Test AnxietyNCT07860489
Neurofeedback Therapy Added to Cognitive Behavioural Therapy-Based Psychoeducation for Test Anxiety Among Undergraduate Students: A Randomised Controlled Trial
A study testing Neurofeedback Therapy and Cognitive Behavioural Therapy-based Psychoeducation in people with Test Anxiety and Test Anxiety Scale, run by International Islamic University Malaysia at 1 site in Malaysia.
Trial summary
The goal of this clinical trial was to learn whether adding neurofeedback therapy to cognitive behavioural therapy (CBT)-based psychoeducation could reduce test anxiety in university students more than CBT-based psychoeducation alone. The main questions it aimed to answer were: 1. Read more about this study
- Who is it for?
- Ages 19 to 24 years
- Conditions the study is for
- Test Anxiety, Test Anxiety Scale, Exam Anxiety
- What is being tested?
- Neurofeedback Therapy and Cognitive Behavioural Therapy-based Psychoeducation
- Type of treatment
- Medical device, Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 32 participants
- Where
- 1 siteMalaysia
- Study dates
- 20 Apr 2026to 3 Jul 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 19 to 24 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- (1) IIUM undergraduate students aged 19-24 years,
- (2) achieve a baseline score of ≥ 3.0 on the Westside Test Anxiety Scale (WTAS)
- (3) Provide informed consent to participate in the study
- (4) Be willing to attend EEG assessment and neurofeedback sessions for the experimental group.
Who cannot join
- (1) Clinically diagnosed with a neurological disorder, severe psychiatric condition, or any disabilities that may affect EEG recordings
- (2) Have received CBT and neurofeedback (NFB) therapy in the past or are currently receiving it
- (3) Currently receiving psychological treatment for anxiety and
- (4) Unable to attend the required intervention sessions.
Trial locations and contacts
1 site in 1 country.
Malaysia1 site
Neurocoach Digital Lab Kulliyyah of Information & Communication Technology
Kuala Lumpur, Selangor, 50728
About this study
The goal of this clinical trial was to learn whether adding neurofeedback therapy to cognitive behavioural therapy (CBT)-based psychoeducation could reduce test anxiety in university students more than CBT-based psychoeducation alone.
The main questions it aimed to answer were:
Read more
- Did adding neurofeedback to CBT-based psychoeducation produce a greater reduction in test anxiety than CBT-based psychoeducation alone?
- Did test anxiety levels change from before the intervention to the middle and end of the intervention period?
Researchers compared two groups. One group received CBT-based psychoeducation together with neurofeedback training, while the other group received CBT-based psychoeducation alone. Participants were randomly assigned to one of the two groups.
Participants:
- Completed screening for test anxiety using the Westside Test Anxiety Scale (WTAS).
- Completed the Test Anxiety Inventory (TAI) before, during, and after the intervention.
- Received CBT-based psychoeducation on test anxiety and coping strategies.
- Participants assigned to the neurofeedback group also completed a baseline EEG assessment and received 10 sessions of EEG-based neurofeedback training targeting high-beta2 activity at the F4 electrode site.
- Practised CBT-based coping strategies during the intervention period.
The main outcome was change in Test Anxiety Inventory scores across the three assessment points and whether the pattern of change differed between the two study groups.
Read the detailed description
This study used a two-arm, parallel-group randomised controlled design to examine the incremental effect of adding electroencephalography (EEG)-based neurofeedback to cognitive behavioural therapy (CBT)-based psychoeducation for test anxiety among undergraduate students. Participants were randomly allocated in a 1:1 ratio to either CBT-based psychoeducation combined with neurofeedback or CBT-based psychoeducation alone. The study was conducted at the International Islamic University Malaysia, with neurofeedback and EEG procedures delivered at the Neurocoach Digital Lab, KICT, IIUM.
Both study groups received the same CBT-based psychoeducation programme. The programme introduced the cognitive-behavioural model of test anxiety and strategies for managing examination-related thoughts and physiological arousal, including cognitive restructuring, deep breathing, progressive muscle relaxation, and structured self-monitoring and was conducted by a registered clincial psychologist and assisted by a co-investigator. The experimental group subsequently received additional neurofeedback training over approximately four weeks. The groups therefore differed in exposure to neurofeedback, while the CBT-based psychoeducation component was held constant across conditions.
