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Chapter 1
Anxiety
A Common but Multifaceted Condition
Love looks forward, hate looks back, anxiety has eyes
all over its head.
—Mi g n o n McLa u g hL i n (American journalist, 1915– )Anxiety is ubiquitous to the human condition. From the beginning of recorded his-
tory, philosophers, religious leaders, scholars, and more recently physicians as well as
social and medical scientists have attempted to unravel the mysteries of anxiety and
to develop interventions that would effectively deal with this pervasive and troubling
condition of humanity. Today, as never before, calamitous events brought about by
natural disasters or callous acts of crime, violence, or terrorism have created a social
climate of fear and anxiety in many countries around the world. Natural disasters like
earthquakes, hurricanes, tsunamis, and the like have a significant negative impact on
the mental health of affected populations in both developing and developed countries
with symptoms of anxiety and posttraumatic stress showing substantial increases in the
weeks immediately following the disaster (Norris, 2005).
Elevated levels of anxiety and other posttraumatic symptoms spike in the first few
weeks after acts of terrorism, war, or other large-scale acts of community violence. In
5–8 weeks after the September 11, 2001, terrorist attacks on the World Trade Center
towers in New York City, symptoms of posttraumatic stress disorder (PTSD) doubled
(Galea et al., 2002). An Internet-based survey (N = 2,729) found that 17% of individu-
als outside New York City reported PTSD symptoms 2 months after 9/11 (Silver, Hol-
man, McIntosh, Poulin, & Gil-Rivas, 2002). The National Tragedy Study, a telephone
survey of 2,126 Americans, found that 5 months after the 9/11 terrorist attacks month,
30% of Americans reported difficulty sleeping, 27% felt nervous or tense, and 17%
indicated they worried a great deal about future terrorist attacks (Rasinski, Berktold,
Smith, & Albertson, 2002). The Gallup Youth Survey of American teenagers conducted
2½ years after 9/11 found that 39% of teens were either “very” or “somewhat” worried
that they or someone in their families will become a victim of terrorism (Lyons, 2004).