions (DMHIs) could provide accessible support; however, their effectiveness in alleviating test anxiety has not been systematically evaluated. This review aimed to assess how effectively DMHIs reduce test anxiety in students and to identify key features of these interventions.
Method:
The protocol was preregistered on OSF (July 21, 2025) and adhered to PRISMA 2020 guidelines. Searches were conducted in PubMed, PsycINFO, Scopus, Web of Science, ERIC, and ClinicalTrials.gov in August 2025. Eligible studies involved higher education students, utilized a DMHI, reported validated test anxiety outcomes, and employed experi mental designs. Risk of bias was assessed using RoB 2 and ROBINS-I tools.
Results:
Eight studies with a total of 813 students met inclusion criteria, including six randomized controlled trials. Inter ventions utilized multicomponent, mindfulness-based, or serious game formats delivered through web or app platforms. All studies reported reductions in test anxiety post-intervention; however, only three found statistically significant improvements over controls. Multicomponent programs showed the most consistent benefits. Most studies assessed test anxiety with a bidimensional measure, though emerging models highlight the importance of a multidimensional perspec tive to distinguish components.
Conclusion:
DMHIs hold promise for reducing test anxiety, especially when integrating cognitive or dialectical behavioral therapy with study skills or mindfulness. Further research, including follow-ups and multidimensional assessments, is essential to establish their full efficacy.
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