| Objectives:This study chose 549 middle school students as the subjects to explore the main influencing factors of anxiety, and the impact of exam stress on cortisol and saliva alpha-amylase levels. We aimed to provide theoretical basis for the anxiety interventions and exam stress-related mental health work in middle school students.Methods:We first used cluster sampling method for the psychological evaluation and investigation of all the students. The psychological questionnaires included:self-rating Anxiety Scale, Stress Scale of Middle School Students, Chinese Maslach Burnout Inventory Student Survey, Cognitive Emotion Regulation Questionnaire-Chinese Version, Big Five Factor Inventory, Social Support Rating Scale. We collected the test scores of three courses including Chinese, Math and English after their final exams. We collected the saliva samples of 103 first-year junior middle school students during usual time and at the day before the exam respcetively. We used High Performance Liquid Chromatography method with fluorescence precolumn derivatization for the cortisol analysis, and iodine-starch colorimetry for saliva alpha-amylase (sAA) activity. The SPSS 16.0 software was used for the statistical analysis of data, including:T-test, χ2-test, correlation analysis, ANOVA analsis, Regression analysis, et al.Results:(1) The mean SAS standard scores (42.31±10.35) of all 549 students were significantly higher compared to the national norm and the 2462 teenagers’SAS standard scores. The SAS standard scores of male and female students had no significant difference. The incidence rate of anxiety in all the 549 middle school students was 20.22%:mild anxiety accounting for 13.65%, moderate and heavy anxiety accounting for 6.55%. (2) The anxiety level of students from different grades was significant different. The students of grade three had the highest SAS standard scores and highest incidence rate of anxiety, while the preparatory class students had the lowest SAS standard scores and lowest incidence rate of anxiety. Both the highest and lowest SAS standard scores were significantly different with the scores of students from other grades. The highest and lowest incidence rate of anxiety were different significantly with the incidence rate of grade one and grade two students. (3) The SAS standard scores of students from different grades were further divided into four ranks (<39,40-49,50-59,>60). The test scores of students with the lowest SAS standard scores (<39) were significant higher than students in other three ranks. The test scores were not significantly different among other three groups. (4) Anxiety was significantly correlated with exam stress, cognitive emotion regulation, five-factor personality, social support, and study burnout. (5) Nervousness, physiologica burnout, self body-mental stress, positive re-appraisal, catastrophizing were the main influencing factors of anxiety, and these factors could explain 54% of anxiety. The dangerous factors were:nervousness, physiologica burnout, self body-mental stress and catastrophizing, while the protective factor was positive re-appraisal. (6) The cortisol level at the day before exam was significant higher than the days during usual time. However, the sAA activity at the day before exam was lower than the days during usual time. (7) There were no significant difference of cortisol levels between boys and girls at the day before exam and other days. The girls’sAA activity was significantly lower than boys at the day before exam. (8) Students with different ranks (high, medium, low) of sAA activity showed significant difference on study burnout, social support, positive re-appraisal, and exam scores. The medium SAA activity group at the day before exam showed higher study burnout, social support and positive re-appraisal, but lower exam scores.Conclusions:(1) The anxiety level of the middle school students in this school reached one fifth, which showed the anxiety problem was obvious. (2) The anxiety level of different grades was significantly different. The preparatory grade students’anxiety level was lowest, while the third grade students’anxiety level was highest. The gender difference of anxiety problem was not significant. (3) Students whose SAS scores were lower than 40 had higher exam scores, while students whose SAS scores were higher than 40 had relative lower exam scores, although the difference among groups were not significant. (4) Anxiety was closely correlated with stress, cognitive regulation, personality, social support and study burnout. These five factors:nervousness, physiological burnout, self body-mental stress, positive re-appraisal and catastrophizing could predict anxiety. The main influencing factor was nervousness. (5) Cortisol level and sAA activity were both sensitive to psychological stress. Although there was no gender difference of cortisol levels when exposed to exam stress, the sAA activity showed gender difference under exam stress. Students with different sAA activity showed significant difference in exam scores and psychological status. |
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