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OTHER TOPICS IN THIS CHAPTER
Overview of Personality Disorders
Antisocial Personality Disorder
Avoidant Personality Disorder
Borderline Personality Disorder (BPD)
Dependent Personality Disorder
Histrionic Personality Disorder
Narcissistic Personality Disorder
Obsessive-Compulsive Personality Disorder
Paranoid Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder
, MD, Rhode Island Hospital
Full review/revision May 2021 | Modified Sep 2022
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Avoidant personality disorder is characterized by avoiding social situations or interactions that involve risk of rejection, criticism, or humiliation.
People with avoidant personality disorder are afraid of being rejected, criticized, or embarrassed and thus avoid situations where they may experience such reactions.
Doctors diagnose avoidant personality disorder based on specific symptoms, such as avoiding situations that involve interpersonal contact because of fear of rejection and disapproval or feelings of being socially incompetent, unappealing, or inferior to others.
People with this disorder may benefit from cognitive-behavioral therapy, other psychotherapies, and antianxiety drugs and antidepressants.
Personality disorders Overview of Personality Disorders Personality disorders are long-lasting, pervasive patterns of thinking, perceiving, reacting, and relating that cause the person significant distress and/or impair the person's ability to function... read more are long-lasting, pervasive patterns of thinking, perceiving, reacting, and relating that cause the person significant distress and/or impair the person's ability to function.
People with avoidant personality disorder feel inadequate. They manage these feelings by avoiding situations in which they may be evaluated negatively.
Avoidant personality disorder occurs in over 2% of the general population in the United States. It affects men and women equally.
Other disorders are also often present. They include one or more of the following:
Major depressive disorder Major depressive disorder A short discussion of prolonged grief disorder. Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to... read more or persistent depressive disorder Persistent depressive disorder A short discussion of prolonged grief disorder. Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to... read more
An anxiety disorder Overview of Anxiety Disorders Anxiety is a feeling of nervousness, worry, or unease that is a normal human experience. It is also present in a wide range of psychiatric disorders, including generalized anxiety disorder,... read more , such as panic disorder, particularly social phobia Social Phobia Social phobia is fear or anxiety about certain social or performance situations. These situations are often avoided or endured with much distress. Humans are social animals, and their ability... read more (social anxiety disorder)(Video) What is Mental Disorder | Psychopathology | Abnormal Psychology | Types of Mental Disorders
Another personality disorder (such as dependent Dependent Personality Disorder Dependent personality disorder is characterized by a pervasive, excessive need to be taken care of, leading to submissiveness and clinging behaviors. People with dependent personality disorder... read more or borderline Borderline Personality Disorder (BPD) Borderline personality disorder is characterized by a pervasive pattern of instability in relationships, self-image, moods, and behavior and hypersensitivity to possible rejection and abandonment... read more )
People who have social phobia and avoidant personality disorder have more severe symptoms and are more disabled than those who have only one of the disorders.
Causes of Avoidant Personality Disorder
Genes and environmental factors may contribute to the development of avoidant personality disorder. For example, people may have an inborn anxiety in social situations, and/or they may experience rejection and marginalization during childhood. Avoidance in social situations has been observed in children as young as about 2 years old.
Symptoms of Avoidant Personality Disorder
Fear of rejection
People with avoidant personality disorder avoid social interaction, even at work, because they fear that they will be criticized or rejected or that people will disapprove of them. For example, they may do the following:
They may refuse a promotion because they fear coworkers will criticize them.
They may avoid meetings.
They may avoid making new friends unless they are sure they will be liked.
People with this disorder assume others will be critical and disapproving until there is clear-cut, indisputable proof to the contrary. Thus, before joining a group and forming a close relationship, people with this disorder require repeated assurances of support and uncritical acceptance.
People with avoidant personality disorder are reluctant to talk about themselves lest they be mocked or humiliated.
People with this disorder are very reluctant to take 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 why they are not participating. They may prefer a limited lifestyle because of their need for security and certainty.
