Avoidant personality disorder is characterized by the avoidance of social situations or interactions that involve risk of rejection, criticism, or humiliation. Diagnosis is by clinical criteria. Treatment is with psychotherapy, anxiolytics, and antidepressants. People with avoidant personality disorder have intense
feelings of inadequacy and cope maladaptively by avoiding any situations in which they may be evaluated negatively. Reported prevalence of avoidant personality disorder in the US varies, but estimated prevalence is about 2.4%. Avoidant personality disorder affects women and men equally. Comorbidities are common. Patients often also have
major depressive disorder
Major depression (unipolar disorder) Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. Exact cause is unknown... read more , persistent depressive disorder,
obsessive-compulsive disorder
Obsessive-Compulsive Disorder (OCD) Obsessive-compulsive disorder (OCD) is characterized by recurrent, persistent, unwanted, and intrusive thoughts, urges, or images (obsessions) and/or by repetitive behaviors or mental acts that... read more , or an anxiety disorder
Overview of Anxiety Disorders Everyone periodically experiences fear and anxiety. Fear is an emotional, physical, and behavioral response to an immediately recognizable external threat (eg, an intruder, a car spinning on... read more (eg,
panic disorder
Panic Attacks and Panic Disorder A panic attack is the sudden onset of a discrete, brief period of intense discomfort, anxiety, or fear accompanied by somatic and/or cognitive symptoms. Panic disorder is occurrence of repeated... read more , particularly
social phobia
Social Phobia Social phobia is fear of and anxiety about being exposed to certain social or performance situations. These situations are avoided or endured with substantial anxiety. Phobias are a type of... read more [social anxiety disorder]). They may also have another personality disorder
(eg, dependent
Dependent Personality Disorder (DPD) Dependent personality disorder is characterized by a pervasive, excessive need to be taken care of, leading to submissiveness and clinging behaviors. Diagnosis is by clinical criteria. Treatment... read more ,
borderline
Borderline Personality Disorder (BPD) Borderline personality disorder is characterized by a pervasive pattern of instability and hypersensitivity in interpersonal relationships, instability in self-image, extreme mood fluctuations... read more ). Patients with social phobia and avoidant
personality disorder have more severe symptoms and disability than those with either disorder alone. Research suggests that experiences of rejection and marginalization during childhood and innate traits of social anxiousness and avoidance may contribute to avoidant personality disorder. Avoidance in social situations has been detected as early as about age 2 years. Patients with avoidant personality disorder avoid social interaction, including those at work, because they fear that they will be criticized or rejected or that people will disapprove of them, as in the following situations: They may refuse a promotion because they fear coworkers will criticize them. They may avoid meetings. They avoid making new friends unless they are sure they will be liked. These patients assume people will be critical and disapproving until rigorous tests proving the contrary are passed. Thus, before joining a group and forming a close relationship, patients with this disorder require repeated assurances of support and uncritical acceptance. Patients with avoidant personality disorder long for social interaction but fear placing their well-being in the hands of others. Because these patients limit their interactions with people, they tend to be relatively isolated and do not have a social network that could help them when they need it. These patients are very sensitive to anything slightly critical, disapproving, or mocking because they constantly think about being criticized or rejected by others. They are vigilant for any sign of a negative response to them. Their tense, anxious appearance may elicit mockery or teasing, thus seeming to confirm their self-doubts. Low self-esteem and a sense of inadequacy inhibit these patients in social situations, especially new ones. Interactions with new people are inhibited because patients think of themselves as socially inept, unappealing, and inferior to others. They tend to be quiet and timid and try to disappear because they tend to think that if they say anything, others will say it is wrong. They are reluctant to talk about themselves lest they be mocked or humiliated. They worry they will blush or cry when they are criticized. Patients with avoidant personality disorder are very reluctant to take personal risks or participate in new activities for similar reasons. In such cases, they tend to exaggerate the dangers and use minimal symptoms or other problems to explain their avoidance. They may prefer a limited lifestyle because of their need for security and certainty.
For a diagnosis of avoidant personality disorder, patients must have
This pattern is shown by the presence of ≥ 4 of the following:
Also, symptoms must have begun by early adulthood. Avoidant personality disorder must be distinguished from the following 2 disorders:
Patients with avoidant personality disorder often avoid treatment. Effective therapies for patients with both social phobia and avoidant personality disorder include
Patients with avoidant personality disorder benefit from
Psychodynamic psychotherapy, which focuses on underlying conflicts, may be helpful. Click here for Patient Education  Copyright © 2022 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved. What are the similarities and differences between schizoid personality disorder and avoidant personality disorder?According to the current DSM (DSM-5, APA, 2013), individuals with schizoid personality disorder reportedly do not desire relationships because of deficits in their capacity to relate meaningfully with others whereas individuals with avoidant personality disorder reportedly desire relationships but fear rejection, shame ...
What is similar to schizoid personality disorder?Although a different disorder, schizoid personality disorder can have some similar symptoms to schizotypal personality disorder and schizophrenia, such as a severely limited ability to make social connections and a lack of emotional expression. People with these disorders may be viewed as odd or eccentric.
Which of the following pathological personality traits is associated with avoidant personality disorder?People with avoidant personality disorder have chronic feelings of inadequacy and are highly sensitive to being negatively judged by others. Though they would like to interact with others, they tend to avoid social interaction due to the intense fear of being rejected by others.
What does the schizoid and schizotypal personality disorders have in common?Both schizoid and schizotypal personality disorder fall into cluster A personality disorders, a group marked by odd and bizarre thoughts and behaviors. People with schizoid personality disorder do not desire close relationships.
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Avoidant personality disorder and schizoid personality disorder are similar in that both involve
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