Before neurofeedback training, participants allocated to the experimental group underwent a 19-channel quantitative EEG assessment under eyes-closed, eyes-open, and cognitive-task conditions. Neurofeedback training used a standardized high-beta2 inhibition protocol targeting the F4 electrode site. Training was delivered using the BrainMarker EXG system, with real-time feedback provided according to participants' EEG activity relative to the training threshold. Test anxiety assessments were conducted before the intervention, during the intervention period, and after completion of the intervention to examine changes over time and differences in change between the two study groups
- Conditions
- Test Anxiety, Test Anxiety Scale, Exam Anxiety
- Being tested
- Neurofeedback Therapy, Cognitive Behavioural Therapy-based Psychoeducation
- Keywords
- Neurofeedback, CBT, Psychoeducation, Test Anxiety, Exam Anxiety, University students
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Neurofeedback TherapyDevice
Electroencephalography (EEG)-based neurofeedback training sessions are designed to evaluate real-time brainwave activity and assist participants in self-regulating neural activities associated with stress and test anxiety among undergraduate students.
Cognitive Behavioural Therapy-based PsychoeducationBehavioural
Structured psychoeducational modules based on Cognitive Behavioural Therapy (CBT) principles, designed to help undergraduate students identify, understand, and modify unhelpful cognitive distortions and behavioral responses related to test anxiety.
| Study group | Role | What they receive |
|---|---|---|
| Neurofeedback + Cognitive Behavioural Therapy-based Psychoeducation | Experimental | Participants in this arm receive electroencephalography (EEG)-based neurofeedback training sessions in combination with Cognitive Behavioural Therapy (CBT)-based psychoeducation modules designed to reduce test anxiety among undergraduate students. Receives: Device: Neurofeedback Therapy; Behavioral: Cognitive Behavioural Therapy-based Psychoeducation |
| Cognitive Behavioural Therapy-based Psychoeducation | Active comparator | Structured psychoeducational modules based on Cognitive Behavioural Therapy (CBT) principles, designed to help undergraduate students identify, understand, and modify unhelpful cognitive distortions and behavioral responses related to test anxiety. Receives: Behavioral: Cognitive Behavioural Therapy-based Psychoeducation |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Test Anxiety Inventory (TAI) Total Score Across Pre-, Mid-, and Post-Intervention
Test anxiety was measured using the 20-item Test Anxiety Inventory (TAI). Each item is rated on a 4-point Likert scale, producing a total score ranging from 20 to 80, with higher scores indicating greater test anxiety. The primary outcome was change in TAI total score across three assessment points: pre-intervention, mid-intervention, and post-intervention. The analysis examined whether TAI scores changed over time and whether the pattern of change differed between participants receiving neurofeedback plus CBT-based psychoeducation and those receiving CBT-based psychoeducation alone.
Measured: Baseline (pre-intervention), approximately 2 weeks after intervention initiation (mid-intervention), and approximately 4 weeks after intervention initiation (post-intervention).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Oct 2026
- Study start20 Apr 2026
- Primary completion3 Jul 2026
- Study completion3 Jul 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Test AnxietyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- This study used a two-arm parallel-group randomised controlled design. Participants were randomly allocated in a 1:1 ratio to either (1) CBT-based psychoeducation combined with neurofeedback therapy or (2) CBT-based psychoeducation alone. Participants remained in their assigned intervention group throughout the study, with outcomes assessed at pre-, mid-, and post-intervention.
