Use and abuse of academic examinations in stress research.

Previous research suggests that certain types of academic examinations can have a significant impact on psychological and physical health. However, there has not been adequate discussion about the methodological and statistical issues associated with using academic examinations as a model for short-term stress in the context of psychoneuroimmunology research. Limitations of the model are presented with recommendations for appropriate use. Specific suggestions include use of subjective and objective measures of test difficulty, within-subjects designs including measurements during the examination itself, statistical models for testing interactions of continuous variables, and participants with clinical conditions.