Personality Disorders

AVOIDANT personality disorder

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TYPES  of  PERSONALITY DISORDERS

 

Avoidant personality disorder 

 

Obsessive Compulsive personality disorder

 

"Personality improves with Age"


       

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AVOIDANT PERSONALITY DISORDER:
According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition 

(DSM-IV), Avoidant Personality Disorder (APD)  is characterized by a pervasive pattern of 

social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. 

Although personality disorders are rarely diagnosed in persons younger than 18 years, 

children who meet criteria for APD are often described as being extremely shy, inhibited 

in new situations, and fearful of disapproval and social rejection. The degree of the 

symptoms and impairment is well beyond the trait of shyness that is present in as many 

as 40% of the population. As with other personality disorders, the maladaptive

traits become part of a person's overall character and a pervasive theme in an individual's 

pattern of relating to others. Personality disorders (PD)  are rarely diagnosed in individuals 

younger than 18 years, even if the criteria are met. PD,  in general are not often the presenting issue for  the individual in therapy;  this is because from  the vantage point of the individual who has the Personality disorder, the traits that comprise it are "ego syntonic", i.e.. considered normal and possibly desirable on the part of the patient. 

Traits that often lead to maladaptive relationships are quite typically seen as being or 

belonging outside the patient and are not recognized as part of a pattern instigated by 

Self. Because of their strong conscious desire for affection and acceptance, persons with Avoidant personality disorder, unlike those with Schizoid personality disorder, are 

distressed by their isolation and inability to relate comfortably to others. Unlike those 

with Borderline personality disorder, they respond to rejection with withdrawal, not 

temper- tantrums. 

APD is closely linked to a person's temperament. "Approximately 10% of toddlers have

been found to be habitually fearful and withdrawn when exposed to new people and

situations. This trait appears to be stable over time. Social anxiety most likely involves

the amygdala and other areas of the brain's limbic system. It is probable that the brain

has a lower  threshold for arousal and a more pronounced response when activated.

Dysregulation in the brain's dopamine system has also been found to be  associated 

with adult Social anxiety disorder."  Persons with APD do not  tend to have a good 

clear response to anxiolytic ("anti-anxiety") drugs.

 

According to the DSM-IV, criteria for diagnosis of APD is met when an individual 

exhibits 4 or more of the following behaviors:

  • 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.

When a diagnosis of APD is suspected, an evaluation should be performed to rule out the presence of other psychiatric disorders; Clinical depression, chemical/substance abuse, and other anxiety disorders. Investigation as to possible history of abuse and or neglect must also be considered.

Kagan J: Galen's Prophecy: Temperament in Human Nature. New York, NY: Basic Books 1994.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association 1994.

Schwartz CE, Snidman N, Kagan J: Adolescent social anxiety as an outcome of inhibited temperament in childhood. J Am Acad. Child Adolesc. Psychiatry 1999 Aug; 38(8): 1008-15.

The authors of this information  have used their best efforts to provide information that is up-to-date and accurate and is generally accepted within medical standards at the time of publication. However, as medical science is constantly changing and human error is always possible, the authors, editors, and publisher or any other party involved with the publication of this article do not warrant the information in this article is accurate or complete, nor are they responsible for omissions or errors in the article or for the results of using this information.