- Masking
- None (open label)
- Enrolment
- 32 participants (actual)
Sponsor and investigators
- Lead sponsor
- International Islamic University Malaysia
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Jamilah Hanum Abdul Khaiyom, PhD, International Islamic University Malaysia
- Investigators
- Jamilah Hanum binti Abdul Khaiyom (Assoc. Prof. Dr.), Psychology, Principal investigator, International Islamic University Malaysia
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07860489
- Sponsor's protocol ID
- SPI26-321-0321
- Other IDs
- Southern Ambition 473cc
- Status last verified
- Sep 2026
- First submitted
- 30 Sep 2026
- Last updated
- 6 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Westside Test Anxiety Scale (WTAS) Test Anxiety Inventory (TAI) Scores Demographic Information
Study at a glance
From the registry record, last updated by the sponsor on 6 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Neurofeedback Therapy Added to Cognitive Behavioural Therapy-Based Psychoeducation for Test Anxiety Among Undergraduate Students: A Randomised Controlled Trial
- ClinicalTrials.gov ID
- NCT07860489
- Acronym / sponsor ID
- SPI26-321-0321
- Conditions
- Test Anxiety, Test Anxiety Scale, Exam Anxiety
- Keywords
- Neurofeedback, CBT, Psychoeducation, Test Anxiety, Exam Anxiety, University students
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 32 participants (actual)
- Lead sponsor
- International Islamic University MalaysiaUniversity, hospital or other
- Study start
- 20 Apr 2026 (actual)
- Primary completion
- 3 Jul 2026 (actual)
- Study completion
- 3 Jul 2026 (actual)
- First posted
- 6 Oct 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial was to learn whether adding neurofeedback therapy to cognitive behavioural therapy (CBT)-based psychoeducation could reduce test anxiety in university students more than CBT-based psychoeducation alone.
The main questions it aimed to answer were:
- Did adding neurofeedback to CBT-based psychoeducation produce a greater reduction in test anxiety than CBT-based psychoeducation alone?
- Did test anxiety levels change from before the intervention to the middle and end of the intervention period?
Researchers compared two groups. One group received CBT-based psychoeducation together with neurofeedback training, while the other group received CBT-based psychoeducation alone. Participants were randomly assigned to one of the two groups.
Participants:
- Completed screening for test anxiety using the Westside Test Anxiety Scale (WTAS).
- Completed the Test Anxiety Inventory (TAI) before, during, and after the intervention.
- Received CBT-based psychoeducation on test anxiety and coping strategies.
- Participants assigned to the neurofeedback group also completed a baseline EEG assessment and received 10 sessions of EEG-based neurofeedback training targeting high-beta2 activity at the F4 electrode site.
- Practised CBT-based coping strategies during the intervention period.
The main outcome was change in Test Anxiety Inventory scores across the three assessment points and whether the pattern of change differed between the two study groups.
Detailed description
This study used a two-arm, parallel-group randomised controlled design to examine the incremental effect of adding electroencephalography (EEG)-based neurofeedback to cognitive behavioural therapy (CBT)-based psychoeducation for test anxiety among undergraduate students. Participants were randomly allocated in a 1:1 ratio to either CBT-based psychoeducation combined with neurofeedback or CBT-based psychoeducation alone. The study was conducted at the International Islamic University Malaysia, with neurofeedback and EEG procedures delivered at the Neurocoach Digital Lab, KICT, IIUM.
Both study groups received the same CBT-based psychoeducation programme. The programme introduced the cognitive-behavioural model of test anxiety and strategies for managing examination-related thoughts and physiological arousal, including cognitive restructuring, deep breathing, progressive muscle relaxation, and structured self-monitoring and was conducted by a registered clincial psychologist and assisted by a co-investigator. The experimental group subsequently received additional neurofeedback training over approximately four weeks. The groups therefore differed in exposure to neurofeedback, while the CBT-based psychoeducation component was held constant across conditions.
Before neurofeedback training, participants allocated to the experimental group underwent a 19-channel quantitative EEG assessment under eyes-closed, eyes-open, and cognitive-task conditions. Neurofeedback training used a standardized high-beta2 inhibition protocol targeting the F4 electrode site. Training was delivered using the BrainMarker EXG system, with real-time feedback provided according to participants' EEG activity relative to the training threshold. Test anxiety assessments were conducted before the intervention, during the intervention period, and after completion of the intervention to examine changes over time and differences in change between the two study groups
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- This study used a two-arm parallel-group randomised controlled design. Participants were randomly allocated in a 1:1 ratio to either (1) CBT-based psychoeducation combined with neurofeedback therapy or (2) CBT-based psychoeducation alone. Participants remained in their assigned intervention group throughout the study, with outcomes assessed at pre-, mid-, and post-intervention.
