Tag Archive for: PRITE

Syndrome Series: Obsessive Compulsive Disorder

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obsessive compulsive disorder shoes

What is Obsessive Compulsive Disorder

Obsessive Compulsive Disorder (OCD) is a condition characterized by the presence of obsessions and/or compulsions. Obsessions are recurrent thoughts, urges, or images that are intrusive and unwanted, while compulsions are repetitive behaviors or mental acts that are applied to the obsessions (or other rules) that are rigidly followed.

Types of Obsessions and Compulsions

The types of obsessions and compulsions vary broadly, although there are common themes. Stereotypical OCD symptoms showcased in media are fear of contamination accompanied by compulsive cleaning (seen famously on the TV show Monk). Other common themes include symmetry (organizing, ordering, or counting compulsions), morality (sexual, aggressive, or religious based compulsions), or harm (checking compulsions for fear of harming others). These themes are seen globally across cultures with minor variances.

The performance of the compulsion is done in an attempt to mitigate anxiety or distress associated with the obsession. Individuals with OCD typically have an impending sense of doom if they don’t perform the compulsions, or they may believe something horrific will occur if they do not perform the tasks. The individual with this condition finds distress in their compulsions and obsessions and avoiding the compulsion or obsession can take up a significant amount of time. Because of this, they may avoid of people or certain places in order to avoid a trigger for a compulsion.

Realistically, the action and obsessions are not connected in any significant way. However, the extent that the individual believes this depends on their insight.

Insight

Insight refers to how well the individual recognizes the credibility of their beliefs. They may have good or fair insight in which they realize their disordered beliefs are definitely or most likely untrue; poor insight in which they think their obsessive compulsive beliefs are probably true; or absent insight in which they are completely convinced their disordered beliefs are true.

Prevalence and Transmission

The average age of onset is 19.5 years old, with a quarter of cases starting by the age of 14. Females tend to be affected slightly more than males in adulthood, while males are more affected in childhood. The prevalence in the U.S. is 1.2%, with similar prevalence rates seen globally. There is a 2x rate of familial transmission among first degree relatives with the condition compared to those without first degree relatives with the condition.

First Line Treatments

Treatment options for OCD generally includes psychotherapy and pharmaceuticals. These can be used exclusively or in combination with each other.

Psychotherapy

Cognitive Behavioral Therapy (CBT) is one of the first line treatment options for OCD. CBT is effective in treating OCD by helping the individual become aware of the cognitive distortions present that are leading to their compulsive behavior. Once identified, the clinician can work with the patient to untangle how the obsession and compulsion are not directly related and ultimately remove the desire to complete the compulsion when faced with a trigger.

In addition to standard CBT, there is another type of CBT called Exposure and Response Prevention (ERP) that can be highly effective in the treatment of OCD. With this type of therapy, the client is systematically exposed to gradually increasing levels of the trigger for their compulsions and assisted in learning how to reject the compulsion.

Pharmaceuticals

Mayo clinic reports the following antidepressants approved by the U.S. Food and Drug Administration (FDA) to treat OCD:

  • Clomipramine (Anafranil) for adults and children 10 years and older
  • Fluoxetine (Prozac) for adults and children 7 years and older
  • Fluvoxamine for adults and children 8 years and older
  • Paroxetine (Paxil, Pexeva) for adults only
  • Sertraline (Zoloft) for adults and children 6 years and older

Additional Treatment Options

Other treatment options may be considered if first line treatments fail. These include Deep Brain Stimulation and Transcranial Magnetic Stimulation. These options are typically reserved for cases in which neither first line treatments have been found to be effective, and are generally used in patients over the age of 18. In both these treatment options, different neurological regions of the brain are stimulated using electrodes in order to suppress compulsive thoughts and behaviors.

Ready to learn more?

Give our question banks a try- FREE- using our Free Trial! Or if you’re ready to take the plunge, check out our Question Banks and find the perfect fit for you! Or, contact us with any questions you have so we can get you on the right path today!

REFERENCES:

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

Mayo Clinic:https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/diagnosis-treatment/drc-20354438#:~:text=Antidepressants%20approved%20by%20the%20U.S.,children%208%20years%20and%20older

How the 5 minute rule can help YOU!

