E-ISSN:2456-3110

Research Article

Anxiety

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 1 Jan-Feb
Publisherwww.maharshicharaka.in

Assessment of Chittodwega in BAMS 1st year students w.s.r to Anxiety by Hamilton Anxiety Rating Scale

D. Totad C.1*, B. Utlaskar S.2, S. Sarangi M.3
DOI: http://dx.doi.org/10.21760/jaims.7.1.8

1* Channabasavva D. Totad, Assistant Professor, Dept. of Kriya Sharira, JSS Ayurveda Medical College & Hospital, Mysuru, Karnataka, India.

2 Santoshkumar B. Utlaskar, Associate Professor, Dept. of Samhita & Siddhanta, JSS Ayurveda Medical College & Hospital, Mysuru, Karnataka, India.

3 Manohar S. Sarangi, Associate Professor, Dept of Agada Tantra, Shri Veer Pulakeshi Ayurveda Medical College & Hospital, Badami, Karnataka, India.

Chittodvega is a term denoting the anxious state of mind. It is individualistic and occurs without knowledge of person. Exam anxiety can be considered as one kind of Chittodvega we are seeing in students. Chittodvega is having adverse effect over the mind as well as body and it also affects the quality of life. Therefore, study has been conducted to assess the level of Chittodvega with special reference to Exam anxiety in students.

Keywords: Chittodvega, Vatadosha, Exam anxiety

Corresponding Author How to Cite this Article To Browse
Channabasavva D. Totad, Assistant Professor, Dept. of Kriya Sharira, JSS Ayurveda Medical College & Hospital, Mysuru, Karnataka, India.
Email: 		Channabasavva D. Totad, Santoshkumar B. Utlaskar, Manohar S. Sarangi, Assessment of Chittodwega in BAMS 1st year students w.s.r to Anxiety by Hamilton Anxiety Rating Scale. J Ayu Int Med Sci. 2022;7(1):54-61.
Available From
https://jaims.in/jaims/article/view/1680

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2021-12-29 2021-12-31 2022-01-07 2022-01-14 2022-01-21
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 17%

© 2022by Channabasavva D. Totad, Santoshkumar B. Utlaskar, Manohar S. Sarangiand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Totad C. et al: Assessment of Chittodwega in BAMS 1st year students w.s.r to Anxiety

Introduction

Ayurveda – an eternal science of healthy living treasures deals with physical, psychological and spiritual wellbeing of the human being and covers all the aspect of human life.[1] Human life is considered as the invaluable opportunity to achieve the prime goals of life i.e., Dharma, Artha, Kaama and Moksha. To achieve all these things, one needs a healthy and calm life.[2] On the other hand today everyone is trying to gain good education, financial status and to fulfill all the physical desires, today’s metaphysical society is facing unsteady, weakened, hard and everyday changing  lifestyle. As a gift of this lifestyle, almost everyone appears to be stressed and confused; this reflection can lead to mental disability like Chittodwega i.e., anxiety disorders.[3]

In Ayurveda various psychological disorders are mentioned, which show some similarity with the anxiety disorders, Chittodwega seems to be nearest term for anxiety disorders, which is one of the psychological disorders described by Acharya Charaka. Various texts have described many terms related to mental status i.e., Chittavibramsa, Chittanasa, Chittavibrama, Chittaviparyaya, Anavasthita Chitta etc. But Chittadwega seems to be more appropriate for the anxiety disorder. The etiology of Chittodwega clearly indicates the anxious status of mind.[4]

Examinations are part of every curricular activity. These are often tiresome and extremely stressful for students at any level of education. Stressful feelings can alter the ability to think during examination everybody experiences anxiety from time to time. Sometimes it has a clear cause examination though this type of anxiety can be quite disruptive, it is transitory and disappears in short order. But the unpleasant feelings associated with anxiety can also have no apparent cause and can become a chronic condition.[5]

Performance anxiety is known problem in most of the students they develop this anxiety and tends to do the mistake. Hence anxiety (Chittodwega) has to be controlled through various modalities of intervention which includes self-appraisal behavior modification, counseling and self-motivating techniques. Anxiety (Chittodwega) is very common problem among students and understanding anxiety (Chittodwega) becomes a need of hour.

