The term anxiety is currently used in psychology and psychiatry to refer to at least three related, yet logically different, constructs. Although most commonly used to describe an unpleasant emotional state or condition, anxiety also denotes a complex psychophysiological process that occurs as a reaction to stress. In addition, the concept of anxiety refers to relatively stable individual differences in anxiety proneness as a personality trait.
Anxiety states can be distinguished from other unpleasant emotions such as anger, sorrow or grief, by their unique combination of experiential, physiological and behavioural manifestations. An anxiety state is characterized by subjective feelings of tension, apprehension, nervousness and worry, and by activation (arousal) and discharge of the autonomic nervous system. Such states may vary in intensity and fluctuate over time as a function of the amount of stress that impinges on an individual. Calmness and serenity indicate the absence of anxiety; tension, apprehension and nervousness accompany moderate levels of anxiety; intense feelings of fear, fright and panic are indicative of very high levels of anxiety.
The physiological changes that occur in anxiety states include increased heart rate (palpitations, tachycardia), sweating, muscular tension, irregularities in breathing (hyperventilation), dilation of the pupils, and dryness of the mouth. There may also be vertigo (dizziness), nausea, and muscular skeletal disturbances such as tremors, tics, feelings of weakness and restlessness. Individuals who experience an anxiety state can generally describe their subjective feelings, and report the intensity and duration of this unpleasant emotional reaction.
Anxiety states are evoked whenever a person perceives or interprets a particular stimulus or situation as potentially dangerous, harmful or threatening. The intensity and duration of an anxiety state will be proportional to the amount of threat the situation poses for the individual and the persistence of the individual’s interpretation of the situation as personally dangerous. The appraisal of a particular situation as threatening will also be influenced by the person’s skills, abilities and past experience.
Anxiety states are similar to fear reactions, which are generally defined as unpleasant emotional reactions to anticipated injury or harm from some external danger. Indeed, Freud regarded fear as synonymous with ‘objective anxiety’, in which the intensity of the anxiety reaction was proportional to the magnitude of the external danger that evoked it: the greater the external danger, the stronger the perceived threat, the more intense the resulting anxiety reaction. Thus, fear denotes a process that involves an emotional reaction to a perceived danger, whereas the anxiety state refers more narrowly to the quality and the intensity of the emotional reaction itself.
The concept of anxiety-as-process implies a theory of anxiety as a temporally ordered sequence of events which may be initiated by a stressful external stimulus or by an internal cue that is interpreted as dangerous or threatening. It includes the following fundamental constructs or variables: stressors, perceptions and appraisals of danger or threat, anxiety state and psychological defence mechanisms. Stressors refer to situations or stimuli that are objectively characterized by some degree of physical or psychological danger. Threat denotes an individual’s subjective appraisal of a situation as potentially dangerous or harmful. Since appraisals of danger are immediately followed by an anxiety state reaction, anxiety as an emotional state is at the core of the anxiety process.
Stressful situations that are frequently encountered may lead to the development of effective coping responses that quickly eliminate or minimize the danger. However, if people interpret a situation as dangerous or threatening and are unable to cope with the stressor, they may resort to intraphsychic manoeuvres (psychological defences) to eliminate the resulting anxiety state, or to reduce its level of intensity.
In general, psychological defence mechanisms modify, distort or render unconscious the feelings, thoughts and memories that would otherwise provoke anxiety. To the extent that a defence mechanism is successful, the circumstances that evoke the anxiety will be less threatening, and there will be a corresponding reduction in the intensity of the anxiety reaction. But defence mechanisms are almost always inefficient and often maladaptive because the underlying problems that caused the anxiety remain unchanged.
While everyone experiences anxiety states from time to time, there are substantial differences among people in the frequency and the intensity with which these states occur. Trait anxiety is the term used to describe these individual differences in the tendency to see the world as dangerous or threatening, and in the frequency that anxiety states are experienced over long periods of time. People high in trait anxiety are more vulnerable to stress, and they react to a wider range of situations as dangerous or threatening than low trait anxiety individuals. Consequently, high trait anxious people experience anxiety state reactions more frequently and often with greater intensity than do people who are low in trait anxiety.
To clarify the distinction between anxiety as a personality trait and as a transitory emotional state, consider the statement: ‘Ms Smith is anxious’. This statement may be interpreted as meaning either that Smith is anxious now, at this very moment, or that Smith is frequently anxious. If Smith is ‘anxious now’, she is experiencing an unpleasant emotional state, which may or may not be characteristic of how she generally feels. If Smith experiences anxiety states more often than others, she may be classified as ‘an anxious person’, in which case her average level of state anxiety would generally be higher than that of most other people. Even though Smith may be an anxious person, whether or not she is anxious now will depend on how she interprets her present circumstances.
Two important classes of stressors have been identified that appear to have different implications for the evocation of anxiety states in people who differ in trait anxiety. People high in trait anxiety are more vulnerable to being evaluated by others because they lack confidence in themselves and are low in self-esteem. Situations that involve psychological threats (that is, threats to self-esteem, particularly ego-threats when personal adequacy is evaluated), appear to be more threatening for people high in trait anxiety than for low trait anxious individuals. While situations involving physical danger, such as imminent surgery, generally evoke high levels of state anxiety, persons high or low in trait anxiety show comparable increases in anxiety state in such situations.
Individuals very high in trait anxiety, for example, psychoneurotics or patients suffering from depression, experience high levels of state anxiety much of the time. But even they have coping skills and defences against anxiety that occasionally leave them relatively free of it. This is most likely to occur in situations where they are fully occupied with a non-threatening task on which they are doing well, and are thus distracted from the internal stimuli that otherwise constantly cue state anxiety responses.
Charles D.Spielberger
University of South Florida
Further reading
Freud, S. (1936) The Problem of Anxiety, New York.
Lazarus, R.S. (1966) Psychological Stress and the Coping Process, New York.
Levitt, E.E. (1980) The Psychology of Anxiety, Hillsdale, NJ.
