Introduction The twenty-first century with rapid changes in environmental structure has been called a stressful, anxious and pressured century. Therefore, psychological disorders have been increasing among people. 1 Anxiety is the most prevalent psychiatric disorder; in the United States more than 23 million people are affected every year and one in four has anxiety. 2 Although a comprehensive and epidemiological study has not been done, available evidence implies that the prevalent amount of anxiety disorder in Iran, is not less than other countries. It is pervasive, and unpleasant, causing physical symptoms such as sweating, palpitation, chest muscle spasm, gastrointestinal diseases and agitation, 3 which are created as a response to internal and external stimulation and it tends toward cognitive, emotional, physical and behavioral symptoms. 4 Although anxiety is not so serious and people experience it everywhere and constantly within all cultures, 5 today the educational system is worried about students' anxiety which can be intolerable for some. 6 Reportedly a few of the students with academic anxiety have committed suicide. 7 Academic anxiety during education is the most important kind of anxiety in teen years. It threatens students' psychological health and affects their efficiency, aptitude, personality formation and social identity. 8 Academic anxiety is a general expression which refers to a social phobia or social anxiety in which the person falters in their function and cannot confront situations assessing themselves, such as examinations. 9 This anxiety is functional and different studies show that 10%-30% of students are involved. 10 In fact, academic anxiety is a self-obsession which is characterized by feelings of self-inferiority, regarding their abilities and students often tend toward negative cognitive assessment, lack of concentration, undesirable physiological reactions, such as increase of heart rate, cold fingers, drop in blood pressure and lower educational performance. 11 This anxiety is related to students' competition with S-37 J Pak Med Assoc (Suppl. 1) The Effect of Assertiveness Training on Student's Academic Anxiety S. Mohebi, 1 G.H.R. Sharifirad, 2 M. Shahsiah, 3 S. Botlani, 4 M. Matlabi, 5 M. Rezaeian 6 Qom University of Medical Sciences, Qom, Iran, Student in Health Education of Isfahan University of Medical Sciences, 1 Isfahan University of Medical Sciences, Isfahan, 2 Qom University of Medical Sciences, Qom, 3 M.A. Family Counseling, Isfahan, 4 Gonabad University of Medical Sciences, Gonabad, Student in Health Education of Isfahan University of Medical Sciences, 5 Rafsanjan University of Medical Sciences, Rafsanjan, 6 Iran. Corresponding Author: G.H.R. Sharifirad. (sharifirad@hlth.mui.ac.ir). Abstract Introduction and purpose: Academic anxiety is an important educational problem that affects millions of students in colleges and schools over the world each year. Although a low level of anxiety can cause positive motivation for improvement of educational functioning, high levels of it can cause a disturbance in concentration, attention, storage of knowledge, recall and educational reduction. It has also been recently determined that there is a relationship between anxiety and assertiveness. Therefore, this study is an attempt to determine the effect of assertiveness training on reducing anxiety levels in pre-college academic students in Gonabad city in 2008. Methods: In this clinical trial study, all the pre-college students of Gonabad city were invited to participate and 89 students were divided into experimental and control groups. There were 3 questionnaires, namely demographic, academic anxiety and assertiveness Rathus questionnaires in which the validity and reliability were calculated and approved. The intervention for the experimental group was 5 sessions of assertiveness training using the PRECEDE model and 1 session for parents and teachers to help and support the intervention program. We had a post-test 8 weeks after the last training session for each group was conducted. The data was analyzed by SPSS. Results: The results showed that anxiety levels and decisiveness in the target group were moderate to high and it is seen as a significant reverse relationship between these two factors (r=-0.69 and p<0.001). The results also showed that there was a significant anxiety decrease in the experimental group after the intervention. On the one hand, there was a significant increase in decisiveness for both groups, but there was not a significant difference between academic anxiety and assertiveness in the control group before and after the intervention. Conclusion: Due to a significant decrease in anxiety and increased decisiveness in the experimental group, it can be claimed that assertiveness training is an effective non-pharmacological method for reducing academic anxiety and it can improve academic performance. Keywords: Academic anxiety, Assertiveness training, Students, PRECEDE model (JPMA 62: S-37; 2012). Original Article