So, with this view present study is planned to explain and understand the description of anxiety (Chittodwega) disorder in Ayurveda and compared with modern parlance in 1styear BAMS students and holistic approach in combating anxiety (Chittodwega) related problems or disorders among the students.

Review of Literature

Scriptures of Ayurveda has mentioned the ‘abnormal status of mind’, i.e., Psychopathology in various contexts. Caraka states that Raja and Tama are chief Pathogenic factors of the mind and due to them many Manasa Vikaras are produced like Kaama, Krodha, Soka, Chittodvega[6] etc., The term Chittodvega comprises of two words i.e., Chitta and Udvega. Chitta: It is derived from root “Cit” which denotes the following meanings: To perceive, fix the mind upon, attend to, beat tentive, to observe, take notice of, to aim at, intend, to be anxious about, care for, to resolve, to understand, comprehend, know, make attentive.

The main Dosas of the Manasa are Rajas and Tamas,[8] Hence the Nidnana, which vitiate Rajas and Tamas may be considered as etiological factors of Chittodvega. Following three factors are responsible for the all physical and mental diseases.[9]


  1. Prajnaparadha
  2. Parinama
  3. Asatmendriyarthasamyoga

Dorland’s illustrated medical dictionary defines Anxiety as it is the unpleasant emotional state consisting of psychophysiological responses to anticipation of unreal or imagined danger, ostensibly resulting from unrecognized intra psychic conflict. Physiological concomitants include increased heart rate, altered respiration rate, sweating, trembling, weakness and fatigue; psychological concomitants include feelings of impending danger, powerlessness, apprehension and tension.[9]

Anxiety Disorders

As we know the unity of the body, mind and spirit is quite complex. Mental imagery, entrainment theory, divinity theory, split- brain research, and beta-endorphins all approach the same unity, each from a different vantage point, and each supporting the ancient axiom that "all points connect".[10]



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Totad C. et al: Assessment of Chittodwega in BAMS 1st year students w.s.r to Anxiety

Concept of Examination Anxiety

Students of higher institutions are associated with anxiety especially when they are preparing for examinations.  Examination anxiety is a phenomenon that is associated with low performance of student’s academic achievement. Because Lower courses' grades, decreased motivation and increased stress.

Examination anxiety is a combination of physiological, over-arousal, tension and somatic symptoms along with worries, dread, fear of failure and catastrophizing that occur before or during examination situations Examination anxiety has immense negative impact, hence students’ low academic performance in schools.[11]

Aims and Objectives

To assess Chittodwega amongst 1st year BAMS students.

Materials and Methods

Source of Data

Study design

Observational study: 100 students were selected from Ashwini Ayurvedic Medical College, Tumkur.

Methods of Collection of Data

100 BAMS students appearing examination were selected from Ashwini Ayurvedic Medical College, Tumkur and their Chittodwega status will be assessed according to parameters.

Plan for the Study

  • A standard questionnaire will be prepared and distributed among 100 UG students and their responses will be assessed.
  • The result will be assessed, analyzed and tabulated according to the respond given by the students and the score.
  • The Chittodwega pattern in those individuals is assessed before, 15 days before and 15 days after their exams with the help of a questionnaire. In order to check the Chittodwega pattern of students in regular routine period,
  • Chittodwega in terms of Exam anxiety in those individuals is assessed 15 days before
  • and 15 days after their exams with the help of Hamilton Anxiety scale.

Observation and Results

Wilcoxon Signed Rank Test

The Wilcoxon signed-rank test is used to determine whether there is a median difference between paired or matched observations. This test can be considered as the nonparametric equivalent to the paired-samples t-test. The participants are either the same individuals tested on two occasions or under two different conditions on the same dependent variable.

Table 1: Wilcoxon signed rank test Bhaya Vishedana.


Parameters Ranks N Mean rank Z value Signifi.
Bhaya After Exam - Bhaya Before Exam Negative 78 39.50 -8.154 0.000
Positive 0 .00 - -
Ties 22 00 - -
Total 100 -- - -

Wilcoxon signed rank test showed that Bhaya Vishedena a statistically significant reduction in the 100 students After examination (z = -8.15, p=0.000).

Table 2: Wilcoxon signed rank test Shoka Dhainyena.


