What is Avoidant Personality Disorder and How to Treat It
Avoidant Personality Disorder, or AVPD, is a mental health condition in which 1.8 percent to 6.4 percent of the general population is affected.
As the website Out of the Fog points out, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) lists Avoidant Personality Disorder as a “Cluster C” anxious or fearful disorder.
Psychology Today defines AVPD as a “psychiatric condition characterized by a lifelong pattern of extreme shyness, feelings of inadequacy, and sensitivity to rejection.”
The publication notes that 14.8 percent of American adults meet the diagnostic criteria for at least one personality disorder.
Symptoms of Avoidant Personality Disorder
WebMD breaks down the symptoms:
- Avoiding work, social, or school activities for fear of criticism or rejection. It may feel as if you are frequently unwelcome in social situations, even when that is not the case. This is because people with avoidant personality disorder have a low threshold for criticism and often imagine themselves to be inferior to others.
- Low self-esteem
Out of the Fog gives more specifics:
- 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 initiating intimate relationships because of the fear of being ashamed, ridiculed, or rejected due to severe low self-worth.
- Preoccupies himself or herself with receiving criticism or rejection 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.
A formal diagnosis of AvPD requires a mental health professional to identify 4 out of the above 7 criteria as positive. Some people with AvPD may exhibit all 7. Most will exhibit only a few.
Nobody’s perfect. Even normal healthy people will experience or exhibit a few of the above criteria from time to time. This does not make a person AVPD.
Characteristics of Avoidant Personality Disorder (Intro)
Out of the Fog has put together a number of characteristics for those who have AVPD. It is important to note that these are merely guidelines and should NOT be used for self-diagnosis. Everyone exhibits “avoidant” (not avoident) behaviors.
Just because someone displays one or multiple of the characteristics below does not mean they have Avoidant Personality Disorder.
Characteristics of Avoidant Personality Disorder (Part 1)
“Always” and “Never” Statements – “Always” and “Never” Statements are declarations containing the words “always” or “never.” You hear then often, but they are rarely true.
Avoidance – The practice of withdrawing from relationships with other people as a defensive measure to reduce the risk of rejection, accountability, criticism or exposure.
Blaming – The practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.
Catastrophizing – The habit of automatically assuming a “worst case scenario” and inappropriately characterizing minor or moderate problems or issues as catastrophic events.
Circular Conversations – Arguments which go on almost endlessly, repeating the same patterns with no resolution.
Confirmation Bias – The tendency to pay more attention to things which reinforce your beliefs than to things which contradict them.
“Control-Me” Syndrome – This describes a tendency which some people have to foster relationships with people who have a controlling narcissistic, antisocial or “acting-out” nature.
Cruelty to Animals – Acts of Cruelty to Animals have been statistically discovered to occur more often in people who suffer from personality disorders than in the general population.
Denial – Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.
Dependency – An inappropriate and chronic reliance by an adult individual on another individual for their health, subsistence, decision making or personal and emotional well-being.
Depression – People who suffer from personality disorders are often also receive a diagnosis with symptoms of depression.
Characteristics of Avoidant Personality Disorder Part 2
Escape To Fantasy – Taking an imaginary excursion to a happier, more hopeful place.
Identity Disturbance – A psychological term used to describe a distorted or inconsistent self-view.
Imposed Isolation – When abuse results in a person isolates himself or herself from their support network, including friends and family.
Lack of Object Constancy – An inability to remember that people or objects are consistent, trustworthy and reliable, especially when they are out of your immediate field of vision.
Low Self-Esteem – A common name for a negatively-distorted self-view which is inconsistent with reality.
Magical Thinking – Looking for supernatural connections between external events and one’s own thoughts, words and actions.
Manipulation – The practice of steering an individual into a desired behavior for the purpose of achieving a hidden personal goal.
Masking – Covering up one’s own natural outward appearance, mannerisms and speech in dramatic and inconsistent ways depending on the situation.