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stop watch for 5 minute rule

Spring is in the air, the sun is starting to shed some warm rays, and the first shoots of green grass are starting to burst out of the ground. If you’re like me, the LAST thing you want to do is be cooped up inside studying. Spring fever is real! But…so are exams 🙂

Some days it feels like there’s a mental block stopping you from doing anything productive. Whether it be due to distractions, mental overload, or just plain old tired of doing the same things, everyone feels this way from time to time. And let’s be real, being where you are right now is overwhelming. If you’re prepping for boards, maybe you’re in rotations, maybe you’ve got your own practice, either way there’s a lot of stuff going on around you. Your brain can get a little worn out from everything and demand a break. That’s where a good method like the 5 minute rule can come in!

What is the 5 minute rule?

The 5 minute rule is a concept used in several therapy modalities. It’s pretty simple- all you have to do is sit and do an activity for 5 minutes. That’s it. Then you can get up, walk outside for some fresh air, check your socials, do whatever you want. YOU GET YOUR BREAK!

The next step to this rule is after a while you go back and do another 5 minutes. 5 minutes on, an interval of time off, 5 minutes on, an interval of time off,– you get the point. Even though it doesn’t seem like you can do much in 5 minutes, you’d be surprised how far into a question bank you can get or how far into a chapter you can read in that much time. Especially when you’ve come back to it a few times!

So if the springtime song of birds are calling you to run outside, or the spring fever cleaning bug is making you want to reorganize your house, you can let it! Just slip in those 5 minutes throughout the day and you won’t get too off track.

Curious how far into a bank you CAN get in 5 minutes? Give our question banks a try- FREE- using our Free Trial! Jump on Test Mode and get a feel for how the timed version of exams work. Want more material to work with? Check out our Question Banks and find the perfect fit for you! Or, contact us with any questions you have so we can help you get your 5 minutes in!

How to Navigate Daylight Savings This Year

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Daylight on a green leaf
You need water and sunlight…you’re kind of like a houseplant with more complicated emotions 😉

In the coming days, most of the continental U.S. will adopt Daylight Savings Time (DST). From March to approximately November, most people will lose a whole hour of sleep by moving the clocks forward one hour. Because of this shift, those individuals will be exposed to less morning sunlight and more evening sunlight.

If you feel like your whole body is dragging for days, or even weeks, following this time change you’re not alone. Losing an hour of sleep may sound insignificant, but as most parents of small children and exhausted students cramming for exams can attest, that precious 60 minutes makes a huge difference.

The disruption of your circadian rhythm can lead to a host of difficulties including increase in depression, slow metabolism, cluster headaches, and weight gain. Further, in the weeks following DST there’s a noted spike in fatal car accidents, strokes, digestive and immune related diseases, and risk of heart attacks. AND…who wants to study when they feel like they can’t stay awake? It can make you feel more awake at night instead of during the day and then your whole schedule is out the window.

Daylight Savings Savers

This transition is difficult, but there are things you can do to help if you know you are particularly effected by the time change.

Maintain your sleep hygiene. If you have a solid sleep routine, be sure to keep on top of it during the time change. If you regularly journal or read before lights out, or whatever the ritual may be, be sure to start that process one hour sooner than normal to trigger the same conditioning.

Get outside in the morning! Depending on your geographical location, this may be easier said than done. However, if you can get out into the morning sunlight for just a little while that can help keep your circadian rhythm intact, or at least less skewed. Too cold where you live? Some people find benefit of using a sunlight lamp!

Try a morning workout routine. This involves the brute force of physical activity to wake up your body and reset your internal clock. Some people find a morning run refreshing, some people would rather crawl in a hole than do that. It’s all about balance 🙂

Do you bounce back from the DST transition, or do you find it difficult to function for a while? We want to help you either way. Let us help you get studying back on rhythm by trying out our Question Banks and find the best option for you! Or Contact us with any questions you have so we can help you set up a plan to help you reset your individual exam prepping clock.

REFERENCE:

https://www.nm.org/healthbeat/healthy-tips/daylight-savings-time-your-health#:~:text=%22With%20DST%2C%20between%20March%20and,and%20awake%20in%20the%20evening.

Make Your Residency Application POP

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hands filling out residency application on computer, smart phone, and paper

Matching a residency program is a stressful and time consuming process. Everyone that applies for a medical license has to undergo at least one year of residency in their medical specialty. And with about 40,000 applicants swarming the 35,000 open positions each year, the competition can be intense.

