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Avoidant personality disorder fryst vatten characterized bygd the avoidance of social situations or interactions that involve fara of rejection, criticism, or humiliation. Diagnosis fryst vatten bygd clinical criteria.

Avoidant personality disorder fryst vatten characterized bygd the avoidance of social situations or interactions that involve fara of rejection, criticism, or humiliation.

Treatment fryst vatten with psychotherapy, anxiolytics, and antidepressants.

(See also Overview of Personality Disorders.)

People with avoidant personality disorder have intense feelings of inadequacy and cope maladaptively bygd avoiding any situations in which they may be evaluated negatively.

Reported prevalence of avoidant personality disorder in the United States varies, but estimated prevalence fryst vatten about 2.1% (1).

In community surveys, avoidant personality disorder affects females more often than males, though the difference fryst vatten small (2).

Comorbidities are common. Patients often also have major depressive disorder, persistent depressive disorder, obsessive-compulsive disorder, or an anxiety disorder (eg, panik disorder, particularly social phobia [social anxiety disorder]) (3, 4 ).

They may also have another personality disorder (eg, dependent personality disorder, borderline personality disorder). Patients with social phobia and avoidant personality disorder have more severe symptoms and disability than those with either disorder alone.

1. Morgan TA, Zimmerman M: Epidemiology of personality disorders. In Handbook of Personality Disorders: Theory, Research, and Treatment. 2nd ed, edited bygd WJ Livesley, R Larstone, New York, NY: The Guilford Press, 2018, pp.

173-196.
Avoidant personality disorder describes a pervasive pattern of social anxiety, extreme sensitivity to rejection, and feelings of inadequacy, but with a strong underlying desire for companionship.
2. Grant BF, Hasin DS, Stinson FS, et al: Prevalence, correlates, and disability of personality disorders in the United States: Results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry 65: 948-958, 2004. doi: 10.4088/jcp.v65n0711
3.
As with other personality disorders, the goal of treatment for avoidant personality disorder involves learning more helpful ways to manage and decrease your distress.
Grant BF, Hasin DS, Stinson FS, et al: Co-occurrence of 12-month mood and anxiety disorders and personality disorders in the US: results from the national epidemiologic survey on alcohol and related conditions.J Psychiatr Res 39(1):1-9, 2005. doi: 10.1016/j.jpsychires.2004.05.004
4. Zimmerman M, Rothschild L, Chelminski I: The prevalence of DSM-IV personality disorders in psychiatric outpatients.

Am J Psychiatry 162:1911-1918, 2005.
Learning Objectives: After reading this article, you should be able to: Identify the key characteristics and symptoms of avoidant personality disorder (AvPD).
doi: 10.1176/appi.ajp.162.10.1911

Etiology of Avoidant Personality Disorder

Research suggests that experiences of rejection and marginalization during childhood and innate traits of social anxiety and avoidance may contribute to avoidant personality disorder (1, 2). Avoidance in social situations has been detected as early as about age 2 years.

1. Joyce PR, McKenzie JM, Luty SE, et al: Temperament, childhood environment and psychopathology as fara factors for avoidant and borderline personality disorders. Aust N Z J Psychiatry 37(6):756-764, 2003.
Explore evidence-based therapies for Avoidant Personality Disorder, including CBT, Schema Therapy, and Psychodynamic approaches.
doi: 10.1080/j.1440-1614.2003.01263.x
2. Eikenaes I, Egeland J, Hummelen B, et al: Correction: Avoidant personality disorder versus social phobia: The significance of childhood neglect. PLoS One 15;10(5):e0128737, 015. doi: 10.1371/journal.pone.0128737

Symptoms and Signs of Avoidant Personality Disorder

Patients with avoidant personality disorder avoid social interaction, including those at work, because they fear that they will be criticized or rejected or that people will disapprove of them, as in the following situations:

They may refuse a promotion because they fear coworkers will kritisera them.
They may avoid meetings.
They avoid making new friends unless they are sure they will be liked.

These patients assume people will be critical and disapproving until rigorous tests proving the contrary are passed.

