AVOIDANT PERSONALITY STYLE AND DISORDER

1 AVOIDANT PERSONALITYSTYLE AND DISORDERTHE AVOIDANT PERSONALITY TYPE IN A NUTSHELL The essential feature of AVOIDANT PERSONALITY DISORDER is a pervasive pattern of socialinhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. 1 The AVOIDANT PERSONALITY TYPE tends to avoid close interpersonal relationships andsocial situations. While the schizoid individual has the same aversion to interpersonalsituations, the reason for the AVOIDANT individual s aversion to interpersonal relationships isdue to fear of embarrassment or being hurt by others. The schizoid individual simplydoesn t have the desire for interpersonal CLOSER LOOKThis individual will often use various rationalizations to reinforce their need to refrainfrom significant interpersonal relationships.

2 These will be elaborate explanations loadedwith apparently reasonable examples based on past experience. This will immediatelypresent a significant problem for therapeutic cases of crisis, the client is likely to fall into apathetic withdrawal, especially if thetherapist moves too quickly to help resolve the social fears. It is not unreasonable that thetherapist will see the individual completely isolate themselves socially. This may includeactual cases of AVOIDANT PERSONALITY TYPE can originate from a variety of childhood sources. It isimportant for the therapist to attempt to locate the source since that may provide valuableinformation for healing.

3 The therapist should carefully read through the PsychosocialEtiology section of this PERSONALITY individual is subject to numerous Axis I disorders . Those include Panic Attacks,Anxiety disorders , various Mood disorders including Dysthymic DISORDER and the event that the AVOIDANT individual has engaged in a serious interpersonalrelationship and that relationship has ended badly, the therapist should understand thatclient reactions might be more significantly pronounced. 1 American Psychiatric Association: DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL disorders , FOURTH EDITION,TEXT REVISION.

4 Washington , American Psychiatric Association. 2000., p. BOTTOM LINEFear of being hurt or embarrassed is the key to this PERSONALITY crisis. Although theindividual may wish to engage in significant interpersonal relationships, they will refraindue to those DSM-IV-TR CRITERIAFOR DIAGNOSIS OF A FULL PERSONALITY DISORDERThe official DSM-IV-TR diagnostic criteria for AVOIDANT PERSONALITY DISORDER are:2A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity tonegative evaluation, beginning in early adulthood and present in a variety of contexts,as indicated by four (or more) of the following:1.

5 Avoids occupational activities that involve significant interpersonal contact,because of fears of criticism, disapproval, or Is unwilling to get involved with people unless certain of being Show restraint within intimate relationships because of the fear of beingshamed or Is preoccupied with being criticized or rejected in social Is inhibited in new interpersonal situations because of feelings of Views self as socially inept, personally unappealing, or inferior to Is unusually reluctant to take personal risks or to engage in any new activitiesbecause they may prove embarrassing.

6 [The therapist is reminded that the above criteria must be (1) a pervasive pattern, (2) andmust begin by early adulthood. If those main criteria cannot be met, a PERSONALITY disordercannot be diagnosed (technically). If many of the other criteria are present, the therapistshould understand that the PERSONALITY STYLE has drifted toward undesirable and maladaptivebehaviors associated with the DISORDER . Treatment techniques described below should beused to move the PERSONALITY toward STYLE rather than DISORDER .]DIFFERENTIAL DIAGNOSIST here are a number of other disorders that contain similar characteristics to AVOIDANTPERSONALITY DISORDER .

7 This list contains some of those disorders . The therapist isencouraged to research these similar disorders using the PHOBIA. This is a possible alternative diagnosis especially based on the diagnosticcriteria of DISORDER WITH AGORAPHOBIA. PANIC DISORDER with or without AGORAPHOBIAcan coexist with AVOIDANT PERSONALITY DISORDER . The avoidance with PANIC DISORDER 2 DSM-IV-TR, p. starts after the onset of PANIC ATTACKS. The avoidance in AVOIDANT PERSONALITYDISORDER tends to have an early PERSONALITY DISORDER . AVOIDANT PERSONALITY DISORDER occurs to avoidhumiliation and rejection.

8 With DEPENDENT PERSONALITY DISORDER avoidance is related tobeing taken advantage AND SCHIZOTYPAL PERSONAL disorders . All three disorders have socialisolation as a criteria. AVOIDANT PERSONALITY DISORDER desires to have a relationship andthe individual suffers loneliness without one. Whereas, with SCHIZOID and SCHIZOTYPALPERSONALITY disorders the individual is indifferent to PERSONALITY DISORDER . The common element between these two isreluctance to confide in others. AVOIDANT PERSONALITY DISORDER , however, also has thefear of being embarrassed as a key DISORDER DUE TO MEDICAL CONDITION.

9 Both disorders may bediagnosed but AVOIDANT PERSONALITY DISORDER must exist before the medical SUBSTANCE ABUSE. Both conditions may be diagnosed but AVOIDANTPERSONALITY DISORDER must exist before the substance ASSOCIATED AXIS I DISORDERST here are a number of DSM-IV Axis I disorders that are commonly associated with theAVOIDANT PERSONALITY TYPE. The therapist should be aware of each of these Axis IDisorders and screen for them, if such screening seems disorders . Various Mood disorders may be present with the AVOIDANTPERSONALITY TYPE.

10 These may include Major Depression DISORDER , CyclothymicDisorder, Dysthymic DISORDER , and (less likely) bipolar disorders . Since the AVOIDANT PERSONALITY TYPE is socially inhibited and hasfeelings of social inadequacy, these traits may result in a number of Anxiety PHOBIA. The hypersensitivity to negative evaluation may result in the AVOIDANTPERSONALITY TYPE suffering from a Social AVOIDANT PERSONALITY CONTINUUMAll PERSONALITY flows on a continuum from order to DISORDER from function todysfunction. Internal and external stressing events are the triggers that motivate apersonality that is functioning in an orderly fashion to move toward DISORDER .