What’s more, the process can take upward of a YEAR to complete. Sound overwhelming? You’re not alone. We’ve compiled some information here to help you get organized and ready to match with your dream residency in 2024. Because, yes although Matching Day is right around the corner and the process is done for one cohort of students, it’s not too soon for you seniors to start thinking about next year!

Matching Timeline

First off, most people want to know exactly what timeframe they’re working with. Based on the current matching year (calendar from NMRP found here!), the process begins with registration opening in mid-September the year prior. So it makes sense to think, “Ok, that’s when I start applying!” and you wouldn’t be -totally- wrong. This blog post from matcharesident.com has a really great breakdown of when and how to start your application process.

You should really start about 3 to 4 months before registration even opens. This is because you want to take the time to research your programs of choice. You have to apply for and buy your ERAS token through ECFMG. Make sure you’ve taken and gotten your results back from the USMLE Step 2, CK (need a practice question bank? We know a guy 😉

Application Process

Next, you need to actually fill out your application. This can take as long as you need. Just BE SURE NOT TO CERTIFY your application until you are 100% finished with it, have proof read it 20 times, and have made sure it is completely and totally filled in. Ok, maybe not 20 times. You do you, boo.

You need to gather letters of recommendation and write personal statements (one statement for each specialty if you have more than one!). You need to request your USMLE transcript, your medical school transcript, and MSPE. Finally, once you have all your documents and letters uploaded, you’ve got a cute professional picture, and all your applications clean and shiny, you can start submitting them to programs. Lots and lots and lots of programs.

What makes your application special?

What we all want to know: what makes us stand out in a crowd? In this case, it’s a blend of extracurricular activity that aligns with your specialty interests along with an attitude to match. You need to have built a portfolio of volunteer basis work that shows your interest in helping others. But if you have a long list of volunteer work that has no apparent connection to wanting to be a physician or psychiatrist, the committees may see it as someone who doesn’t know what they want to do. It’s all about balance

Another aspect that can make or break an application process is your impression. Going into an interview with a positive, helpful, and caring attitude can be really difficult when you’re sweating bullets and terrified of messing up your opportunity. Be authentic, be open, and let your optimistic little light shine!

And then you wait

Yes. That is the unfortunate truth. You fill out miles of applications and pull together all the documents you need. Then you go sit for interviews (and send Thank You notes afterwards!). And then you rank the programs. Then you wait. Matching is released mid- March (the third Friday) and you will be notified either via email or R3 system.

We want the best match possible for you. We want to see you succeed in your specialty. Give yourself time, start thinking about programs now, and let us help you build your academic experience to be ready to apply. You’ve got this!

How to Break Bad Habits…For Good!

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neon sign reads bad habits

Every day we go about our day doing dozens of things on autopilot. We do them every day, so we don’t think about it. Most of the time, these are mundane tasks; sometimes, they’re good habits like taking a multivitamin or doing morning yoga; other times, they’re bad habits that over time become detrimental to our well being.

Maybe it’s picking up your smart phone first thing in the morning and scrolling through social media so that you end up running late. Maybe it’s staying up too late under the pretense of “me time” so that you’re not getting enough sleep and end up dragging through the next day. Whatever the habit may be, it’s important to identify these behaviors and put an end to them.

Recognizing Good vs. Bad habits

Habits can be physical, mental, reactive…they can take on almost any form. And as mentioned before, we have dozens if not hundred of habits. They aren’t all bad– a lot of these are necessary because we don’t need to be thinking intentionally about every little thing we do every moment of every day. So if takes deep personal reflection to mull over what habits you may have that are negatively impacting you. A good way to start this is to ask yourself, “Where is there a sense of discontentment in my life, and what are my actions or reactions surrounding that?”

How long does it take to break a bad habit?

Habits don’t form overnight. It takes time to wire your brain into doing the same thing over and over, and just the same it takes time to UN-wire your brain. Depending on the person, it can take anywhere from 18 days to almost a year to break a habit. This of course depends on several factors such as why the habit has persisted, what the habit is representing or reinforcing, and whether or not there’s something that can temporarily replace the habit.

Most habits are intrinsically reinforcing. That is, they make us feel good (hello, dopamine). They make our brain think it’s being rewarded even if the action itself isn’t positive. Maybe this sounds familiar, and it should. This is the foundational framework that addictions are based on! Breaking habits and addictions are difficult, but with a little help and persistence you can stop the cycle yourself.