Parameters Ranks N Mean rank Z value Signifi.
Shoka After Exam - Shoka Before Exam Negative 0 .00 -6.838 0.000
Positive 52 26.50 - -
Ties 48 - - -
Total 100 - - -

Wilcoxon signed rank test showed that Shoka Dhainyena a statistically significant reduction in the 100 students After examination (z = -6.83, p=0.000).

Wilcoxon signed rank test showed that Mana-artheshu avyabhicharanena a statistically significant reduction in the 100 students after examination (z = -4.20, p=0.000).


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Table 3: Wilcoxon signed rank test Mana Artheshu Avyabhicharanena.


Parameters Ranks N Mean rank Z value Signifi.
Mana After Exam - Mana Before Exam Negative 21 11.00 -4.208 0.000
Positive 0 .00 - -
Ties 79 - - -
Total 100 - - -

Table 4: Wilcoxon signed rank test Chinta.

Parameters Ranks N Mean rank Z value Signifi.
ChintaAfter Exam - Chinta Before Exam Negative 82 41050 -8.131 .000
Positive 0 .00 - -
Ties 18 - - -
Total 100 - - -

Wilcoxon signed rank test showed that Chinta a statistically significant reduction in the 100 students after examination (z = -4.20, p=0.000).

Table 5: Wilcoxon signed rank test Dhairyam.

Parameters Ranks N Mean rank Z value Signifi.
Dhairyam After Exam – Dhairyam Before Exam Negative 0 0.00 -6.259 0.000
Positive 46 23.50 - -
Ties 54 - - -
Total 100 - - -

Wilcoxon signed rank test showed that Dhairyam a statistically significant reduction in the 100 students before examination (z = -6.259,p=0.000).

Table 6: Wilcoxon signed rank test Driti Alaulyena.


Parameters Ranks N Mean rank Z value Signifi.
Driti alaulyena After Exam - Driti alaulyena Before Exam Negative 51 26.00 -6.567 .000
Positive 0 .00 - -
Ties 49 - - -
Total 100 - - -

Wilcoxon signed rank test showed that Driti- Alaulyena a statistically significant reduction in the 100 students before examination (z = -6.567,p=0.000).

Table 7: Wilcoxon signed rank test Harsha.


Parameters Ranks N Mean rank Z value Signifi.
Harsha After Exam - Harsha Before Exam Negative 66 33.50 -8.124 .000
Positive 0 .00 - -
Ties 34 - - -
Total 100 - - -

Wilcoxon signed rank test showed that Harsha a statistically significant reduction in the 100 students before examination (z = -8.124, p=0.000).

Table 8: Wilcoxon signed rank test Priti.

Parameters Ranks N Mean rank Z value Signifi.
Priti After Exam - Priti Before Exam Negative 18 9.50 -4.234 .000
Positive 0 .00 - -
Ties 82 - - -
Total 100 - - -

Wilcoxon signed rank test showed that Priti a statistically significant reduction in the 100 students before examination (z = -4.234, p=0.000).

Table 9: Wilcoxon signed rank test Shraddha.

Parameters Ranks N Mean rank Z value Signifi.
Shraddha After Exam – Shraddha Before Exam Negative 18 9.50 -4.243 .000
Positive 0 .00 - -
Ties 82 - - -
Total 100 - - -

Wilcoxon signed rank test showed that Shraddha a statistically significant reduction in the 100 students after examination (z = -4.243,p=0.000).

Wilcoxon signed rank test showed that Medha grahanena a statistically significant reduction in the 100 students before examination (z = -4.123, p=0.000).


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Table 10: Wilcoxon signed rank test Medha-Grahanena.


Parameters Ranks N Mean rank Z value Signifi.
Medha-grahanena After Exam Medha-grahanena Before Exam Negative 17 9.00 -4.123 .000
Positive 0 .00 - -
Ties 83 - - -
Total 100 - - -

Table 11: Wilcoxon signed rank test Smriti Smaranena.


Parameters Ranks N Mean rank Z value Signifi.
Smriti Smaranena After Exam Smriti Smaranena Before Exam Negative 17 11.00 -2.837 .005
Positive 4 11.00 - -
Ties 79 - - -
Total 100 - - -

Wilcoxon signed rank test showed that Smriti-Smaranena a statistically significant reduction in the 100 students before examination (z = -2.837, p=0.005).

Table 12: Wilcoxon signed rank test Anxious mood.