Extreme sensitivity to criticism
People with avoidant personality disorder are very sensitive to anything 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 people in social situations, especially new ones. They hold back in interactions with new people because they think of themselves as socially inept, unappealing, and inferior to others. They tend to be quiet and timid because they tend to think that if they say anything, others will say it is wrong.
People with avoidant personality disorder long for social interaction but fear placing their well-being in the hands of others. Because these people with avoidant personality limit their interactions with others, they tend to be relatively isolated and to lack a social network that could help them when they need it.
Diagnosis of Avoidant Personality Disorder
A doctor's evaluation, based on specific criteria
Doctors usually diagnose personality disorders based on criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5 Classification and Diagnosis of Mental Illness In 1980, the American Psychiatric Association published the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), marking the first attempt to approach the diagnosis... read more ), published by the American Psychiatric Association.
For doctors to diagnose avoidant personality disorder, people must persistently avoid social contact, feel inadequate, and be hypersensitive to criticism and rejection, as shown by at least four of the following:
They avoid job-related activities that involve interpersonal contact because they fear that they will be criticized or rejected or that people will disapprove of them.
They are unwilling to get involved with people unless they are sure of being liked.
They are reserved in close relationships because they are afraid of being ridiculed or humiliated.
They are preoccupied with being criticized or rejected in social situations.
They are inhibited in new social situations because they feel inadequate.(Video) Common Psychiatric Disorder: Personality Disorder
They view themselves as socially incompetent, unappealing, or inferior to others.
They are reluctant to take risks or participate in any new activity because they may be embarrassed.
Also, symptoms must have begun by early adulthood.
Treatment of Avoidant Personality Disorder
Cognitive-behavioral therapy that focuses on social skills
Other types of psychotherapy
Antianxiety drugs and antidepressants
General treatment Treatment Personality disorders are long-lasting, pervasive patterns of thinking, perceiving, reacting, and relating that cause the person significant distress and/or impair the person's ability to function... read more of avoidant personality disorder is similar to that for all personality disorders.
People with avoidant personality disorder may avoid treatment.
If people have social phobia and avoidant personality disorder, the following treatments can be effective:
Cognitive-behavioral therapy Psychotherapy Extraordinary advances have been made in the treatment of mental illness. As a result, many mental health disorders can now be treated nearly as successfully as physical disorders. Most treatment... read more that focuses on acquiring social skills, done in groups
Other group therapies if the group consists of other people with the same difficulties
People with avoidant personality disorder benefit from
Individual therapies that are supportive and are considerate of the person's hypersensitivity to rejection and criticism
Psychodynamic psychotherapy Psychodynamic psychotherapy Extraordinary advances have been made in the treatment of mental illness. As a result, many mental health disorders can now be treated nearly as successfully as physical disorders. Most treatment... read more may be helpful. This type of psychotherapy focuses on underlying conflicts.
Antidepressants Drug therapy for depression A short discussion of prolonged grief disorder. Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to... read more , such as selective serotonin reuptake inhibitors (SSRIs), and antianxiety drugs Drugs Used to Treat Anxiety Disorders can help reduce anxiety enough to enable people to manage new social situations.
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What is the DSM-5 criteria for avoidant personality disorder? ›
Avoidant Personality Disorder DSM 5 Criteria
Avoidance of any involvement with other people unless certain they will be liked. Restrained behavior in close relationships because they are afraid of being shamed or ridiculed. Deep concern about being criticized, disapproved of or rejected in social settings.
AVPD is often comorbid with depression and substance abuse, and is likely to be associated with increased odds of suicidal ideation and attempts,2,6,9 explaining, perhaps in part, why AVPD may be a significant predictor of chronic depression.What famous people have avoidant personality disorder? ›
Whoopi Goldberg, Donny Osmond and Kim Basinger have something in common other than fame — it is avoidant personality disorder, or simply, AvPD. This disorder is estimated to affect around two percent of the general adult population.What is the root cause of avoidant personality disorder? ›
Avoidant Personality Disorder Causes and Risk Factors
A family history of depression, anxiety, or personality disorders. Childhood abuse, trauma, or neglect. Trauma including suffering an extreme incident of ridicule or rejection in childhood.
