By Tamara Rosier, PhD, Research Committee Chair

Worry-based and Irrelevant Thoughts:
Students with ADHD and Their Test Anxiety

It’s back to school again. Many of my new clients are returning to classrooms with the same complaint: Test anxiety. They participate in class, do all of their homework, study diligently, and feel that they have a grip on the material. But on the day of the test, they blank out, freeze up or zone out. They feel so nervous that they can’t gather their thoughts together to respond to the questions they knew the answers to the night before. Although a touch of nervous anticipation can actually help an individual focus and remain at peak performance while taking the test, some students experience nervousness so strong that it interferes with their concentration or performance.

Test anxiety is not only a problem for the test taker; it is also a problem for those wanting to interpret the test. It can lead to underestimation of the individual’s knowledge. A recent study examined test anxiety in college students with and without attention deficit hyperactivity disorder (ADHD). Researchers hypothesized that college students with ADHD would report higher test anxiety than those without ADHD.1


Sixty ADHD participants (25 female, 35 male) were carefully selected based on clinical evaluations, and a diagnosis using DSM-IV-TR. Individuals with any additional psychiatric diagnoses were excluded so the researchers could reasonably conclude that group differences were due to ADHD.

Non-clinical participants were 60 undergraduates (25 female, 35 male) enrolled at a large Southeastern university. These participants were recruited from a research pool comprising students in introductory psychology courses. Exclusionary criteria included any self-reported current or previous learning disorder (LD and/or ADHD) diagnoses.

Each group took the Test Anxiety Inventory (TAI), a self-report psychometric scale, used to measure individual differences in test anxiety as a situation-specific trait. Two major aspects are measured: (1) worry – cognitive concerns about consequences of failure and, (2) emotionality – reactions of the autonomic nervous system that are evoked by evaluative stress.


Results confirmed the hypothesis that college students with ADHD would report significantly higher test anxiety than college students without ADHD. Though these results are consistent with previous findings, they enhance prior findings in that comorbid disorders were excluded in the current study, permitting a clearer picture of ADHD, rather than co-occurring disorders, as the reason for heightened test anxiety. As predicted by the researchers, females with ADHD reported higher levels of the emotionality aspect of test anxiety than did males with ADHD.

The differences between the groups with and without ADHD on the Worry scale were large. The mean score responses of college students with ADHD to the TAI Worry scale was over a standard deviation higher than the mean score for college students without ADHD. Nearly half of the sample with ADHD (26 of 60 participants) reported clinically significant levels of the worry aspect of test anxiety. Compared with their peers without ADHD, more than six times as many college students with ADHD reported this level of worry-based test anxiety.

What This Means for Coaching

Though this research only concluded that college students with ADHD self-reported a much higher level of test anxiety ADHD students, it suggests that college students with ADHD may expend a substantial amount of their cognitive resources on distracting, worry-based, irrelevant thought while test taking. For example, a student I know worries as she takes a test, “I will get grounded if I fail this test.” Her worry, not only distracting, leaves her with less processing capabilities, exacerbating her working memory difficulties. Instead, she needs new skills and strategies to replace her test anxiety behaviors.

Test anxiety, though very real, is a waste of energy. As ADHD Coaches, we can help our students when we teach them strategies to confront their test anxiety such as —

  • Cognitive rehearsal, visualizing the “perfect test day” with incredible sensory detail;
  • Writing briefly about their anxiety before a test;
  • Replacing maladaptive self-talk with useful metacognitive self-coaching.


1. Nelson, J. M., Lindstrom, W., and Foels, P.A. (2014). Test Anxiety and College Students With Attention Deficit Hyperactivity Disorder. Journal of Psychoeducational Assessment, 32:548. (originally published online 18 February 2014 DOI: 10.1177/0734282914521978)

TamaraRosierTamara Rosier, PhD, has been an administrator, professor, leadership consultant, public speaker, and high school teacher. Now she is a passionate Leadership and ADHD Coach who helps her clients develop more confidence, smoother communication, closer relationships, and increased success. Contact her at 616-648-1969 and