Avoidant Personality Disorder - APD

Avoidant Personality Disorder apd- avoidant personality disorder Treatment, Medication

In DSM-IV the term avoident is used to denote avoidant personality disorder, whilst in ICD-10 the term anxious personality is preferred, with 'avoidant' as an accepted alternative.

Avoidant personality disorder (APD) is considered to be an active-detached personality pattern, meaning that avoidants purposefully avoid people due to fears of humiliation & rejection.

Marked social inhibition, feelings of inadequacy, and extremely sensitive to criticism.

Avoidant personality disorder is characterized by extreme social anxiety. People with this disorder often feel inadequate, avoid social situations, and seek out jobs with little contact with others. They are fearful of being rejected and worry about embarassing themselves in front of others. They exaggerate the potential difficulties of new situations to rationalize avoiding them. Often, they will create fantasy worlds to substitute for the real one. Unlike schizoid personality disorder, avoidant people yearn for social relations yet feel they are unable to obtain them. They are frequently depressed and have low self-confidence.

People with avoidant personality disorder may have no close relationships outside of their family circle, although they would like to, and are upset at their inability to relate well to others.

Cause of Avoidant Personality Disorder

The exact cause of APD is unknown. The disorder may be related to temperamental factors that are inherited. Genetic factors have been hypothesized to cause APD and social phobia because both conditions are found more frequently in certain families. Although not specifically studied in cases of APD, traumatic experiences, parental overprotection, poor social skills, and parental anxiety have been found to be related to social anxiety. Retrospective studies of adults with APD report high levels of childhood emotional abuse (61%). Physical abuse, however, may be more closely linked with a diagnosis of another personality disorder or PTSD. A multifactorial model of causation is likely, with several of the above factors exerting variable influence in individual cases.

Diagnostic Criteria of Avoidant Personality Disorder

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

1. avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection
2. is unwilling to get involved with people unless certain of being liked
3. shows restraint within intimate relationships because of the fear of being shamed or ridiculed
4. is preoccupied with being criticized or rejected in social situations
5. is inhibited in new interpersonal situations because of feelings of inadequacy
6. views self as socially inept, personally unappealing, or inferior to others
7. is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing

Treatment of Avoidant Personality Disorder

Avoidance reduction is typically an action-oriented approach to handling the causes, complications & consequences of APD. It borrows from the active techniques found in other psychotherapies. Generally, avoidants are encouraged to "do" rather than contemplate, to engage themselves ín fearful situations as a means of overcoming their fear.

Antidepressant medications can often reduce sensitivity to rejection. Psychotherapy, particularly cognitive/behavioral approaches, may be helpful. A combination of medication and talk therapy may be more effective than either treatment alone.

Without treatment, a person with avoidant personality disorder may become resigned to a life of near or total isolation.

Features of avoidant (anxious) personality disorder

• Feelings of tension*
• Avoids involvement
• Preoccupied with rejection
• Feels socially inferior
• Avoids risk Avoids social activity

Note: DSM-IV has two additional criteria

• restraint in intimate relationships because of fear of being shamed or ridiculed; and
• inhibited in new personal situations because of feelings of inadequacy.

*Note a DSM-IV criterion.

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Site last updated: March 4, 2008

Avoidant Personality Disorder - avoidant personality disorder Treatment, Medication