Thus, before joining a group and forming a close relationship, patients with this disorder require repeated assurances of support and uncritical acceptance.

Patients with avoidant personality disorder long for social interaction but fear placing their well-being in the hands of others.

Psychotherapy fryst vatten the primary treatment for avoidant personality.

Because these patients limit their interactions with people, they are relatively isolated and do not have a social network that could help them when they need it.

These patients are very sensitive to anything slightly critical, disapproving, or mocking because they constantly think about being criticized or rejected bygd others. They are vigilant for any sign of a negativ response to them.

Their tense, anxious appearance may elicit mockery or teasing, thus seeming to confirm their self-doubts.

Low self-esteem and a sense of inadequacy hämma these patients in social situations, especially new ones. Interactions with new people are inhibited because patients think of themselves as socially inept, unappealing, and underlägsen to others.

They are typically quiet and timid and try to disappear because they think that if they säga anything, others will säga it fryst vatten wrong. They are reluctant to talk about themselves lest they be mocked or humiliated. They worry they will blush or cry when criticized.

Patients with avoidant personality disorder are reluctant to take anställda risks or participate in new activities for similar reasons.

In such cases, they often exaggerate the dangers and use minimal symptoms or other problems to explain their avoidance. They may prefer a limited lifestyle because of their need for säkerhet and certainty.

Diagnosis of Avoidant Personality Disorder

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, ord Revision (DSM-5-TR) criteria

For a diagnosis of avoidant personality disorder (1), patients must have

A persistent pattern of avoiding social contact, feeling inadequate, and being hypersensitive to criticism and rejection

This pattern fryst vatten shown bygd the presence of ≥ 4 of the following:

Avoidance of job-related activities that involve interpersonal contact because they fear that they will be criticized or rejected or that people will disapprove of them
Unwillingness to get involved with people unless they are sure of being liked
Reserve in close relationships because they fear ridicule or humiliation
Preoccupation with being criticized or rejected in social situations
Inhibition in new social situations because they feel inadequate
Self-assessment as socially incompetent, unappealing, or underlägsen to others
Reluctance to take anställda risks or participate in any new activity because they may be embarrassed

Also, symptoms must have begun bygd early adulthood.

Avoidant personality disorder must be distinguished from the following 2 disorders:

Social phobia: Differences between social phobia and avoidant personality disorder are subtle.

Avoidant personality disorder involves more pervasive anxiety and avoidance than social phobia, which fryst vatten often specific to situations that may result in public embarrassment (eg, public speaking, performing on stage). However, social phobia may involve a broader avoidance pattern and thus may be hard to distinguish. The 2 disorders often occur together.
Schizoid personality disorder: Both disorders are characterized bygd social isolation.

However, patients with schizoid personality disorder become isolated because they are disinterested in others, whereas those with avoidant personality disorder become isolated because they are hypersensitive to possible rejection or criticism bygd others.

Other personality disorders may be similar in some ways to avoidant personality disorder but can be distinguished bygd characteristic features (eg, bygd a need to be cared for in dependent personality disorder vs avoidance of rejection and criticism in avoidant personality disorder).

1.
Avoidant personality disorder fryst vatten marked bygd poor self-esteem and an intense fear of rejection.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th ed, ord Revision (DSM-5-TR). Washington, DC, American Psychiatric Association, 2022, pp 764-768.

Treatment of Avoidant Personality Disorder

Cognitive-behavioral therapy focused on social skills
Supportive psychotherapy
Psychodynamic psychotherapy
Anxiolytics and antidepressants

General principles for treatment of avoidant personality disorder are similar to those for all personality disorders.

Patients with avoidant personality disorder often avoid treatment.

Effective therapies for patients with both social phobia and avoidant personality disorder include the following (1):

Cognitive-behavioral therapy that focuses on acquisition of social skills, done in groups
Other group therapies if the group consists of people with the same difficulties

Patients with avoidant personality disorder benefit from individual therapies that are supportive and sensitive to the patient's hypersensitivities toward others.

Psychodynamic psychotherapy, which focuses on underlying conflicts, may be helpful.

There are no placebo-controlled studies of medicinering.