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Research summary: Despite abundant anecdotal evidence that many top executives experience anxiety in their jobs, the upper echelons literature has remained largely silent on the organizational implications of executive job anxiety. In this study, we theorize that job anxiety will cause executives to (1) create a social buffer against threats by surrounding themselves with supportive decision-making teams, and (2) pursue lower-risk firm strategies. We further argue that these effects will vary depending upon whether strategic decisions occur in gain versus loss contexts. We test our ideas using a novel multisource, multimethod approach that includes data from 84 top executives of large organizations, their decision-making teams, their friends and families, and archival sources. Results from an analysis of 154 major strategic decisions provide general support for our theory. Managerial summary: Although many top executives experience anxiety in their jobs, some struggle more with anxiety than others. Our paper is the first to focus on how job anxiety affects executives' decisions. We analyze 154 major strategic decisions made by 84 top executives of large organizations in a range of industries, collecting data from personal interviews with executives and surveys of their decision-making teams, spouses, and friends. We find that anxious executives take fewer strategic risks, especially when things are going well. We further argue that anxious executives focus more on 'buffering” themselves from threats, and find that they surround themselves with close supporters when times are tough. Our results demonstrate a pattern through which anxiety causes top executives to focus more heavily on avoiding potential threats.