Avoidant Personality Disorder
otherwise known as Anxious personality disorder is a personality disorder characterized as a pattern of social anxiety, feelings of inadequacy, extreme sensitivity to negative criticism and the avoidance of social interactions. Individuals with avoidant personality disorder are aware of the symptoms. They typically consider themselves to be socially inept or unappealing so they avoid social situations and interactions with others due to fear of being made fun of, humiliated or judged. They typically live and function as loners and report feeling a sense of living on the outer fringe of society.
Avoidant Personality Disorder Symptoms
The symptoms of avoidant personality disorder usually are first noticed in early adulthood. The American Psychiatric Association's DSM-IV-TR
defines avoidant personality disorder as 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." Avoidant Personality Disorder Indications (four or more):
- 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, ridiculed, or rejected
- 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 to be embarrassing
Avoidant personality disorder is often confused with antisocial personality disorder. While both disorders are marked by profound social interaction challenges, individuals with antisocial personality disorder have an extreme disregard for society's norms and rules, not just social inhibitions.
Causes of Avoidant Personality Disorder
The cause of avoidant personality disorder may be a combination of social, genetic, and biological factors. The genetic influence may be temperamental factors that are inherited. Specific environmental experiences have been noted in individuals with avoidant personality disorder. Many individuals have had painful early experiences of chronic parental criticism and rejection. The need to bond with the rejecting parents makes the avoidant person yearn for a relationship and connection but their longing gradually develops into a defensive shell of self-protection against repeated criticisms and attack. What began as real criticism in childhood becomes internalized and projected onto all social situations and interactions creating anxiety and the need to self-protect and withdraw in adulthood.
Symptoms of Avoidant Personality Disorder
As much as individuals with antisocial personality disorder individuals are oblivious to their symptoms, individuals with avoidant personality disorder are preoccupied with their shortcomings, anxiety and flaws. They form relationships with others only if they are assured they will not be rejected. Loss and rejection are so painful that these individuals will choose to be alone rather than risk trying to connect with others. Symptoms Include:
- Hypersensitivity to criticism or rejection
- Self-imposed social isolation
- Strong desire for close relationships accompanied by fear
- Avoids interpersonal relationships
- Feelings of inadequacy
- Low self-esteem
- Mistrust of others
- Extreme shyness/timidity
- Emotional block related to intimacy
- Highly self-conscious and self-critical
- Occupational problems
- Inferiority feelings
- Substance abuse
- Fantasy relationships
Treatment of avoidant personality disorder can be a combination of psychotherapy, social skills training, cognitive therapy, exposure treatment to gradually increase social contact, and sometimes medication for any accompanying anxiety disorder or depression that maybe present. The therapeutic alliance and positive regard of individual therapy can be very helpful so the individual can experience not being criticized or rejected when they have feelings or needs. If the individual can tolerate the anxiety and fear that will arise when they perceive judgment by the therapist they will begin to develop trust and challenge their exaggerated negative beliefs. Group therapy to gain support and practice social skills is also key.