Avoidant Personality Disorder (APD/AvPD) is a lesser-known anxiety disorder that is more commonly known for being related to Social Phobia. There are debates on whether it is a subgroup of Social Phobia or belongs in its own category. Avoidant Personality Disorder is “characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and a hypersensitivity to negative evaluation” (DSM-5). Social Phobia is a condition of “a person with social anxiety disorder [who] feels symptoms of anxiety or fear in certain or all social situations. He or she may be afraid of being humiliated, judged, and rejected” (Social). Since their definitions are very similar, it is easy to see why those debates are happening. They both deal with being uncomfortable in social situations, feeling an intense fear of rejection, and desire interactions. Although people living with Social Phobia may want social interactions, they don’t yearn for it to the extent that people with Avoidant Personality Disorder do. However, as much as people with AvPD desire it, they also reject it. Since there is a lot of overlap between these two disorders and anxiety disorders in general, we will dive into what AvPD is.
There are many causes of Avoidant Personality Disorder, with a few studies attempting to pin causes down to heritability. There was a study done with female Norwegian twins to determine whether environment and heritability were factors in their Dependent Personality Disorder (DPD) and Avoidant Personality Disorder. The results for the experiment was that environmental effects weren’t as significant as heritability was. APD got .64 for the heritability results and DPD has .66(Gjerde et al., 2012). These results suggest that there is the statistical significance of heritability being a cause of Avoidant Personality Disorder more so than environmental factors. Another potential cause of Avoidant Personality Disorder is a negative childhood and, more specifically, childhood neglect. There was a study on childhood neglect and the significance it had on Social Phobia and Avoidant Personality Disorder. The results were that childhood neglect affected “that the experiences of physical and emotional neglect in childhood are risk factors for adult AvPD and SP, most pronounced for AvPD though”(Turner et al., 1986).
The most successful and used treatment for Avoidant Personality Disorder is psychotherapy and, more specifically, cognitive therapy. Since APD is a result of engrained repeated behaviors and ways of thinking, it is a bit tricky to treat. The therapy that would be done, described by the Cleveland Clinic, as focuses on overcoming fears, changing thought processes and behaviors, and helping the person better cope with social situations. The Cleveland Clinic also advises that medication may help as well for the anxiety aspect, but the best treatment is a mix of both medication and psychotherapy.
Untreated AvPD can truly inhibit a person’s life and, in some cases, may even be fatal. By avoiding social interactions, it becomes very difficult to excel in relationships and work environments. Because of this, it also likely that a person with Avoidant Personality Disorder is not able to reach their full potential. In the case of violence and more specifically domestic abuse, a study found that 12% of domestic abuse survivors had comorbid AvPD. Even more alarming, the researchers also found that 35% of wife batterers scored above a statistical range for APD (Lynn et al., 2002).
It is important that people with Avoidant Personality Disorder receive help, as it is highly devitalizing to live with. It is also important to distinguish between Social Phobia and Avoidant Personality Disorder, as arduous as that may be. Avoidant Personality Disorder has different causes and can lead to a much more hindered life. This stems from an intense fear of rejection but yearning for interaction. By receiving treatment, someone living with AvPD might be able to reach their full potential and live the lives that they deserve.
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Lynn E. Alden, Judith M. Laposa, Charles T. Taylor, Andrew G. Ryder, (2002). Avoidant Personality Disorder: Current Status and Future Directions. Journal of Personality Disorders: Vol. 16, No. 1, pp. 1-29. https://doi.org/10.1521/pedi.126.96.36.19958
Gjerde, L. C., Czajkowski, N., Røysamb, E., Ørstavik, R. E., Knudsen, G. P., Østby, K., … Reichborn-Kjennerud, T. (2012). The heritability of avoidant and dependent personality disorder assessed by personal interview and questionnaire. Acta Psychiatrica Scandinavica, 126(6), 448–457. http://doi.org/10.1111/j.1600-0447.2012.01862.x
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