Parameters Ranks N Mean rank Z value Signifi.
Anxious mood - After Exam Anxious mood - Before Exam Negative 86 43.50 -8.357 .000
Positive 0 .00 - -
Ties 14 - - -
Total 100 - - -

Wilcoxon signed rank test showed that anxious mood a statistically significant reduction in the 100 students after examination (z = -8.357, p=0.000).

Wilcoxon signed rank test showed that that Tension a statistically significant reduction in the 100 students after examination (z = -8.250, p=0.000).


Table 13: Wilcoxon signed rank test Tension.

Parameters Ranks N Mean rank Z value Signifi.
Tension - After Exam Tension - Before Exam Negative 85 43.00 -8.250 .000
Positive 0 .00 - -
Ties 15 - - -
Total 100 - - -

Table 14: Wilcoxon signed rank test Fear.

Parameters Ranks N Mean rank Z value Signifi.
Fear After Exam - Fear Before Exam Negative 89 45.00 -8.354 .000
Positive 0 .00 - -
Ties 11 - - -
Total 100 - - -

Wilcoxon signed rank test showed that fear a statistically significant reduction in the 100 students after examination (z = -8.354, p=0.000).

Table 15: Wilcoxon signed rank test Insomnia.

Parameters Ranks N Mean rank Z value Signifi.
Insomnia After Exam - Insomnia Before Exam Negative 85 43.00 -8.140 .000
Positive 0 .00 - -
Ties 15 - - -
Total 100 - - -

Wilcoxon signed rank test showed that insomnia a statistically significant reduction in the 100 students after examination (z = -8.140, p=0.000).

Table 16: Wilcoxon signed rank test Intellectual.

Parameters Ranks N Mean rank Z value Signifi.
Intellectual After Exam - Intellectual Before Exam Negative 57 29.00 -6.725 .000
Positive 0 .00 - -
Ties 43 - - -
Total 100 - - -

Wilcoxon signed rank test showed that intellectual a statistically significant reduction in the 100 students after examination (z = -6.725, p=0.000).


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Table 17: Wilcoxon signed rank test Depressed mood.


Parameters Ranks N Mean rank Z value Signifi.
Depressed mood  After Exam - Depressed mood  Before Exam Negative 51 26.00 -6.304 .000
Positive 0 .00 - -
Ties 49 - - -
Total 100 - - -

Wilcoxon signed rank test showed that depressed mooda statistically significant reduction in the 100 students after examination (z = -6.304, p=0.000).

Table 18: Wilcoxon signed rank test Muscular changes.


Parameters Ranks N Mean rank Z value Signifi.
Muscular changes After Exam - Muscular changes Before Exam Negative 24 12.50 -4.564 .000
Positive 0 .00 - -
Ties 76 - - -
Total 100 - - -

Wilcoxon signed rank test showed that muscular changes a statistically significant reductioni n the 100 students after examination (z = -4.564, p=0.000).

Table 19: Wilcoxon signed rank test Sensory changes.


Parameters Ranks N Mean rank Z value Signifi.
Sensory changes After Exam - Sensory changes Before Exam Negative 31 16.00 -5.126 .000
Positive 0 .00 - -
Ties 69 - - -
Total 100 - - -

Wilcoxon signed rank test showed that sensory a statistically significant reduction in the 100 students before examination (z = -5.126, p=0.000).

Table 20: Wilcoxon signed rank test Cardiovascular Symptoms.

Parameters Ranks N Mean rank Z value Signifi.
Cardiovascular Symptoms  After Exam - Cardiovascular Symptoms  Before Exam Negative 9 5.00 -3.000 .003
Positive 0 .00 - -
Ties 91 - - -
Total 100 - - -

Wilcoxon signed rank test showed that cardio vascular symptoms a statistically significant reduction in the 100 students after examination (z = -3.000,p=0.003).

Table 21: Wilcoxon signed rank test Respiratory Symptoms.

Parameters Ranks N Mean rank Z value Signifi.
Respiratory Symptoms  After Exam - Respiratory Symptoms  Before Exam Negative 2 1.50 -1.414 .157
Positive 0 .00 - -
Ties 98 - - -
Total 100 - - -

Wilcoxon signed rank test showed that respiratory symptoms a statistically significant reduction in the 100 students after examination (z = -1.414, p=0.157).

Table 22: Wilcoxon signed rank test Gastrointestinal Symptoms.

