According Diagnostic and Statistical Manual of Mental

According to the Encyclopedia
of Psychology (Kazdin, 2000):

Anxiety is an emotion characterized by
heightened autonomic system activity. specific activation of the sympathetic
nervous system (i.e. increased heart rate, blood pressure, respiration, and
muscle tone), subjective feelings of tension. and cognitions that involve
apprehension and worry. (p.210)

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Although the idiographic study of anxiety shows that it is
not necessarily accompanied by particular behaviors, behavioral indicators are
often present such as speech fluency-related impairment
(Pashak et al., 2017).
Several subtypes of anxiety, such as test anxiety. social anxiety, performance
anxiety, appearance anxiety, sexual anxiety, and speech anxiety, have been
identified (Endler & Kocovski, 2001). These subtypes share certain
features in common, and any one of them could be characterized with terms such as apprehension, dread, panic,
tension, and worry. The Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) lists about 13 different
diagnostic categories of anxiety disorders including panic attacks, specific
phobias, social phobias, posttraumatic stress disorder. and generalized anxiety

Two concepts to which anxiety is related are fear and phobia
(Ding, 1988). Although the relationships
are commonly used interchangeably, Fear is often defined as a response to a
clearly identifiable danger, whereas anxiety is conceptualized as a response to
an unidentified threat or an anticipated danger (McNaughton, 2011). In addition, whereas the
fear response is comparable to the objective danger, anxiety responses are
often more intense than is warranted by the perceived threat. However. not all
theorists agree with these distinctions between fear and anxiety.

Phobia is defined as excessive anxiety or fear that occurs
in response to a particular stimulus (Barlow, 1988). The magnitude of the person’s
response to the feared stimulus clearly exceeds the objective threat, and
phobias usually have a debilitating effect on the person’s life, Phobias are
typically divided into three categories: specific phobias, social phobia, and
agoraphobia. As the name implies, specific phobias are fears of specific
objects or situations, such as heights, flying, and animals. Social phobia
represents a person’s fear of social or performance situations in which he or
she might be embarrassed or humiliated. People with agoraphobia fear being in situations from which they would have
difficulty escaping. such as crowds, buses, or airplanes (Kazdin, 2000).

As anyone who has experienced anxiety can attest, anxiety
can have a detrimental effect on behavior and cognitions
(Pyevich, Newman, & Daleiden, 2003). Students who anticipate
performing poorly on a test may experience anxiety to such a degree that they
have difficulty recalling relevant information, However, like most emotions,
anxiety is inherently adaptive. The performance-enhancing effects of moderate
levels of arousal have long been known. In addition, anxiety acts as an
interrupt mechanism drawing attention away from secondary concerns to the
problem at hand, thereby leading the individual to stop behavior that may be
dangerous or threatening. For example, a person who experiences social anxiety
may stop behaviors that are potentially embarrassing and might lead to
interpersonal rejection.

One way of distinguishing adaptive from maladaptive anxiety
is by viewing the “reasonableness” of the anxiety. For example, a
person who is afraid of heights, avoidance of the focal object or event,
immobilization or observable tremor is, in fact, in little danger of falling.
However, a person who is socially anxious may be rightfully concerned with
being evaluated by others in undesired ways.

State Versus Trait Anxiety

People differ markedly in their tendency to experience
anxiety. Whereas some people experience anxiety quite often, others feel
anxious only rarely. Many of the early difficulties in defining anxiety stemmed
from the failure to distinguish between state and trait anxiety. As defined by
Charles Spielberger in Anxiety and Behavior (C D Spielberger, 1966), state anxiety refers to
transient feelings of anxiety at a given moment in time (i.e., “I feel
anxious”). Trait anxiety, on the other hand, reflects individual
differences in anxiety proneness or people’s tendency to appraise situations as
threatening and to respond to those situations with state anxiety behaviors
(i.e., “I am an anxious person”). Trait anxiety does not imply that
the person is chronically anxious but rather that he or she has a higher
tendency than low trait anxious people to experience anxiety.

Low and high trait anxious people do not differ in their
responses to nonthreatening situations or
to situations that nearly everyone would appraise as stressful. Rather, the
state anxiety reactions of trait anxious individuals exceed those of low trait
anxious people only in situations that trait anxious people appraise as more
threatening than low trait anxious people.

Comparative Theoretical Perspectives on Anxiety

A complete understanding of the etiology of anxiety has
remained elusive, due in large part to the myriad of factors that may
precipitate and maintain anxiety. For the purposes of this paper, we will try
to comparatively analyze anxiety from two personality theoretical approaches of
psychodynamic and cognitive schools of thought. Each of these theories explains
aspects of anxiety, and all are needed to understand the phenomenon fully.

