Acupuncture alleviates test anxiety. Changchun University of Traditional Chinese Medicine researchers conducted a clinical trial consisting of undergraduate students with test anxiety, a type of performance anxiety. The results demonstrate that acupuncture reduces pre-examination anxiety and reduces sleep disturbances. [1]

HAMA (Hamilton Anxiety Rating Scale) and PSQI (Pittsburgh Sleep Quality Index) scores significantly improved for student receiving acupuncture. A total of 58 students were randomly divided into three groups. One group received traditional acupuncture, another received scalp acupuncture, and a third group received no treatment.

Inclusion criteria for the clinical trial were a HAMA score of ≥ 15 and a PSQI score of ≥ 7. The symptoms were required to be induced by pre-examination stress and not related to systemic illnesses such as fever, cough, surgery, pain, or any other external factor. Students that had taken psychotropic or anti-anxiety medications in the previous two weeks or had complications including cardiovascular, lung, liver, kidney, or hemopoietic disorders were excluded from the trial. Students were required to give informed consent to participate and were not permitted to receive any additional treatments during the clinical trial period. Students assigned to the traditional acupuncture group received treatments at the following acupoints:

  • Sishencong (MHN1)
  • Shenmen (HT7)
  • Sanyinjiao (SP6)

Treatment was administered with each patient in a seated or supine position and 0.25 × 25 mm or 0.25 × 40 mm needles were utilized. Needles were manipulated for five minutes using an even technique and were retained for a total of 30 minutes. Students assigned to the scalp acupuncture group received treatments at the following acupoints:

  • Upper Middle Line Occiput (MS12)
  • Middle Line Vertex (MS5)
  • Middle Line Forehead (MS1)

Treatment was administered with each patient in a seated or supine position. Needles were inserted rapidly at a 10 or 15-degree angle to the scalp, to a depth of 1–1.5 cm. Needles were manipulated for five minutes using an even technique and were retained for a total of 30 minutes. For both acupuncture groups, treatment commenced four weeks prior to an examination and was conducted daily with five treatments making up one course of care. A total of four courses were administered, separated by a two-day break each time.

 

Outcomes
Primary outcome measures included HAMA and PSQI scores plus total effective rates. The HAMA is a scale comprised of 14 parameters, each rated from 0–4, with higher scores indicating increases in anxiety. Mean pre-treatment HAMA scores were 25.67 in the control group, 25.0 in the traditional acupuncture group, and 25.2 in the scalp acupuncture group.

After one week, HAMA scores in all groups reduced slightly to 23.28, 22.4, and 22.4 respectively. After two weeks, HAMA scores in the non-treatment control group remained relatively stable at 24.22, while scores in the traditional and scalp acupuncture groups fell further to 17.5 and 18.5 respectively. After four weeks, HAMA scores in the control group were 21.22, while the traditional and scalp acupuncture groups fell to 6.95 and 5.8 respectively. One week post-treatment, respective HAMA scores for the three groups were 11.78, 5.80, and 4.55. The results indicate that acupuncture is effective for the treatment of test anxiety.

The PSQI rates sleep quality and duration over nine parameters, each rated on a scale of 0–3, with higher scores indicating increases in sleep disturbances. Mean pre-treatment PSQI scores were 15.78 in the control group, 15.75 in the traditional acupuncture group, and 15.95 in the scalp acupuncture group. After one week, PSQI scores in the non-treatment control group remained at 15.78, while scores in the traditional and scalp acupuncture groups reduced to 13.75 and 12.95 respectively.

After two weeks, PSQI scores in the control group rose slightly to 15.95, while scores in the traditional and scalp acupuncture groups continued to fall to 11.15 and 8.95 respectively. After four weeks, PSQI scores in the control group were 16.5, while the acupuncture groups fell further to 8.05 and 5.95 respectively. One week post-treatment, respective PSQI scores for the three groups were 9.78, 6.25, and 4.7. The results indicate that acupuncture successfully benefits sleep for test anxiety patients.

Total effective rates for the three groups were calculated based on total reductions in HAMA and PSQI scores. At the end of the study, students with reductions in HAMA scores of ≥ 75% and PSQI scores of 0–5 points were classified as cured. For students with < 75% reductions in HAMA scores and PSQI scores of 6–10, the treatment was classified as markedly effective. For students with < 50% reductions in HAMA scores and PSQI scores of 11–15, the treatment was classified as effective. For students with < 25% reductions in HAMA scores and PSQI scores of 16–20, the treatment was classified as ineffective. The cured, markedly effective, and effective cases were added together to give the total effective rates for each group.

Regarding anxiety symptoms, the non-treatment control group had 8 cured, 4 markedly effective, 3 effective, and 3 ineffective cases, yielding a total effective rate of 83.33%. The traditional acupuncture group had 18 cured, 2 markedly effective, no effective, and no ineffective cases, yielding a total effective rate of 100%. Similarly, the scalp acupuncture group had 16 cured, 2 markedly effective, 1 effective, and no ineffective cases, yielding a total effective rate of 100%.

Regarding sleep disorders, the control group had no cured, no markedly effective, 2 effective, and 16 ineffective cases, yielding a total effective rate of 11.11%. The traditional acupuncture group had 14 cured, 4 markedly effective, 1 effective, and 1 ineffective case, yielding a total effective rate of 95%. The scalp acupuncture group had 16 cured, 2 markedly effective, 1 effective, and 1 ineffective case, yielding a total effective rate of 95%. The results of this study indicate that both traditional and scalp acupuncture offer effective relief for students suffering from anxiety and sleep disturbances due to pre-examination stress.

 

Reference:
Guo-juan Dong, Di Cao, Yue Dong, Jing Zhang, Fu-chun Wang (2018). “Scalp acupuncture for sleep disorder induced by pre-examination anxiety in undergraduates,” World Journal of Acupuncture-Moxibustion, vol. 28, pp. 156-160.

 

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