Three factors contribute to the development of anxiety: your heredity; your personality, which is influenced strongly by your upbringing and childhood experiences; and cumulative stress, the amount of stress you experience in your adult life.

Your genes and your personality traits can predispose you toward a panic or phobic disorder, but actually developing that disorder is usually triggered either by one major stressor such as the death of a loved one or a series of life stresses over a period of time.

Most people with anxiety difficulties display at least two or three of these traits, which include:

• excessive need for approval
• insecurity and over-dependency
• over-control
• perfectionism
• over-cautiousness
• "confinement phobia"

People prone to anxiety disorders also have plenty of positive traits, such as creativity, intuitive ability, emotional sensitivity, and amiability. Such traits often endear them to their relatives and friends.

Anxiety-prone personality characteristics tend to be associated with specific, deep-seated fears. Such "core fears" often have their origin in childhood or past trauma. They underlie most of the worries and phobias that come up for people with anxiety.

The six traits described above are motivated by these core fears, which include: fear of rejection; fear of abandonment; fear of losing control; fear of illness, injury, or death; and the fear of confinement.

Certainly there are other fears that can influence anxiety disorders, such as the fear of what is strange or unfamiliar, the fear of failure, or the fear of meaninglessness.

Yet the five core fears just mentioned play the most central role in motivating anxiety-prone personality traits. These traits and the core fears tend to be associated in the following way:

ANXIETY-PRONE TRAIT

• Excessive need for approval
• Insecurity and overdependency
• Overcontrol
• Perfectionism
• Overcautiousness
• Confinement phobia

CORE FEAR

• Fear of rejection
• Fear of abandonment
• Fear of losing control
• Fear of rejection
• Fear of illness, injury, death
• Fear of being stuck, confined

Which of these characteristics fit you? If you've received therapy, particularly cognitive-behavioral therapy, for your anxiety disorder, were these issues addressed?

Effective cognitive-behavioral treatment may help you deal with some of these issues indirectly. For example, changing self-talk and the underlying beliefs that cause social anxiety may help you to overcome your fear of rejection.

Or taking time out to work on relaxation may enable you to let go of some of your over-control and perfectionism. Or, if you're agoraphobic and learn through exposure therapy to drive farther from home, you may begin to overcome feelings of insecurity and over-dependency.

Without a doubt, cognitive-behavioral therapy (CBT) can have a favorable impact on anxiety-prone personality traits and associated core fears. The question is whether it's enough. CBT tends to address primarily the cognitive aspects of your personality i.e., your anxiety-provoking self-talk, attitudes, and beliefs.

But there are also emotional factors that influence the traits and fears listed above. Insecurity and over-dependency, for example, may be influenced by having not developed a strong sense of your own identity.

In my blog I discuss in a series of 6 articles the personality issues on anxiety. Each article begins with a list of five questions to help you assess whether the particular trait applies to you. The remainder of the section describes the characteristic in more detail and then suggests strategies to help you overcome it.