How to break a bad habit step by step…

Firstly,

You must identify what the habit is. Let’s say every time you sit down to study for your boards, your mind starts drifting to some household tasks you’ve been meaning to do. Then you find yourself ruminating on the fact that you haven’t done any of those tasks in a while and your living space is falling apart. After a few minutes, you’ve convinced yourself that now is the ONLY time to do them and studying can wait.

The next day, you sit down to study and…your mind starts drifting to what you’re making for dinner. Do you have the risotto, or should you run to the grocery store? If you don’t go now, it’ll get too late and– suddenly you’re off on an errand. And so on. This is a mental habit. The association of studying and drifting becomes so strong that after long enough, it will become harder and harder to intentionally sit and complete the initial task (studying).

Next,

You need to set a goal. Use the acronym SMART (see our previous blog here on how to set SMART goals!) so make sure it’s realistic. Tell yourself you will sit and study for 10 minutes without distraction the first day. The next day make it 12 minutes. The next day make it 15 minutes. As you build up time, you’re training your brain to ignore the impulse to drift away while maintaining a reasonable goal for yourself so that you get that dopamine “boost” that the habit previously was providing.

Lastly,

Understand why you want to break the habit. In this example, studying for your boards is a vital step toward furthering your career. That’s a pretty motivating factor!

We want to help you break your bad studying habits! Contact us with any questions you have so we can help you set up a plan to get your habits on track! Want to make a habit to study more? Check out our Question Banks and find the best option for you! You’ve got this, and can definitely achieve whatever you put your mind to!

Is the Multiple Choice Question Really the Worst?

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the word "what" on a pile of question marks for multiple choice question

Most standardized tests, such as the USMLE, PMHNP, PRITE, or ABPN, are in multiple choice question format. The difficulty of MCQ tests seem to vary across individuals. Some love them, some (most?) hate them. There’s a biological reason for this!

Have you noticed that taking a test based on multiple choice questions makes you think differently compared to taking a test based on essays? Multiple choice questions make your brain process information differently. Specifically, multiple choice questions rely on recognition, whereas essay and open ended questions rely on retrieval.

Recognition… plus a little more

When you’re presented with options to answer a question, your brain kicks into recognition mode. It will look for associated information it has seen before to bypass using retrieval (a process that takes more effort). While this is cut and dry, an interesting phenomena can occur in regard to the distractor answers, i.e., the incorrect answers.

You may disregard the incorrect answers because you recognize the correct option, but your brain tucks those incorrect options away. Later, when you are presented with a question related to those answers your brain can spontaneously retrieve those answers more easily because its seen them associated with questions before. Crazy, right? Even if the MCQ test primarily uses recognition, your brain MacGyvers it into a means of storing more information to use later!

Ready to learn more?

Want to boost your brain storage for FREE? Give our question banks a try- FREE- using our Free Trial! Or if you’re ready to take the plunge, check out our Question Banks and find the perfect fit for you! Or, contact us with any questions you have so we can get you on the right path today!

REFERENCES:

Little JL, Frickey EA, Fung AK. The role of retrieval in answering multiple-choice questions. J Exp Psychol Learn Mem Cogn. 2019 Aug;45(8):1473-1485. doi: 10.1037/xlm0000638. Epub 2018 Aug 16. PMID: 30113206.

Time to go back to the ABC’s

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Yes, we know you know your ABC’s 🙂 But, sometimes it helps to reinvent the old classics to help us in the here and now. We’ve compiled a quick list of test taking tips that might help you as you prepare for your exams ( using A-E, because those are the letters you’ll see on the exams and maybe that will help keep these in mind!).

ABC blocks

The ABC’s of Test Taking

A Apply basic knowledge

This is the old adage, if you hear hoof beats, don’t assume it’s zebras. When you get your first look at a test question, whether it’s a standard multiple choice or a multiset vignette, the first thing to do is to look for the obvious. Most questions will be testing your basic knowledge and will give you clear signs that point to an answer. Some will be trickier of course, but a good rule of thumb is to dust off Occam’s razor and keep it in mind as you go through the questions. Keep your basic knowledge front and center!

