Those with Avoidant PD (AvPD) experience an intense level of social anxiety. Extremely self-conscious, they tend to avoid social situations and gravitate to jobs that involve little interpersonal contact. Avoidants often feel inadequate or inferior to others and are hypersensitive to rejection. Unlike individuals with schizoid personality disorder, those with AvPD do crave social relationships, but feel that social acceptance is unattainable (Dobbert 2007).
Diagnosis of AvPD
There are currently 10 conditions considered to be personality disorders, some of which have very little in common. Mental health professionals typically group those PDs that share characteristics into one of three clusters. Avoidant Disorder is a Cluster C Personality Disorder, a class which also contains Obsessive-Compulsive and Dependent PD; all three distinguished by anxious, fearful behavior.
AvPD is only diagnosed when the characteristic behaviors are pervasive and disabling. According to the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders), a patient must fit at least four of the following criteria in order to be diagnosed with Avoidant Personality Disorder:
- avoids activities involving interpersonal contact
- unwilling to get involved due with people unless certain of being liked
- shows restraint in intimate relationships due to a fear of shame or ridicule
- marked preoccupation of being rejected or criticized by others
- inhibited in new social situations because of feelings of inadequacy
- views self as socially inept, personally unappealing, or inferior to others
- reluctant to take personal risks or engage in new activities, for a fear of being embarrassed
Prevalence of Avoidant Personality
Estimates of the prevalence of Avoidant Personality Disorder in the general population have ranged from 0.5% to 2.5% (NESARC 2002).
Cause & Course of AvPD
There is no clear cause for Avoidant Personality Disorder. It is relatively uncommon and there is little information on occurrence by gender or existence of family pattern.
The course of AVPD is chronic and typically manifests by early adulthood. It tends to be more severe earlier in life and often improves in middle age (Kantor 2003).
Treatment of AvPD
As is common with many other personality disorders, those with Avoidant personalities are unlikely to seek treatment for the disorder itself. And sweeping changes in personality are not a realistic outcome.
Psychotherapy for Avoidant Disorder
Individual short-term psychotherapy focused on specific life problems appears to be the most effective treatment strategy for those with AvPD. It is important to establish trust early in the therapist-client relationship, since Avoidants are prone to abandon treatment. Group therapy, which focuses on interpersonal interactions, can ultimately be beneficial if the patient has made progress in individual therapy and is willing. Assertiveness training can also be an effective treatment approach.
AvPD and Medication
Medication may be used to treat the associated symptoms of depression or anxiety, but must be carefully monitored. Physicians should be cautious when prescribing to those with AvPD, as the some of the patient’s social anxiety or emotional disconnectedness can be situational and medication may interfere with psychotherapeutic treatment (Dobbert 2007, Kantor 2003).This article is a brief summary of the personality disorder AvPD. The contents of this article are not meant to be used for diagnosis and are not a substitute for professional help and counseling.
Sources
American Psychiatric Association APA (2000). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR).
Dobbert, D. (2007) Understanding Personality Disorders: An Introduction. Greenwood Press.
Kantor, M. (2003) Distancing: Avoidant Personality Disorder, Revised and Expanded. Greenwood Press.
