This paper reports of findings pertaining to levels of psychological distress, perceived health status, and physician utilization among a sample of Americans (N = 1204) and West Germans (N = 1266) living in Illinois and North-Rhine Westphalia, respectivey. The conflicting perspectives of labeling theory and the clinical approach to cross-cultural variations in mental disorder are discussed. There were no significant differences between the two population groups with respect to anxiety tendencies or psychological distress generally, with the exception of Germans having significantly more tendency toward depression. In both countries, person with the lowest expressions of anxiety were the most likely to perceive symptoms of physical problems as requiring a doctor's attention, thereby suggesting that anxiety operates to influence a denial of general readiness to deal with symptoms. Yet persons with the highest anxiety, depression, and overall psychological distress were most likely to report having experienced physical symptoms and visiting a doctor because of it. Persons with the highest anxiety, depression, and overall psychological distress also rated their status the lowest. © 1988.