Personality - What Causes Anxiety: Mental Health

Content provided by the Faculty of the Harvard Medical School

Personality

Personality is also important. Some personality traits, such as shyness, are inherited. Both shyness and a characteristic known as anxiety sensitivity increase the risk of developing certain anxiety disorders. Avoidant personality, a form of personality disorder, also seems to be a risk factor.

Shyness

Jerome Kagan, a Harvard University psychologist, has found that children who are inhibited are more likely to develop anxiety. By adolescence, 61% of youngsters who had been inhibited as toddlers had social anxiety (social phobia), compared with just 27% of those who had been uninhibited. The research points to a possible explanation. Shy people have certain physiological traits, such as a heightened excitability of the amygdala. In people with certain anxiety disorders, the amygdala also tends to be overly reactive. It could be that a hypersensitive amygdala makes people susceptible to anxiety.

Anxiety sensitivity

Anxiety sensitivity is another personality trait that increases the risk for anxiety disorders, particularly panic disorder. Anxiety sensitivity is a tendency to misinterpret the sensations that accompany anxiety — irregular breathing, heart palpitations, trembling, flushing, sweating, stomach rumbling — as indications of imminent physical danger or serious illness ("I'm going to have a heart attack" or "I'm going to faint"), loss of control ("I can't concentrate — I'm going crazy"), or humiliating social rejection ("Everyone will notice that I'm trembling"). Anxiety sensitivity can show up in children as young as age six. It can be innate or learned through observation or misinformation. For example, anxiety sensitivity could arise from a parent telling a child that too fast a heartbeat could be fatal.

Research shows that cognitive behavioral therapy can help people with anxiety sensitivity temper their anxious personalities and possibly prevent panic disorder. Cognitive behavioral therapy aims to teach people that their anxiety-related sensations are harmless. For example, a patient may be asked to hyperventilate for a few minutes and then observe that the ensuing dizziness and palpitations don't have catastrophic results. Anyone with a high level of anxiety sensitivity (as measured, for example, by the Anxiety Sensitivity Index, a brief questionnaire) may benefit from psychotherapy directed specifically toward that sensitivity.

Avoidant personality disorder

Avoidant personality disorder also increases the risk of developing anxiety. People with personality disorders see the world differently and therefore behave differently from what is expected in their culture. They are often inflexible and cope with the world in ways that are counterproductive.

Those with avoidant personality disorder are hesitant, tense, fearful, self-deprecating, and exceedingly sensitive to social rejection. They see criticism and mockery everywhere. Their low threshold for fear is coupled with a heightened arousal of the autonomic nervous system, which induces the fight-or-flight response. To prevent the rejection that they anticipate, people with avoidant personalities narrow their interests and range of activities. These defenses set the stage for social phobia.

Therapy can help people with avoidant personality disorder reduce their extreme behaviors and possibly their tendency to develop anxiety. Various therapeutic approaches, including cognitive behavioral therapy, can help them be more aware of how their habits affect their lives and can aid in modifying those habits.

Last updated:	September 05, 2008