What is Avoidant Personality Disorder?
Avoidant Personality Disorder, also known as Anxious Personality Disorder, is a pervasive pattern of behavior of social inhibition, feelings of inadequacy, intense sensitivity to negative comments, and avoidance of social interaction. Due to these feelings of inhibition and inadequacy, someone with Avoidant Personality Disorder may attempt to avoid any activities that involve social interactions - including work, school, and socializing with friends and/or family. People with Avoidant Personality Disorder may be described by others as "shy" or "timid."
Those who have Avoidant Personality Disorder are often vigilant in regards to the expressions and movement of those with whom they do come into contact; those with Avoidant Personality Disorder may become anxious that they will begin to cry or blush if they are criticized. Unfortunately, their timid and tense demeanor may cause others to bully and tease them, which further reinforces their self-doubts and lowers their self-esteem.
Due to their low self-esteem, individuals with Avoidant Personality Disorder often have extreme problems functioning socially or at work. Those with Avoidant Personality Disorder may become socially isolated, without a support system of interpersonal relationships, even though those with Avoidant Personality Disorder want nothing more than to be socially accepted. Their inhibition may cause them to lose promotions as they avoid the social situations important for meeting the demands of a job. They may fantasize about interpersonal relationships with others.
This is the key difference between someone with Avoidant Personality Disorder and someone with Schizotypal Personality Disorder. Those with Schizotypal Personality Disorder often have similar anxiety and uncertainty about social situations, but they absolutely do not crave social interaction. Instead they crave social isolation.
Causes For Avoidant Personality Disorder
As with many other mental illnesses, researchers do not know what causes Avoidant Personality Disorder. Many different theories exist, but the most widely accepted theory is what’s called a “biopsychosocial model of causation" - meaning that the cause of Avoidant Personality Disorder is likely due to genetic and biological factors, social factors, and psychological factors. This means that no single cause is to blame for the development of Avoidant Personality Disorder.
Diagnosis of Avoidant Personality Disorder
As with any personality disorder, the person must be at least 18 years old to be diagnosed with Avoidant Personality Disorder. The DSM-IV-TR specifies that to be diagnosed with Avoidant Personality Disorder, the individual must meet four of the following seven criteria.
- The person avoids occupational activities that require significant interpersonal contact. Job interviews or promotions may be turned down because the person's own perceptions of his or her abilities do not match the job description.
- The person is reluctant to participate in social involvement without clear assurance that they will be accepted. People with this disorder assume other people are not safe to trust until proven otherwise. Others must offer repeated support and encouragement in order to persuade them to participate in a social event.
- The person fears being shamed or ridiculed in close relationships. As a result, people with this disorder become overly alert to behavioral cues that may indicate disapproval or rejection. They will flee a situation in which they believe that others might turn against them.
- The person is preoccupied with being criticized or rejected. Much mental and physical energy is spent brooding about and avoiding situations perceived as "dangerous."
- The person is inhibited in unfamiliar social situations due to feelings of inadequacy. Low self-esteem undermines their confidence in meeting and conversing with new acquaintances.
- The person regards him or herself as socially inept. This self-disparagement is especially apparent when the person must make social contacts with strangers. People with Avoidant Personality Disorder perceive themselves as unappealing or inferior to others.
- The person is reluctant to take social risks, in order to avoid possible humiliation. S/he seeks interactions that promise the greatest amount of acceptance while minimizing the likelihood of embarrassment or rejection.
Diagnosis of Avoidant Personality Disorder
A person must be at least 18 years old in order to be diagnosed with any personality disorder. Symptoms will generally decrease in intensity with age, with the peak level of symptoms displayed in their 40s or 50s.
Many people with Avoidant Personality Disorder do not seek out treatment, thinking that they are not good enough or that their symptoms don't matter, even though the disorder has a significant impact upon their lives. Typically help is sought when life becomes too stressful and they are unable to cope with it.
Unlike other mental illnesses, it’s extremely difficult for a general practitioner to diagnose Avoidant Personality Disorder; therefore, a diagnosis must be made by a trained mental health professional.
A diagnosis of Avoidant Personality Disorder can be made after a thorough examination by a psychiatrist or psychologist and a detailed analysis of both the symptoms and health history of the individual. If the symptoms meet the diagnostic criteria, a diagnosis of Avoidant Personality Disorder is made and treatment can begin.
Treatment of Avoidant Personality Disorder
As with most other personality disorders, the treatment of choice for those with Avoidant Personality Disorder is psychotherapy. Group therapy may be useful if the person with Avoidant Personality Disorder agrees to attend sessions, although group therapy is often a tool that is used later in treatment, once the person feels more comfortable in social situations.
Those with Avoidant Personality Disorder often have low self-esteem about any social interactions, often finding it difficult to see the positive in life. This may be challenging for a therapist, as the person may under-report symptoms, deeming them unimportant. A more thorough, detailed interview may be required.
Therapy is generally short-term and oriented toward solution-based approaches looking for solutions to specific life problems.
Medications should only be prescribed for specific diagnoses occurring co-morbidly with Avoidant Personality Disorder.
Additional Resources for Avoidant Personality Disorder
Out of the Fog - information and support for those with a loved one suffering a personality disorder.
Avoidant Personality Disorder - Support group and website devoted to people with Avoidant Personality Disorder and those who love them.
Social Anxiety And Shyness Info contains information about Avoidant Personality Disorder, shyness, social anxieties, and treatment options.
Avoidant Personality Disorder Meetup - locations for meetups and support group for those who suffer from Avoidant Personality Disorder.