People diagnosed with Avoidant Personality Disorder report high rates of childhood physical and emotional abuse, which can disrupt healthy psychological development and impair your ability to form healthy, strong attachments while simultaneously causing you to internalize criticism and shaming.What is the best medication for avoidant personality disorder? ›
Sertraline (Zoloft) Zoloft and other SSRI medications are considered first-line treatment for APD and social phobia. Benefits of SSRIs include relatively high tolerance, ease of administration, and relative safety in overdose.What are the characteristics of a person diagnosed with avoidant personality disorder? ›
They tend to be shy, awkward, and self-conscious in social situations due to a fear of doing something wrong or being embarrassed. They tend to exaggerate potential problems. They seldom try anything new or take chances. They have a poor self-image, seeing themselves as inadequate and inferior.Is avoidant personality disorder on a spectrum? ›
Avoidant Personality Disorder is a Separable Schizophrenia Spectrum Personality Disorder even when Controlling for the Presence of Paranoid and Schizotypal Personality Disorders - PMC.Are Avoidants usually narcissists? ›
Avoidants are not all narcissists but they do have an ability to detach emotionally from the relationship which triggers an “anxious” person's attachment anxiety.Are avoidant personalities narcissistic? ›
An avoidant person, with no one else to blame, may resort to narcissism (a falsely elevated sense of self), introversion (unaccountable to others), or perfectionism (rigidly accountable to self). The narcissist elevates self at the expense of others, believing self to be superior.
Does avoidant personality run in families? ›
An estimated 2.5 percent of people have it, and it's rarely diagnosed before adulthood. The cause of avoidant personality disorder is still unknown, but researchers have seen this condition run in families, even when family members don't live with each other. This suggests it may be both genetic and environmental.Does avoidant personality disorder get worse with age? ›
Personality disorders that are susceptible to worsening with age include paranoid, schizoid, schizotypal, obsessive compulsive, borderline, histrionic, narcissistic, avoidant, and dependent, Dr. Rosowsky said at a conference sponsored by the American Society on Aging.What childhood trauma causes avoidant attachment? ›
A fearful/avoidant attachment style usually develops when one's caregiver is also the perpetrator of abuse. As a child, this person has likely experienced abuse in the home, in the form of physical or sexual abuse, neglect, or a chaotic family dynamic.How to deal with a person with avoidant personality disorder? ›
You should encourage them to speak openly and honestly about their feelings and experiences. Let them know you are ready and willing to be their safe harbor, so they know they can reveal their deepest fears and biggest disappointments to you without fear of being judged or rejected.What happens in the brain with avoidant personality disorder? ›
For avoidant personality disorder, some of the most prominent risk factors include: Brain abnormalities. People with avoidant personality disorder experience intense bursts of anxiety, which are connected to neurological deficiencies in areas of the brain involved in stress response and emotional control.Are Avoidants emotionally abusive? ›
Abuse at the hands of someone with an avoidant personality disorder often includes psychological and emotional abuse. Don't be afraid to reach out for help, pursue support groups for loved ones, seek your own therapy, separate, or leave the relationship completely. Your sanity depends on it.How are Avoidants triggered? ›
Avoidant / dismissive adults still self regulate in unhealthy ways; they might feel threatened by triggering dating or relationship situations, such as a partner trying to get emotionally close, and they might shut down their emotions in an attempt to feel safe and avoid feeling vulnerable.What do Avoidants avoid? ›
- avoiding emotional closeness in relationships.
- feeling as though their partners are being clingy when they simply want to get emotionally closer.
- withdrawing and coping with difficult situations alone.
- suppressing emotions.
