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Avoidant Personality Disorder

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In-depth look at Avoidant Personality Disorder - signs and symptoms, diagnosis, causes, and treatment.

Avoidant Personality Disorder (AvPD) is a psychiatric condition characterized by a lifelong pattern of extreme shyness, feelings of inadequacy and sensitivity to criticism and rejection criticism (note: these are common traits in children but do not suggest future personality disorder). Avoidant patients long for close interpersonal relationships, but fear humiliation, rejection, and embarrassment, and so avoid and distance themselves from others.

People with Avoidant Personality Disorder have an inferior self-perception and are preoccupied with external views. In addition to the behaviors listed above, other behaviors associated with AvPD include holding off on starting relationships until acceptance is a given, holding back in social situations to avoid appearing foolish and avoidance of jobs with social demands.

This disorder has a relatively low prevalence in the general population (estimated to be between .5 and 1 per cent.

What are the signs and symptoms of Avoidant Personality Disorder?

People with avoidant personality disorders form relationships with others only if they believe they will not

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be rejected. They are preoccupied with their own shortcomings. Loss and rejection are so painful that these people will choose loneliness rather than risking themselves in a relationship.

  • Symptoms include:
  • Being hurt by criticism or disapproval
  • Having no close friends
  • Reluctance to become involved with people
  • Avoiding activities or occupations that involve interpersonal contact
  • Shyness in social situations out of fear of doing something wrong
  • Exaggerating potential difficulties

What causes someone to develop Avoidant Personality Disorder?

In-depth look at Avoidant Personality Disorder - signs and symptoms, diagnosis, causes, and treatment.There is no clear cause for avoidant personality disorder; some theories state that it is a function of how one is brought up, but biological factors are likely as well. Avoidant personality traits typically appear in childhood, with signs of excessive shyness and fear when the child confronts new people and situations. These characteristics are also developmentally appropriate emotions for children, however, and do not necessarily mean that a pattern of avoidant personality disorder will continue into adulthood. When shyness, unfounded fear of rejection, hypersensitivity to criticism, and a pattern of social avoidance persist and intensify through adolescence and young adulthood, a diagnosis of avoidant personality disorder is often indicated.

Many persons diagnosed with avoidant personality disorder have had painful early experiences of chronic parental criticism and rejection. The need to bond with the rejecting parents makes the avoidant person hungry for relationships but their longing gradually develops into a defensive shell of self-protection against repeated parental criticisms. Ridicule or rejection by peers further reinforces the young person's pattern of social withdrawal and contributes to their fear of social contact.

Individuals with a disfiguring condition or illness may overlap with those with this disorder. This disorder is fairly uncommon and there is little information about occurrence by gender or about family pattern.

How is Avoidant Personality Disorder diagnosed?

Many individuals exhibit some avoidant behaviors at one point or another in their lives. Occasional feelings of self-doubt and fear in new and unfamiliar social or personal relationships are not unusual, nor are they unhealthy, as these situations may trigger feelings of inadequacy and the wish to hide from social contact in even the most self-confident individuals. An example would be the anxious hesitancy of a new immigrant in a country with a different language and strange customs. Avoidant characteristics are regarded as meeting the diagnostic criteria for a personality disorder only when they:

  • begin to have a long-term negative impact on the affected person
  • lead to functional impairment by significantly altering occupational choice or lifestyle or otherwise impacting quality of life
  • and cause significant emotional distress

Avoidant personality disorder can occur in conjunction with other social phobias, mood and anxiety disorders, and personality disorders. The diagnosis may be complicated by the fact that avoidant personality disorder may be either the cause or result of other mood and anxiety disorders. For example, individuals who suffer from major depressive disorder may begin to withdraw from social situations and experience feelings of worthlessness, symptoms that are also prominent features of avoidant personality disorder. On the other hand, the insecurity and isolation that are symptoms of avoidant personality disorder can trigger feelings of depression.

The characteristics of avoidant personality disorder may resemble those found in both schizoid and schizotypal personality disorders. Persons with any of these disorders are prone to social isolation. Those diagnosed with avoidant personality disorder, however, differ from those with schizoid or schizotypal disorder, because they want to have relationships with others but are prevented by their social inadequacies. Persons diagnosed with schizoid and schizotypal personality disorders, on the other hand, usually prefer social isolation.

Personality disorders are usually diagnosed following a complete medical history and an interview with the patient. Although there are no laboratory tests for personality disorders, the doctor may give the patient a physical examination to rule out the possibility that a general medical condition is affecting the patient's behavior. For example, people with disorders of the digestive tract may avoid social occasions for fear of a sudden attack of diarrhea or the need to vomit. If the interview with the patient suggests a diagnosis of avoidant personality disorder, the doctor may administer a diagnostic questionnaire or another type of assessment tool.