B Block out distractors

Test makers are devious. There, I said it. They intentionally create distractor answers that will try to trick you (so rude). Falling back on the letter A, keep your basic knowledge in mind and then block out the answers you see off the bat as incorrect. For example, you might be reading a question about someone who is lethargic, has a lack of appetite, low mood, and disrupted sleep. Answer options could be Bipolar I, General Anxiety, Depression, PMDD, or Substance Withdrawal. Now, some of these conditions do in fact share the listed symptoms. But there’s missing information that would be required to make those answers the BEST answer.

Bipolar I would require symptoms of mania; GAD has other hallmark symptoms such as feelings of dread/worry that they cannot control; PMDD is cyclical around menstrual cycles in females; substance withdrawal requires mention of something that would cause the withdrawal. The distractors are there to make you second guess, so if one pops out as the best one, chances are it probably is!

C Check the question stem again

Well, maybe the distractors did a good job and now you can’t get passed it. Go back and find the question stem again. What is the question asking? Does it give the information you would NEED to make the other answer fit, or are you banging a square peg into a round hole? While the test makers are tricky, they aren’t totally evil. They will give you all the information you need with minimal need to fill in the blanks.

D Don’t over think it!

Ok, we got through the distractors and now we have our answer, Depression! Makes sense, fits the symptoms…wait, doesn’t it need a time frame to make a diagnosis? What if it’s none of these answers and actually something like Dysthymia? Or– stop. Stop over thinking it. Again, this is the job of the distractors to make you start thinking in circles. If the answer fits the information given in the best way, move on to the next question.

E Every little bit helps

You get about one minute per question on the exams, so you want to crank out as many answers as possible. And, most exams don’t “penalize” wrong answers, they just add up your correct ones. Leaving answers blanks and guessing and getting it wrong will do the same thing to your score. But, guessing might also get you one right! So if you need to stab a guess at one, DO IT because there’s a chance you could get it right!

Want to give this method a shot? Try our Free Trial and see how well it pans out. We’d love to hear from you, and you can Contact us with any questions you have or to let us know if these tips helped you or not!

The Going Rate: PRITE Passing Scores

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If you’ve bee following us, you may have noticed we’ve been running a series on Going Rates of the Industry. So far we’ve covered the passing rates for the ABPN and USMLE exams, as well as the rates and scores for the PMHNP exam. Today we’re going to delve into the PRITE!

hand writing in book while studying for PRITE

There isn’t a “Passing Rate” for the PRITE to speak of, because in order to continue on in school you HAVE to pass the PRITE. This makes it a little different than the other exams.

PRITE Overview

The PRITE (which stands for Psychiatry Resident In Training Examination) is administered in 2 parts over 2 days. Residents average out to taking the exam 3 or 4 times over the course of their training! This may seem strange, but we also know that repetition is a great form of learning so really it makes sense.

How many questions are on the PRITE?

300 questions make up the exam. It’s a hefty one!

What topics are covered?

Quite a few. Thirteen sections, plus their subsections.

  • Neurosciences
  • Clinical Neurology
  • Clinical Psychiatry
  • Development and Maturation
  • Behavioral & Social Sciences
  • Epidemiology
  • Diagnostic Procedures
  • Psychopathology & Associated Conditions Across the Lifespan
  • Treatment Across the Lifespan
  • Consultation
  • Issues in Practice
  • Research and Scholarship Literacy
  • Administration        

When can you take the exam?

The exam is administered yearly from September 24- October 15. This date range doesn’t change, so you can always know when it’s coming up.

What score do you need to pass?

Like any standard test, a 70% is passing. Chances are you’ll probably score higher than that, though!

How should you prepare?

One way to prep is to NOT use old exams. What, why not? We have a whole blog on this subject that can be found here! Ok, so how DO you prep? Some people jump in cold turkey without any studying (not recommended, but hey, you do you, boo boo). Or, try out some Question Banks which give you real-time practice answering questions that will be like the ones on the exam, full of rich details, and also covering all the above mentioned topics!

We’re ready to help you prep for this test that you can’t avoid. Go ahead and contact us with any questions you have!

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Clinical Vignettes and How to Ace Them

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tangled rope representing vignettes

What are clinical vignettes?

Clinical vignettes are a huge portion of most board exams. They present a scenario to the reader which includes key information they will need to answer a series of questions.