Abstract. Avoidant personality disorder (AvPD) is regarded as a severe variant of social phobia (SP), consistent with a dimensional model. However, these conclusions are largely drawn from studies based on individuals with SP, with or without comorbid AvPD.How do you calm an avoidant? ›
Communicating with empathy, using “I” statements, and avoiding blaming and criticism are some of the ways to help avoidant partners feel safe enough to express their thoughts and feelings, as well as change their behaviors in time. “The most important thing in communication is to hear what isn't being said.”
What are the best jobs for avoidant personality disorder? ›
You can be a groomer, pet sitter, kennel attendant, animal trainer, and more. They are usually responsible for caring for animals like feeding, exercising, and grooming them. Animal care and service workers also see any signs of illness or injury to animals and may need to clean up their living spaces.How does an avoidant behave? ›
Avoidant attachment types are extremely independent, self-directed, and often uncomfortable with intimacy. They're commitment-phobes and experts at rationalizing their way out of any intimate situation. They regularly complain about feeling “crowded” or “suffocated” when people try to get close to them.What are some examples of avoidant behavior? ›
When in social situations, a person with avoidant personality disorder may be afraid to speak up for fear of saying the wrong thing, blushing, stammering, or otherwise getting embarrassed. You may also spend a great deal of time anxiously studying those around you for signs of approval or rejection.How serious is avoidant personality disorder? ›
People with avoidant personality disorder (APD) have a lifelong pattern of extreme shyness. They also feel inadequate and are hypersensitive to rejection. APD can cause psychiatric symptoms that create serious problems with relationships and work.Is AVPD on the schizophrenia spectrum? ›
Avoidant personality disorder is a separable schizophrenia-spectrum personality disorder even when controlling for the presence of paranoid and schizotypal personality disorders The UCLA family study. Schizophr Res.Is avoidant personality disorder more severe than social anxiety? ›
In addition, people who suffer from symptoms of either condition may be described as timid, shy, having low self-esteem, or isolated. Many experts agree that avoidant personality disorder is a more severe form of social anxiety.What age does avoidant personality disorder start? ›
Avoidant personality disorder is not usually diagnosed in individuals younger than 18 years; however, most patients report an onset in childhood or adolescence, and many report continued social anxiety throughout their lives.Do Avoidants have lots of friends? ›
For this reason, and the fact that they find emotional closeness difficult, avoidant adults may be more likely to have a lot of friends rather than a few close ones. Avoidant attachers are often the life and soul of the party due to their elevated confidence and high self-esteem.Are Avoidants emotionally intelligent? ›
People with the avoidant attachment style are more likely than secure attachers to have low levels of emotional intelligence. This is especially the case when it comes to other peoples' emotions.Are Avoidants people pleasers? ›
Key points. A person's attachment style affects the way they behave in relationships. An insecure or avoidant attachment style can cause someone to deny their own needs in order to please others. Understanding what drives people-pleasing behavior can help someone to better manage it.
Are avoidant people manipulative? ›
Manipulation; manipulation tactics vary, however there is always a hidden agenda and goal. Those who suffer with Avoidant Personality Disorder frequently use manipulation to get their needs met. Perfectionism; nothing is good enough, the standard is set unrealistically high for themselves and often for others.Are avoidants self centered? ›
People with an avoidant attachment style can come across as selfish, appearing to put their own needs in front of their partner's needs. When their partner expresses feelings or needs, they might show annoyance or disdain.Is avoidant Behaviour abusive? ›
Here is what I want you to know: people with the avoidant attachment adaptation are not inherently abusive. This stereotype is not only extremely harmful for the people who are working hard to heal themselves, but it's dismissive of their early experiences and their deep longing to connect with others.What are Avoidants like as parents? ›
Parents of children with an avoidant attachment tend to be emotionally unavailable or unresponsive to them a good deal of the time. They disregard or ignore their children's needs, and can be especially rejecting when their child is hurt or sick.Are you born with avoidant personality disorder? ›
Genetics alone cannot explain why some people develop AVPD, because it's possible to have a family history and never have this condition. Researchers suggest that there are early childhood experiences that contribute to avoidant behaviors and personality disorders.What is the hardest personality disorder to treat? ›
Treating antisocial personality disorder
But antisocial personality disorder is one of the most difficult types of personality disorders to treat. A person with antisocial personality disorder may also be reluctant to seek treatment and may only start therapy when ordered to do so by a court.
