Anxiety, Heart Disease, and Mortality

The Nature of Anxiety

Anxiety is a strong negative emotion, accompanied by a sense of unease, worry, and intrusive thoughts that cannot be put to rest. Anxiety disorders are among the most prevalent psychiatric disorders in the United States. Recent surveys estimate the prevalence of anxiety in the general U.S. population ranging from 12.6% to 17.2%. Psychologists have suggested that[Page 56] clinical and subclinical anxiety are not clearly separable phenomena. As a result, prevalence estimates may be conservative because they fail to include individuals who experience high anxiety levels but who do not meet diagnostic criteria for an anxiety disorder.

A characterization of anxiety can be informed by an understanding of the nature of emotions more generally. Theorists generally agree that specific emotions arise out of the interaction between individuals and their environments, and motivate individuals to respond to external events (Frijda, 1986). For example, if one is crossing a street and sees a car approaching quickly, one might feel fear. The fear might then motivate the individual to run out of the way. Although emotions are generally adaptive processes, they can have adverse consequences when the system is taxed beyond the limits of its capability. For example, when individuals are getting ready to take an exam, they might feel anxious about their performance. This anxiety can motivate them to prepare appropriately for the exam. However, if they feel they cannot ever be prepared or cannot cope with their anxiety, the emotion may no longer be adaptive. In such cases, the anxiety may itself become a problem. A variety of theories have been proposed to explain the development of anxiety and its disorders (Amir & Kozak, 1998).

Because the word anxiety represents both a lay construct and a scientific term, precise definitions are needed to facilitate research on the topic. Anxiety is a future-oriented negative emotional state that results from perceptions of threat. It is characterized by a sense that one is unable to predict, control, or obtain desired results in upcoming situations (Barlow, 1988). Most people experience some level of anxiety at different points in their lives. Anxiety may be considered as a state, an episodic experience of the emotion brought on by specific situations. Or it may be considered as a trait, an enduring temperament, or predisposition to experience the state of anxiety frequently. Thus, someone who is characterized as “anxious” may be a person who frequently experiences states of anxiety in response to many different situations.

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