Essential Feature of Avoidant Personality Disorder

The essential feature of the Avoidant Personality Disorder is a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation (DSM-IV, 1994, p. 662).

The ICD-10 (1994, p. 232) has a personality disorder called the anxious (avoidant) personality disorder characterized by feelings of tension, apprehension, insecurity and inferiority. These individuals wish to be liked and accepted but experience hypersensitivity to rejection and criticism. Personal attachments are restricted. People with the anxious personality disorder have a tendency to avoid activities by a habitual exaggeration of the potential dangers or risks involved. They believe that they are socially inept, personally unappealing and inferior.

Millon & Davis (1996, pp. 253-256) call Avoidant Personality Disorder the withdrawn pattern. These are individuals who are oversensitive to social stimuli and are hyperreactive to the moods and feelings of others. Individuals with Avoidant Personality Disorder are chronically overreactive and hyperalert, with affective disharmony, cognitive interference, and interpersonal distrust. They are disposed toward the more severe schizophrenic disorders. Historically, this pattern has been described as being preoccupied with security and strained in associating with people.

Everly (Retzlaff, ed., 1995, pp. 25-38) states that the most severe pathology found in Avoidant Personality Disorder is in the area of self-image. In Avoidant Personality Disorder there is the failure of the core personality to adapt in a competent manner to interpersonal adversity -- presumably both past and present. Stone (1993, p. 355) also sees the key traits of Avoidant Personality Disorder as social reticence and avoidance of interpersonal activities. These individuals are easily hurt by criticism and fear showing their anxiety in public. They would like to be close to others and to live up to their potential, but are afraid of being hurt, rejected, and unsuccessful (Beck, 1990, p. 43).

There is overlap between Avoidant Personality Disorder and social phobia, generalized type (DSM-IV, 1994, pp. 663-664). The essential feature of social phobia (social anxiety disorder) is a marked and persistent fear of social or performance situations that may provoke embarrassment. Most often, the social or performance situation is avoided though it may be endured with dread. The avoidance, fear or anxious anticipation must interfere significantly with daily routine, occupational functioning, or social life or cause significant personal distress (DSM-IV, 1994, p. 411). Sutherland & Frances (Gabbard & Atkinson, eds., 1996, p. 991) suggest that Avoidant Personality Disorder and social phobia are constructs that differ only in the severity of dysfunction. Frances, et.al. (1995, p. 376) propose the possibility that they are two different constructs for the same condition. Benjamin (1993, p. 294) notes that the interpersonal patterns for generalized social phobia are very similar to Avoidant Personality Disorder; both groups avoid social contact and restrain themselves because of fear of humiliation or rejection. She proposes that social phobia is diagnosed if symptoms of pervasive anxiety or panic are present. Millon and Martinez (Livesley, ed., 1995, p. 222) believe that the avoidant personality is essentially a problem of relating to people while social phobia is largely a problem of performing in situations. Stone (1993, pp. 355-356) suggests that social phobia, agoraphobia, and OCD often have an underlying Avoidant Personality Disorder.

It is common for persons with Avoidant Personality Disorder to have comorbidity with other personality disorders. Avoidant Personality Disorder is most often diagnosed with DPD, Borderline Personality Disorder, Paranoid Personality Disorder, Schizoid or Schizotypal Personality Disorder (DSM-IV, 1994, p. 663). Frances, et.al (1995, p. 376) note the considerable overlap between Avoidant Personality Disorder and DPD. These two personality disorders share interpersonal insecurity, low self-esteem, and a strong desire for interpersonal relationships. Benjamin (1993, p.301) describes the desperate attempts to avoid being alone that may be seen in DPD as an exclusionary indicator for Avoidant Personality Disorder.

Avoidant Personality Disorder is found equally in males and females (DSM-IV, 1994, p. 663).

continue: Self-Image, View of Others, Relationships and Issues with Authority

top . pages 1 2 3 . send to friend . personality disorders site map

Reviewed: 04/2006