| Arm | Type | Receives |
|---|---|---|
| Neurofeedback + Cognitive Behavioural Therapy-based Psychoeducation | Experimental | Device: Neurofeedback Therapy, Behavioral: Cognitive Behavioural Therapy-based PsychoeducationParticipants in this arm receive electroencephalography (EEG)-based neurofeedback training sessions in combination with Cognitive Behavioural Therapy (CBT)-based psychoeducation modules designed to reduce test anxiety among undergraduate students. |
| Cognitive Behavioural Therapy-based Psychoeducation | Active comparator | Behavioral: Cognitive Behavioural Therapy-based PsychoeducationStructured psychoeducational modules based on Cognitive Behavioural Therapy (CBT) principles, designed to help undergraduate students identify, understand, and modify unhelpful cognitive distortions and behavioral responses related to test anxiety. |
Who may qualify
- Ages
- 19 to 24 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- (1) IIUM undergraduate students aged 19-24 years,
- (2) achieve a baseline score of ≥ 3.0 on the Westside Test Anxiety Scale (WTAS)
- (3) Provide informed consent to participate in the study
- (4) Be willing to attend EEG assessment and neurofeedback sessions for the experimental group.
Key exclusion criteria (4 listed)
- (1) Clinically diagnosed with a neurological disorder, severe psychiatric condition, or any disabilities that may affect EEG recordings
- (2) Have received CBT and neurofeedback (NFB) therapy in the past or are currently receiving it
- (3) Currently receiving psychological treatment for anxiety and
- (4) Unable to attend the required intervention sessions.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Neurofeedback TherapyElectroencephalography (EEG)-based neurofeedback training sessions are designed to evaluate real-time brainwave activity and assist participants in self-regulating neural activities associated with stress and test anxiety among undergraduate students. | Device | Neurofeedback + Cognitive Behavioural Therapy-based Psychoeducation |
| Cognitive Behavioural Therapy-based PsychoeducationStructured psychoeducational modules based on Cognitive Behavioural Therapy (CBT) principles, designed to help undergraduate students identify, understand, and modify unhelpful cognitive distortions and behavioral responses related to test anxiety. | Behavioural | Cognitive Behavioural Therapy-based Psychoeducation, Neurofeedback + Cognitive Behavioural Therapy-based Psychoeducation |
Primary outcome
Change in Test Anxiety Inventory (TAI) Total Score Across Pre-, Mid-, and Post-Intervention
Time frame: Baseline (pre-intervention), approximately 2 weeks after intervention initiation (mid-intervention), and approximately 4 weeks after intervention initiation (post-intervention).
Test anxiety was measured using the 20-item Test Anxiety Inventory (TAI). Each item is rated on a 4-point Likert scale, producing a total score ranging from 20 to 80, with higher scores indicating greater test anxiety. The primary outcome was change in TAI total score across three assessment points: pre-intervention, mid-intervention, and post-intervention. The analysis examined whether TAI scores changed over time and whether the pattern of change differed between participants receiving neurofeedback plus CBT-based psychoeducation and those receiving CBT-based psychoeducation alone.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Oct 2026.
- Individual participant dataSharing planned: Yes. Westside Test Anxiety Scale (WTAS) Test Anxiety Inventory (TAI) Scores Demographic Information
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jamilah Hanum binti Abdul Khaiyom (Assoc. Prof. Dr.), Psychology principal investigator
International Islamic University Malaysia
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Neurofeedback Therapy and Cognitive Behavioural Therapy-based Psychoeducation in people with Test Anxiety and Test Anxiety Scale, run by International Islamic University Malaysia at 1 site in Malaysia.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 6 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Malaysia. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Test Anxiety Inventory (TAI) Total Score Across Pre-, Mid-, and Post-Intervention (time frame: Baseline (pre-intervention), approximately 2 weeks after intervention initiation (mid-intervention), and approximately 4 weeks after intervention initiation (post-intervention).). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Oct 2026.