Neglect – A passive form of abuse in which the physical or emotional needs of a dependent are disregarded or ignored by the person responsible for them.
Objectification – The practice of treating a person or a group of people like an object.
Obsessive-Compulsive Behavior – An inflexible adherence to arbitrary rules and systems, or an illogical adherence to cleanliness and orderly structure.
Characteristics of Avoidant Personality Disorder Part 3
Panic Attacks – Short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as hyperventilating, shaking, sweating and chills.
Parentification – A form of role reversal, in which a child is inappropriately given the role of meeting the emotional or physical needs of the parent or of the family’s other children.
Passive-Aggressive Behavior – Expressing negative feelings in an unassertive, passive way.
Perfectionism – The maladaptive practice of holding oneself or others to an unrealistic, unattainable or unsustainable standard of organization, order, or accomplishment in one particular area of living, while sometimes neglecting common standards of organization, order or accomplishment in other areas of living.
Sabotage – The spontaneous disruption of calm or status quo in order to serve a personal interest, provoke a conflict or draw attention.
Selective Competence – Demonstrating different levels of intelligence, memory, resourcefulness, strength or competence depending on the situation or environment.
Self-Loathing – An extreme hatred of one’s own self, actions or one’s ethnic or demographic background.
Self-Victimization – Casting oneself in the role of a victim.
Splitting – The practice of regarding people and situations as either completely “good” or completely “bad.”
Testing – Repeatedly forcing another individual to demonstrate or prove their love or commitment to a relationship.
Thought Policing – Any process of trying to question, control, or unduly influence another person’s thoughts or feelings.
Tunnel Vision – The habit or tendency to only see or focus on a single priority while neglecting or ignoring other important priorities
Other Names for Avoidant Personality Disorder
AVPD is known in the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) by the name of Anxious Personality Disorder or Anxious (Avoidant) Personality Disorder.
Treatment For AVPD
Many who suffer from Avoidant Personality Disorder are by nature reluctant to seek treatment. Consequently, most cases of AVPD do not receive a diagnosis or treatment. Those close to the patient are thus responsible to help deal with him or her.
As for those who do seek treatment for AVPD, prescription SSRI antidepressants can alleviate some AVPD symptoms. Therapy usually involves working on social skills, cognitive behavior, and group therapy.
Diagnosing Avoidant Personality Disorder
Dr. Steve Bressert, Ph.D. details how doctors diagnose AVPD in a piece for Psychcentral:
Personality disorders such as avoidant personality disorder is a diagnosis you can receive by a mental health professional, such as a psychologist or psychiatrist. Family physicians and general practitioners do not have the training or experience to make this type of psychological diagnosis.
You can initially consult a family physician about this problem. But they should refer you to a mental health professional for diagnosis and treatment. There are no laboratory, blood or genetic tests that help to diagnose avoidant personality disorder.
Many people with avoidant personality disorder don’t seek out treatment. People with personality disorders, in general, do not often seek out treatment until the disorder starts to significantly interfere or otherwise impact a person’s life. This most often happens when a person’s coping resources are stretched too thin to deal with stress or other life events.
A diagnosis for avoidant personality disorder is made by a mental health professional comparing your symptoms and life history with those listed here. They will make a determination whether your symptoms meet the criteria necessary for a personality disorder diagnosis.
What Causes Avoidant Personality Disorder?
Bressert offers more insight into the causes of AVPD:
Researchers today don’t know what causes avoidant personality disorder. There are many theories, however, about the possible causes of avoidant personality disorder.
Most professionals subscribe to a biopsychosocial model of causation. These causes are likely due to biological and genetic factors, social factors, and psychological factors.
This suggests that no single factor is responsible — rather, it is the complex and likely nature of all three factors that are important.
Bressert also suggests that Avoidant Personality Disorder is genetic. If your parents had it, you are more likely to have it as well.