Prevalence of Avoidant Personality Disorder
An estimated 1.5–2.5% of people in the United States have avoidant personality disorder.
Personality disorders are some of the most difficult disorders to treat in psychiatry. This is mainly because people with personality disorders don't think their behavior is problematic, so they don't often seek treatment.What do Avoidants fear? ›
High levels of avoidance
They fear closeness to their partners and avoid them because of the possibility of rejection. They don't feel comfortable getting close to others. Avoidant adults worry about being hurt if they allow themselves to become too close to others.
Adults with an avoidant-dismissive insecure attachment style are the opposite of those who are ambivalent or anxious-preoccupied. Instead of craving intimacy, they're so wary of closeness they try to avoid emotional connection with others. They'd rather not rely on others, or have others rely on them.
What attachment style is childhood emotional neglect? ›
Individuals with histories of childhood neglect will be characterized by higher levels of anxious attachment style in adulthood, whereas individuals with histories of childhood physical abuse will be characterized by higher levels of avoidant attachment style, compared to individuals without such histories of ...Do Avoidants lack empathy? ›
Because of this emotional distancing, they tend to be less empathic toward people in need (Joireman, Needham, & Cummings, 2001; Wayment, 2006). Further, avoidant people tend to respond negatively to their partner's emotions because those emotions can signal that they need more attention and intimacy.How do psychiatrists diagnose avoidant personality? ›
Diagnosis of HPD
There is no specific test that is used to diagnose HPD. If you are troubled by your symptoms and seek medical care, your primary care provider will likely begin by taking a complete medical history. They may perform a physical exam to rule out any physical problems that might be causing your symptoms.
Unwillingness to get involved with people unless they are sure of being liked. Reserve in close relationships because they fear ridicule or humiliation. Preoccupation with being criticized or rejected in social situations. Inhibition in new social situations because they feel inadequate.Which three behaviors describe the diagnostic criteria for avoidant personality disorder? ›
The criteria are: Avoids occupational activities involving significant interpersonal contact, due to fears of criticism, disapproval, or rejection. Is unwilling to get involved with people unless certain of acceptance. Shows restraint within intimate relationships due to fears of shame or ridicule.How do you get tested for avoidant personality disorder? ›
Only a licensed mental health professional or doctor can give a formal diagnosis of avoidant personality disorder. If you are struggling with the symptoms mentioned below, we encourage you to reach out to your doctor for help and support.What is similar to avoidant personality disorder? ›
According to the DSM-5, avoidant personality disorder must be differentiated from similar personality disorders such as dependent, paranoid, schizoid, and schizotypal. But these can also occur together; this is particularly likely for AvPD and dependent personality disorder.How do people with avoidant personality disorder behave? ›
They tend to be shy, awkward, and self-conscious in social situations due to a fear of doing something wrong or being embarrassed. They tend to exaggerate potential problems. They seldom try anything new or take chances. They have a poor self-image, seeing themselves as inadequate and inferior.How do you fix avoidant personality disorder? ›
Psychotherapy, or talk therapy, is the primary avoidant personality disorder treatment. Psychotherapy may include cognitive-behavioral therapy, which focuses on reducing negative thought patterns and building social skills.Is avoidant personality inherited? ›
Genetics alone cannot explain why some people develop AVPD, because it's possible to have a family history and never have this condition. Researchers suggest that there are early childhood experiences that contribute to avoidant behaviors and personality disorders.