The impact of anxiety on the accuracy of diagnostic decision-making is a neglected area of research despite its clear implications for the welfare of clients receiving health care. This paper presents the findings of two studies examining the effects of experimentally-induced performance anxiety (Study 1) and naturally-occurring state anxiety (Study 2) on the ability of senior radiography students to make simple same–different decisions about simultaneously presented images and to carry out a secondary verbal memory task. In both studies the more anxious group was less accurate in the primary decision-making task, but there was no decrement in performance on the secondary task. The results are difficult to reconcile with predictions from Eysenck and Calvo's9 processing efficiency account of the impact of anxiety on performance. Rather, the results are consistent with the notion that a primary adaptive purpose of anxiety is to disengage from tasks or stimuli currently occupying attention in order to allow organisms to attend to potential threats. Copyright © 2001 John Wiley & Sons, Ltd.