These questions may be syndrome related to identify a condition the case patient is being presented with; they may be symptom related to determine a symptom of a given condition based on the patient’s given history; or they may be treatment related to decide the best course of action for treatment of a given condition. Really, the sky is the limit when it comes to these tricky questions.

Vignettes are helpful learning tools. They hone in on your critical thinking, they test your attention to detail, and they provide a more realistic experience of how to discern information you’re given from a patient to make the best choices. Sometimes they can seem like a giant, tangled mess. Here’s how to untangle it and get started!

Where to start?

Let’s use an example (straight from our question banks!):

“Matt is a 13-year-old patient who is brought to see you because of behavioral problems. His parents report that in the last year Matt has had four separate occasions of intense aggression resulting in physical violence. The outbursts do not last long, typically abating within 20 minutes. The behavior is not in character for Matt and do not seem precipitated by a specifically intense trigger. In one instance he was unable to go to a friend’s house; he began screaming and hitting walls which lead to his hands becoming badly bruised. His outbursts are causing significant distress to his family, who are becoming more and more apprehensive of him harming them or himself. There have not been any major life events in the last year, and he is not diagnosed with any existing medical or mental conditions.“

Following this, you are presented with question such as: “What is the likely diagnosis?” or “What prognostic factors could have increased the likelihood of Matt developing this condition?”

Break it down

The first thing to do is look for key demographic and symptom information. In this vignette, we have an adolescent patient who is male. The vignette also tells us right away that he has behavioral issues. Knowing this narrows down the possibilities. Occam’s razor is true for most cases; you wouldn’t assume a 13-year-old is dealing with frontotemporal dementia for his behavior problems!

Next, look for symptoms ranges. This vignette tells us he’s been experiencing issues for the last year. This is important to know if the symptoms are a new, acute experience or something that has been persisting. It also helps as most diagnoses have requirements on how long symptoms must be present for.

Then, look for the 4 D’s: deviance, distress, dysfunction, and danger. Do the behaviors being presented fit into these criteria? Or is the patient experiencing sub-clinical symptoms with poor coping skills?

Process of Elimination, Vignettes style

Clinical vignettes are almost always multiple choice questions. You’ll be given five or more answer choices with each question and must choose the best option(s). Sometimes there’s more than one answer! Using our example above of “What is the likely diagnosis?“, you may be given answer options of:

A Oppositional defiant disorder
B Intermittent Explosive disorder
C Conduct disorder
D Disruptive Mood Dysregulation disorder
E Antisocial personality disorder

Least likely choices:

Now we need to look at each answer, and applying Occam’s razor, eliminate the least likely choices. Conduct disorder (choice C) does not match the presenting case as Matt does not show persistent disregard for other people or animals, deceitfulness or theft, or serious violation of rules. He does show intense aggression and destruction of property, but these are in brief occurrences and not a chronic issue.

Moving on to Disruptive mood dysregulation disorder (choice D), it also does not fit this scenario as it also requires the patient to have a persistent, irritable, negative mood most of the day every day; further, it cannot be diagnosed unless the behavior began before the age of 10. Matt’s parents have reported that this behavior has only been present for the last year in isolated incidents starting when Matt was 12.

Let’s look at Antisocial personality disorder (choice E). This condition cannot be diagnosed until the patient is 18, with specific disregard for the rights of others being present from the age of 15. Kick that one out.

And Oppositional defiant disorder (choice A). This is recognizable by persistent angry, irritable, vindictive, and argumentative behavior that is noticeable at least once a week for at least six months for Matt’s current age (attention to detail!).

Most likely choice:

Matt is presenting with symptoms that best match intermittent explosive disorder (choice B). His behavioral problems have only arisen in the last year with isolated incidents of intense, aggressive outbursts. The events are not precipitated by major life events or stressors, and the reaction is grossly disproportionate to the triggering incident.

Timing is Everything

The hardest part of mastering vignettes is being able to do them within time constraints. Generally, a board exam allows about 1 minute per question on the exam. 60 seconds is not a lot of time to gather all the information, discern what is valid or not, and eliminate the least likely options.

So what is the secret? The true key is practice, practice, practice. You know your DSM conditions, you know their criteria. You just have to practice the mechanics of gathering information and making critical choices from it. And what better way to do that than to give our clinical vignettes a try- totally FREE? – using our Free Trial!