Psychodynamic Perspective

Tracing their origins back to Freud, psychodynamic theories
of anxiety view anxiety as an unpleasant affective state originating in the unconscious
(Manoel Andrade, 2003). The anxiety is a signal or a
symptom of an unconscious conflict, usually stemming from childhood, that
remains unresolved. To deal with their feelings of anxiety, people develop
psychological defenses that may be either adaptive (i.e., realistic anxiety) or
maladaptive (i.e., neurotic anxiety) (Boag, 2006).

Freud theorized the internal psychological dynamic between,
Id (denoting human instinctual urges), Ego (the rational balancing mechanism
countering Id’s urges) and the Super Ego (the social conscientiousness factor
that balances the Id with Ego being balancing factor) (Halperin & Shakow, 1989). The pathological cause of
Anxiety is therefore (according Freud) was due to a balancing act of
rationality against human primal instinctual desires that symbiotic related to
the erogenous childhood Psychosexual developmental stages of Oral, Anal,
Phallic, Latency & Genital periods (Westen, 1998). Anxiety, therefore has libidinal relevance as outcome of either psychosexual stages or
post-psychosexual regression beyond adolescence and adulthood (McLeod, 2008).

The Ego, according
Freud, plays a repressing in order to balance Id’s urges. The repressive force
of Ego therefore results in neurosis and
anxiety. Another aspect to be addressed is the unconscious expectation of Id’s
desires to be quashed by future action of Ego creates a feeling uncertainty
that may also cause anxiety and later manifest itself as neurotic behavior. The
anxiety can accompany fear that may result in Phobia as well as avoidance.

The Little Hans’

To further the psychopathology of Anxiety from a
psychodynamic lens, let’s consider the famous case of little Hans as
illustrated by Freud (Freud, 1923). Little Hans was Freud’s
client, who according his parents had developed an acute phobia towards horses.

Little Hans was a 5-year-old boy who had manifested a deep
fear of horses as he feared that the horse will bite him and may result in
killing him. It may be noted that previously, Hans’ friend had fell of a horse
and injured himself badly. Furthermore, Hans’ was undergoing a psychosexual
developmental age, an age where according to Freud, there is the unconscious
presence of oedipal desires-the unconscious desires of marrying one’s mother
and killing one’s father.

Freud theorizes that the balancing force that counters
oedipal is the castration anxiety that a male child expects as a reprisal from
his father. In the case of Hans, the fear of death or hurt from a horse was his
castration anxiety. The Horse, according to Freud, represented Hans’ father in
the unconsciousness of Hans. It was further mentioned by Freud, the object co-relationing
of Horse with Hans’ father in Hans’ unconscious was due to an earlier fact that
Hans’ father used to play with Hans in portraying himself as a horse and giving
Hans a horseback ride on his back. So unconsciously little Hans started
relating his father with the horse. The other corresponding event that took
place in Hans’ life was his friend falling of a horse and hurting himself
badly. Freud therefore proposed that little Hans fear (and his resultant
Anxiety) of horses was in fact a manifestation of Hans’ castration anxiety as
an unconscious reprisal for his oedipal desires.

Hans’ case, the Id desires where actually his unconscious oedipal desires
(going through his Phallic psychosocial developmental phase) and Ego’s counter
balancing force was his unconscious Castration anxiety manifested through Hans
fear or phobia of horses.



Cognitive Perspective

All of the prominent cognitive theories of anxiety are
appraisal theories. The appraisal process involves two stages, a primary
appraisal in which an individual determines the threat posed by the environment,
and, following a threatening primary appraisal, a secondary appraisal where the
individual evaluates his or her ability to cope with the demands imposed by the
environment. In their book Anxiety Disorders and Phobias: A Cognitive
Perspective. Beck, Emery, and Greenberg (New York, 1985) suggest that
maladaptive anxiety results from distortions in this appraisal process. People
who suffer from chronic anxiety are those who misperceive benign situations as

In an extension of the cognitive approach, David Barlow
suggests that anxiety is a cognitive-affective phenomenon, at the core of which
lies negative affect (Barlow, 1988). Perceptions of threat are
influenced by early experiences with uncontrollability that create a
psychological vulnerability to anxiety and by a biological predisposition to
experience anxiety in the face of negative life events. Specific negative life
events activate the biological vulnerability to stress, leading trait anxious
individuals to perceive the environment as threatening even in the absence of
an identifiable stressor. If the person then perceives that the event is
uncontrollable and unpredictable (i.e., it could happen again) and perceives
that he or she lacks the necessary coping re­ sources. anxiety will be

The Little Hans’
Case from a Cognitive Theoretical Perspective.

