Avoidant Personality Disorder Symptoms, Causes

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Alexander Pearson
Avoidant Personality Disorder Symptoms, Causes

The avoidant personality disorder It is characterized by the sensitivity of the person to the opinions of others and the consequent avoidance of relationships. Both the fear of rejection and low self-esteem are extreme, making personal relationships limited to people with whom they are very comfortable.

These people do not show a disinterest in interpersonal relationships - as in schizoid personality disorder. Rather, they are asocial because they are interpersonally anxious and fear rejection..

People with this disorder often evaluate the movements and expressions of the people with whom they come in contact. Your fearful and tense attitude can provoke teasing from others, which in turn confirms your own doubts.

The biggest problems associated with this disorder occur in social and work functioning. Low self-esteem and hypersensitivity to rejection are associated with restricted interpersonal contacts, which prevents them from having social supports when they need help.

Article index

  • 1 Symptoms
  • 2 Diagnosis
    • 2.1 DSM-V (APA)
    • 2.2 ICE-10 (WHO)
    • 2.3 Differential diagnosis
  • 3 Causes
  • 4 Subtypes of Millon
    • 4.1 Phobic (includes dependent characteristics)
    • 4.2 Conflictive (includes negativistic characteristics)
    • 4.3 Hypersensitive (includes paranoid features)
    • 4.4 Self-defectors (includes paranoid characteristics)
  • 5 Treatment
    • 5.1 Cognitive-behavioral therapy
    • 5.2 Medication
  • 6 Complications
  • 7 References

Symptoms

These people can choose jobs where they don't have to interact with other people or the public on a regular basis. Due to the need for affection and belonging, they may fantasize about idealized relationships in which they are accepted..

The fear of rejection is so intense that they prefer to be alone than connected with other people and form relationships only if they know that they will not be rejected.

They often look down on themselves and have no ability to identify their own traits that are generally positive in society. The most common symptoms are:

  • Hypersensitivity to criticism.
  • Self-imposed social isolation.
  • Extreme shyness or anxiety in social situations, although the person feels a strong need for close relationships.
  • Avoid physical contact because it has been associated with unpleasant stimuli.
  • Feelings of inadequacy.
  • Very low self esteem.
  • Self-loathing.
  • Distrust of others.
  • Very self conscious.
  • Feeling inferior.
  • Using fantasy as an escape route to interrupt painful thoughts.

Diagnosis

DSM-V (APA)

A general pattern of social inhibition, feelings of inferiority, and hypersensitivity to negative evaluation, beginning in early adulthood and occurring in various contexts, as indicated by four or more of the following items:

  1. Avoid jobs or activities that involve important interpersonal contact due to fear of criticism, disapproval, or rejection.
  2. You are reluctant to get involved with people if you are not sure they will like you.
  3. Demonstrates repression in intimate relationships due to fear of being embarrassed or ridiculed.
  4. Are worried about the possibility of being criticized or rejected in social situations.
  5. Is inhibited in new interpersonal situations because of feelings of inferiority.
  6. You see yourself as socially inept, personally uninteresting, or inferior to others.
  7. You are extremely reluctant to take personal risks or get involved in new activities because they can be compromising.

ICE-10 (WHO)

The World Health Organization's ICD-10 classifies avoidant personality disorder as an anxious personality disorder. It is characterized by at least four of the following:

  1. Persistent and apprehensive feelings of tension and apprehension.
  2. Belief that one is socially inept, personally unattractive, or inferior to others.
  3. Excessive preoccupation with being criticized or rejected in social situations.
  4. Unwillingness to get involved with people unless you are certain to like them.
  5. Lifestyle restrictions due to the need for physical security.
  6. Avoidance of social or work activities that require significant interpersonal contact for fear of criticism, disapproval or rejection.

Differential diagnosis

Research suggests that people with this disorder overly observe their internal reactions when they are in social interaction, as do people with social phobia. 

This extreme self-observation can lead to a wavering, low-pitched voice. However, unlike social phobics, they also observe excessively the reactions of other people with whom they interact.

Avoidant personality disorder is especially prevalent in people with anxiety disorders.

Research suggests that approximately 10-15% of people who have panic disorder with agoraphobia have avoidance disorder, as do 20-40% of people with social phobia.

Other studies have reported a prevalence of up to 45% in people with generalized anxiety and up to 56% in people with obsessive-compulsive disorder..

Causes

According to Millon (1981) these people can be born with a temperament or with complicated personality characteristics.

As a consequence, their parents may reject them or not give them enough affection from an early age. This rejection would lead to low self-esteem and social isolation, situations that would persist into adulthood.

Meyer and Carrer (2000) found that people with this personality disorder were more likely to mention experiences of isolation, rejection, or conflict with others.

Millon subtypes

According to psychologist Theodore Millon, four types of avoidant personality disorder are identified:

Phobic (includes dependent characteristics)

Negative characteristics and passive-aggressive behavior, with ambivalent feelings towards themselves and others. Discord and internal opposition; fear of dependency and independence; hesitant, unstable, confused; tormented, bitter, unable to resolve their anguish.

Conflictive (includes negativistic characteristics)

Suspicious, cautious, alternately panicked, terrified, nervous, timid, petulant, fussy.

Hypersensitive (includes paranoid features)

Apprehensive, they anticipate and avoid all that they fear. Scrupulousness, and nervousness symbolized by disgusting and horrible circumstances or events.

Self-defectors (includes paranoid characteristics)

Fragmented self-awareness. They repress painful images and memories. They discard unbearable thoughts and impulses. They finally deny themselves (suicidal).

Treatment

There are several well-controlled studies of therapeutic methods for people with this disorder. Because the problems of people with this disorder are very similar to people with social phobia, the same treatments are usually applied.

Intervention techniques for anxiety, systematic desensitization, behavioral rehearsal, and social skills training have been successful.

Cognitive-behavioral therapy

The goal of cognitive behavioral psychotherapy is to identify the person's unconscious beliefs and how others see them. It also has the goal of improving social, personal and work functioning..

Techniques such as systematic desensitization, social skills training or behavioral rehearsal are used in it..

Medication

Medication should be seen as an auxiliary treatment and only if its use is seen to be necessary. May help decrease symptoms of rejection sensitivity.

Complications

Without treatment, a person with avoidant personality disorder may be in social isolation or develop a mental disorder such as substance abuse or depression..

References

  1. American Psychiatric Association, ed. (2013). "Avoidant Personality Disorder, 301.82 (F60.6)". Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Publishing. p. 672-675.
  2. "Anxious [avoidant] personality disorder." International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10). Retrieved February 19, 2015.
  3. Hoeksema, Nolen (2014). Abnormal Psychology (6th edition ed.). McGraw Education. p. 275. ISBN 9781308211503.
  4. Millon, Theadore. "Personality Subtypes Summary". millon.net. Institute for Advanced Studies in Personology and Psychopathology. Retrieved January 8, 2013.
  5. Millon, Theodore (2004). Personality Disorders in Modern Life. John Wiley & Sons, Inc., Hoboken, New Jersey. ISBN 0-471-23734-5.
  6. Eggum, Natalie D .; Eisenberg, Nancy; Spinrad, Tracy L .; Brave, Carlos; Edwards, Alison; Kupfer, Anne S .; Reiser, Mark (2009). "Predictors of withdrawal: Possible precursors of avoidant personality disorder." Development and Psychopathology 21 (3): 815-38. doi: 10.1017 / S0954579409000443. PMC 2774890. PMID 19583885.

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