Did you ever worry about blacking out while performing or during an oral exam?

I didn’t, so I was surprised to find that problem was at the top of a list of social situations and performances from a survey of 520 seniors done back in December 2000 at six high schools in the Pisa, Italy area. That list was in an article by Lilian Dell’Osso et al titled Social Anxiety Spectrum, which appeared in 2003 in the European Archives of Psychiatry and Clinical Neuroscience. You can read an abstract here, and download it here.

Students (209 females and 311 males) filled out the Social Anxiety Spectrum Self Report (SHY-SR), which is a 164-item list of yes-no questions grouped into four domains (childhood and adolescence social anxiety, interpersonal sensitivity, behavioral inhibition and somatic symptoms, and specific phobias). The top five feared situations are shown above in a bar chart. (Click on it to see a larger, clearer version. 66% (almost two-thirds) of the students listed blackout while performing or taking an oral exam. 64% listed feeling embarrassed or uncomfortable when taking an oral exam.   60% of the students feared performing in front of an audience, which ranked third. I don’t recall seeing a question about blackout while performing or taking an oral exam in any survey other than this one.

Those top five situations differ from those found by Green et al, which I blogged about last June in a post titled What social situations scare American adolescents, and what are their top 20 fears. There the top situation was performing for audience (35.8%), followed by speaking in class (24.9%), and situation that could be embarrassed (24.6%), meeting new people (23.6%), talking to strangers (22.2%), and talking to authority (20.3%). Taking important exam (19.8%) came in seventh. 

Fainting or blacking out isn’t included on the 51-item Fear Survey Schedule II, which I blogged about last October.

I found an Associated Press article from 2010 about Bill Nye the Science Guy fainting on stage while giving a speech. On YouTube I found a brief video of an Arizona State University (ASU) student fainting while speaking, and David Buckner fainting while appearing as a guest on Glenn Beck’s television show.

There is a fairly readable medical article on Fainting, Swooning, and Syncope that you can read online which appeared in 2010 in a magazine called Primary Care Companion for CNS Disorders. Syncope is the general medical term for fainting, and the subtype that happens during speaking is called vasovagal or neurocardiogenic syncope:

“Syncope, the medical term for fainting/blacking out, is traditionally characterized by a sudden and temporary loss of consciousness (with spontaneous recovery) caused by insufficient oxygen delivery to the brain (via hypotension or other mechanisms). Syncope is a word that often induces fear in patients and their physicians, and the condition frequently leads to hospitalization for further evaluation. The term fainting (more familiar to laypersons) is less intimidating and rarely results in admission to a health care facility.....”

“Neurocardiogenic syncope can occur in emotionally challenging (eg, scary or embarrassing) situations, such as during blood drawing, while observing one's first autopsy, seeing blood or needles, or receiving bad news...” 

How common is fainting? An article by E. S. Soteriades et al from 2002 in the New England Journal of Medicine on the Incidence and Prognosis of Syncope reported that it occurs for just six percent of adults over a decade. So, the percent of seniors reporting blacking out as a fear is way greater than the chance of it actually happening.    

The 1830 painting came from Wikimedia Commons.

UPDATE February 3, 2013

In the textbook iSpeak: Public Speaking for Contemporary Life by Paul E. Nelson, Scott Titsworth, and Judy C. Pearson (McGraw-Hill Higher Education, 2009) page 6 says:

“....Will you faint? One of the authors used to carry a smelling salts capsule (the kind used to revive people who faint when they give blood), just in case a student fainted while giving a speech. After several thousand student speeches the gauze-wrapped capsule started to get very dirty, but not from ever using it. The author finally threw the capsule away. None of the authors has ever seen a student faint.”