Parameters Ranks N Mean rank Z value Signifi.
Gastrointestinal Symptoms  After Exam - Gastrointestinal Symptoms  Before Exam Negative 27 14.00 -4.916 .000
Positive 0 .00 - -
Ties 73 - - -
Total 100 - - -

Wilcoxon signed rank test showed that gastrointestinal symptoms a statistically significant reduction in the 100 students after examination (z = -4.916, p=0.000).


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Table 23: Wilcoxon signed rank test Genitourinary Symptoms.

Parameters Ranks N Mean rank Z value Signifi.
Genitourinary Symptoms  After Exam - Genitourinary Symptoms  Before Exam Negative 17 9.00 -4.123 .000
Positive 0 .00 - -
Ties 83 - - -
Total 100 - - -

Wilcoxon signed rank test showed that genitourinary symptoms a statistically significant reduction in the 100 students after examination (z = -4.123, p=0.000).

Table 24: Wilcoxon signed rank test Autonomic Symptoms.

Parameters Ranks N Mean rank Z value Signifi.
Autonomic Symptoms  After Exam - Autonomic Symptoms  Before Exam Negative 41 21.00 -6.206 .000
Positive 0 .00 - -
Ties 59 - - -
Total 100 - - -

Wilcoxon signed rank test showed that autonomic symptoms a statistically significant reduction in the 100 students after examination (z = -6.206, p=0.000).

Table 25: Wilcoxon signed rank test Behavior at interview.

Parameters Ranks N Mean rank Z value Signifi.
Behavior at interview   After Exam - Behavior at interview Before Exam Negative 80 40.50 -7.949 .000
Positive 0 .00 - -
Ties 20 - - -
Total 100 - - -

Wilcoxon signed rank test showed that behavior at interview statistically significant reduction in the 100 students after examination (z = -7.949, p=0.000).

Discussion

Here a study is conducted to observe the level of anxiety before and after the exams. According to Yerkes-Dodson law, an optimal level of arousal is necessary to best complete a task such as an exam, performance, or competitive event. However, when the anxiety or level of arousal exceeds that optimum, the result is a decline in performance.

Test anxiety is the uneasiness, apprehension, or nervousness felt by students who have a fear of failing an exam. The term "test anxiety" refers specifically to students; many workers share the same experience with regard to their career or profession.

The fear of failing at a task and being negatively evaluated for failure can have a similarly negative effect on the adult, Management of test anxiety focuses on achieving relaxation and developing mechanisms to manage anxiety.

Students of higher institutions are associated with anxiety especially when they are preparing for examinations.  Examination anxiety is a phenomenon that is associated with low performance of student’s academic achievement. Because Lower courses' grades, decreased motivation and increased stress.

Examination anxiety has broader negative consequences, hence, affecting student’s social, emotional and behavioral development as well as their feelings about themselves in school. Highly examination students' anxiety scores rate about 12% points below their low anxiety papers.

The Hamilton Anxiety Rating Scale (HAM-A, sometimes termed HARS), dating back to 1959, is one of the first rating scales to measure the severity of perceived anxiety symptoms. It is still in use today, being considered one of the most widely used rating scales. It has been used as a benchmark for more recently devised scales.

Various parameters are used to study the level of anxiety in individuals such as Anxious mood, Tension, Fear, Insomnia, Intellectual (Cognitive), Depressed mood, Somatic (Muscular), Somatic (Sensory), Cardiovascular Symptoms, Respiratory Symptoms, Gastrointestinal Symptoms, Genitourinary Symptoms, Autonomic Symptoms and Behavior at interview.


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Conclusion

This study was undertaken to assess the Chittodvega in terms of Exam anxiety in 1st year B.A.M.S. students. A survey study was carried out using a self-designed questionnaire. And Exam anxiety was assessed by Hamilton Anxiety Rating Scale. Based on the various observations and taking the whole piece of this work into consideration, the following conclusions can be drawn: The study revealed that there was marked difference in grade of Chittodvega before and after the exams. The Chittodvega level decreased after exams compared to before exams. Study showed that there is a relation between Exam anxiety and health. Study showed marked difference in the health 15 days before and 15 days after exams and it is due to variations in the level of Chittodvega. Exam anxiety is having negative association with quality of life. The study revealed that Chittodvega with special reference to Exam anxiety is having adverse effect on health in students.

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