We tailor each bank to the type of test you’re taking, whether that is Nurse Practitioner Mental Health Certification, ABPN, USMLE, or PRITE. You can take these practice exams over and over again until you get the hang of it. You can use a practice mode that doesn’t penalize for time, or you can use the timed mode that mimics the actual exam.

We want to help you MASTER clinical vignettes. They’re the part of exams most people do the worst on. Let’s tackle this and make it your strongest section! If you like what you see on the trial, check out our Question Banks and find the best option for you! Or, contact us with any questions you have so we can get you on the right path today!

Test Anxiety and How to Manage It!

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Test Anxiety and Performance

Most people know that chronic or acute anxiety has negative impacts on performance. This is particularly true for academic performance in the form of test anxiety. But, what is more stressful than going in to take an exam that will determine the rest of your career? Obviously this goes without saying that exams and anxiety go hand in hand.

However, some people are impacted by this more than others. There are a few factors that influence this, and if you fall into one of these categories, we hope we can offer some help to get you through your next exam with flying colors!

Glasses on notebook from test anxiety

Working memory can amplify the effects of test anxiety

Everyone feels the effects of anxiety. It makes it harder to concentrate, bring information to mind, and sucks your motivation. But there are some lucky individuals that feel these effects harder than others.

Working memory (WM) capacity, or the amount of information you’re able to hold in mind at a given time, differs across individuals. The more WM capacity you have, the more easily you can hold bits of information at the front of your mind and retrieve that information for a task at hand. The lower your WM capacity, the harder this is. This capacity varies from person to person.

People with low WM have increased effects of anxiety on test performance. The relationship seems to be: anxiety interrupts WM (which is already having a hard time), which in turn effects retrieval of additional information. Further, the anxiety the person is feeling diverts attention from the task at hand to worrying about their performance. This results in reduced performance which is not reflective of the person’s true ability!

Distress load

Another factor that can make test anxiety worse some compared to others is total distress their experiencing. Regardless of their working memory, if a person is experiencing high levels of distress, they will under perform on academic tests. High stress shuts down your prefrontal cortex which interrupts executive functioning and critical thinking. This leads to higher anxiety, reduced attention, and thus lower scores.

If you’re experiencing extraneous factors in your life that are causing you significant distress, this may have detrimental effects on your academic strivings.

So we know these different things hurt some people more than others, but what can we do about it?

Social Support

As we all know, people are social creatures. Studies have shown that increases in social support negatively predict test anxiety. So what does this mean? Stop studying for a hot minute and go chill with your friends! (What, a test prep site is telling me to NOT study??- yes!) The more we experience social support, the less likely we are to experience test anxiety. Does this mean it magically disappears? Unfortunately, no. But, it can help mitigate the amount you experience!

Self-Esteem

Self-concept, self-esteem, call it what you want. Individuals that have a greater capacity for self-esteem or self-care tend to have greater academic achievement, and this can reduce the effects of anxiety you experience. This isn’t a one size fits all concept. Some people come in knowing they’re the cat’s pajamas (and let’s be real, you really are 😉 ), but others need some help seeing the value they bring to the table just by being themselves.

Not to be repetitive, but if you fall into the second category, try getting around some people that help boost you up! If this isn’t a friend or other trusted person, sometimes seeing a counselor can help shift our perspectives on ourselves just a bit. And clearly the implications of doing this will reap reward!

Studying skills…what about those?

One last interesting thing about those of us that experience higher levels of test anxiety is we generally have GOOD study skills! So know that you have the tools to accomplish what you’re aiming for. You aren’t less intelligent even if your test scores come out lower than you know you can do. We know that, too.

At the end of the day, text anxiety can’t be totally dispersed as much as we’d like it to be. But, if you know you’re someone prone to experiencing it, we hope we dropped a few tidbits to help you get through your next round of exams with a little less stress! Want some extra practice? Try our question banks – FREE- using our Free Trial! Or if you’re ready to take the plunge, check out our Question Banks and find the best option for you! Or, contact us with any questions you have so we can get you on the right path today!

REFERENCES: Hyseni Duraku, Z., & Hoxha, L. (2018). Self-esteem, study skills, self-concept, social support, psychological distress, and coping mechanism effects on test anxiety and academic performance. Health psychology open, 5(2), 2055102918799963.

Matthews, G., Wohleber, R. W., & Lin, J. (2020). Stress, skilled performance, and expertise: Overload and beyond.