To understand the diversity of theoretical perspective between
Psychodynamic and Cognitive schools of thought, we shall now revisit little
Hans case from a cognitive perspective. As mentioned above, little Hans (aged
5) had developed a phobia towards horses. While Freud saw as collision of Id
and Ego in a psychosocial developmental sphere of Phallic stage. The cognitive
theorists will take it as environmental conditioning of the cognitive process.
The fact that little Hans saw that his friend fell and got hurt while riding a
horse, became environmental conditioning factor that made horses resulting in
injury for little Hans. Little Hans therefore perceived horse-riding as a
dangerous undertaking (primary appraisal) that may result in injury or death to
himself. The avoidance of Hans of not going out and feeling extremely anxious
and fearful near the sight of horse was his rational conclusion (secondary
appraisal resulting in avoidance).


 Because of the
multifaceted nature of anxiety, no one of these theories adequately describes
all of the factors related to its onset and maintenance. Genetic
predispositions. early childhood experiences with uncontrollable events,
certain kinds of cognitions and information processing, all contribute to
creating anxiety.

Self-Report Measures

Self-report measures have been used in the measurement of
anxiety, along with physiological measures (e.g., heart rate. blood pressure,
respiration), and behavioral observations (e.g., speech dysfluencies,
self­manipulation, bodily movement, hand-wringing). One problem, however, is
that the correlations among the three types of measures are often low. Thus, an
individual who is experiencing heightened physiological arousal and who reports
feeling anxious may display few, if any, behaviors indicating anxiety.

Self-report measures can be divided into three categories:
measures of trait anxiety, state anxiety, or situation-specific anxiety (e.g.,
social anxiety. test anxiety, etc.) (Charles D. Spielberger, 2010). One of the most commonly
used self-report measures of anxiety is the State-Trait Anxiety Inventory (STAI)
developed by Spielberger, Gorsuch. and Lushene (Test Manual for the State-Trait
Anxiety Inventory. Palo Alto, CA. 1970). Participants respond to each of the 20
state anxiety items using a four-point Likert scale to indicate the intensity with
which they experience anxiety at a particular point. Representative items
include “I feel tense,” “I feel high­ strung.” and “I
feel anxious.” The 20-trait anxiety items examine the frequency with which
respondents generally experience anxiety through items such as “I feel
nervous and restless.” ” 1 feel like crying,” and “I take
things hard.”

In spite of the wide use of the STAI as a measure of
anxiety, researchers have tended to study specific manifestations of anxiety,
such as performance anxiety, social anxiety. test anxiety. and speech anxiety,
rather than anxiety more generally. Thus. they use situation specific measures
that are tailored to the specific type of anxiety being researched. For
example, to study social anxiety, a researcher might use the Interaction
Anxiousness Scale. the Social Avoidance and Distress Scale. or the Fear of
Negative Evaluation Scale.

Physiological Measures

Because anxiety involves activation of the sympathetic
nervous system, physiological measures of anxiety include assessments of heart
rate. blood pressure, muscle tone. and respiration. Unlike self-report and
behavioral assessments of anxiety. physiological measures are less easily
regulated by the respondent, thereby providing a potentially more accurate
assessment of anxiety.

Behavioral Measures

Ideally, direct observations of behavior would occur in a
naturalistic environment. However, due to the infrequent nature of many
behaviors, the lack of experimental control. and the potential biasing effects
of the presence of an observer. naturalistic observations of anxious behaviors
have not always proved viable. Thus, most behavioral assessments of anxiety
have occurred within a laboratory setting. However, laboratory studies that
induce anxiety in hu­ mans have themselves been problematic. primarily for
ethical reasons. Nevertheless, depending on the type of anxiety under
investigation, any number of behavioral observations can be made including
speech dysfluencies, performance during role plays, and avoidance of anxiety
producing stimuli.


Cultural Variations

Although anxiety is a universal emotion, the experience,
expression. and interpretation of anxiety vary across cultures. Thus, not surprisingly,
the prevalence rates of particular types of anxiety vary across cultures.
Societies that emphasize conformity and inter­ personal evaluation show higher
proportions of social anxiety, for example, than societies that place less
importance on the evaluations of others. Depending on the standards of a
particular culture, what is considered normal in one culture might be
considered pathological anxiety in another.

In spite of some cross-cultural variability in the
experience of anxiety, facial expressions of fear and anxiety are universally
recognized (Allen-Walker & Beaton, 2014). Moreover, some fears, such
as the fear of snakes and children’s fear of strangers, are believed to be
uniformly experienced across cultures, lending support to theories concerned
with the genetic basis of some types of anxiety.