Vulnerability to Anxiety 123
summary anD ConClusionIn this chapter we discussed a number of constructs that have been proposed in the etiol-
ogy of anxiety disorders. Although various genetic, biological, developmental, and envi-
ronmental factors have been implicated in the onset of anxiety, it is our contention that
individuals can also possess cognitive vulnerability for anxiety. As depicted in Figure
4.1, the cognitive model recognizes that genetic predisposition, biological determinants,
childhood experiences, and aversive life events all play a significant role in the etiology
of an anxiety disorder. At the same time, however, general cognitive- personality factors
interact with more specific enduring cognitive structures as contributory pathways to
the expression of anxiety.
At the more general level the cognitive model recognizes that certain personality
characteristics such as high negative emotionality or elevated trait anxiety are non-
specific vulnerability factors in anxiety. There is now considerable empirical evidence
that nonclinical high trait- anxious individuals exhibit a propensity for a threat- related
information- processing bias that is similar to that seen in the anxiety disorders, espe-
cially when induced by training or activated by a stressor (e.g., see review by MacLeod
et al., 2004). High NA has been implicated in the etiology of both anxiety and depres-
sion. However, it is at the more specific level that we see contributory factors that have
even more relevance for anxiety. An extensive literature now exists on the etiological
role of anxiety sensitivity and while perceived uncontrollability is clearly involved in the
pathogenesis of anxiety, it is doubtful its influence is limited to the anxiety disorders.
The remainder of the chapter discussed evidence for the final two hypotheses of
the cognitive model. There is emerging evidence that enduring beliefs or schemas about
threat and personal vulnerability are predisposing factors to anxiety. Although research
on a cognitive vulnerability model of anxiety is still in its infancy, considerable progress
has been made in the last few years in demonstrating the causal status of an information-
processing bias for threat in anxiety. We are only beginning to see how this cognitive
vulnerability research might lead to better treatments for the anxiety disorders.