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:

Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection.

Is unwilling to get involved with people unless certain of being liked.

Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.

Is preoccupied with being criticized or rejected in social situations.

Is inhibited in new interpersonal situations because of feelings of inadequacy.

Views self as socially inept, personally unappealing, or inferior to others.

Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.

Associated Features:

Depressed Mood
Anxious or Fearful or Dependent Personality

Differential Diagnosis:

Some disorders have similar or even overlapping symptoms. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.

Social Phobia, Generalized Type
Panic Disorder With Agoraphobia
Dependent Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder
Paranoid Personality Disorder
Personality Change Due to a General Medical Condition
Symptoms that may develop in association with chronic substance use.

Cause:

There is no clear cause for avoidant personality disorder; some theories suggest that it is a function of how one is brought up, but biological factors are likely as well. This disorder is fairly uncommon and there is little information about occurrence by gender or about family pattern.

Treatment:

Counseling and Psychotherapy [ See Therapy Section ]:

As with most personality disorders, the treatment of choice is psychotherapy. While individual therapy is usually the preferred modality, group therapy can be useful if the client can agree to attend enough sessions. Because of the basic components of this disorder, though, it is often difficult to have the individual attend group therapy early on in the therapeutic process. It is a modality to consider as the patient approaches termination of individual treatment, if additional therapy seems necessary and beneficial to the client.

Pharmacotherapy [ See Psychopharmacology Section ] :

As with all personality disorders, medications should only be prescribed for specific and acute Axis I diagnoses or problems suffered by the individual. Anti-anxiety agents and antidepressants should be prescribed only when there is a clear Axis I diagnosis in conjunction with the personality disorder. Physicians should resist the temptation to overprescribe to someone with this disorder, because they often present with complaints of anxiety in social situations or a feeling of disconnectedness with their feelings. The anxiety in this instance is clearly situationally-related and medication may actually interfere with effective psychotherapeutic treatment.

Self-Help [ See Self-Help Section ]:

There are not any self-help support groups or communities that we are aware of that would be conducive to someone suffering from this disorder. Such approaches would likely not be very effective because a person with this disorder is likely to avoid attending such sessions, due to increased anxiety and difficulty interacting socially.

Avoidant Personality Disorder Links