Avoidant Personality Disorder: Understanding the Condition

Avoidant personality disorder is a condition characterized by extreme social inhibition and introversion, leading to lifelong patterns of limited social relationships and reluctance to enter into social interactions. Individuals with this disorder have a hypersensitivity to, and fear of, criticism and disapproval, which causes them to avoid seeking out other people. Despite this, they desire affection and often feel lonely and bored.

Unlike individuals with schizoid personality disorder, who enjoy their aloneness, individuals with avoidant personality disorder want contact with other people. However, their inability to relate comfortably to others causes them acute anxiety. They are painfully self-conscious in social settings and highly critical of themselves. Not surprisingly, avoidant personality disorder is often associated with depression.

Feeling inept and socially inadequate are the two most prevalent and stable features of avoidant personality disorder. In addition, researchers have documented that individuals with this disorder also show more generalized timidity and avoidance of many novel situations and emotions (including positive emotions), and show deficits in their ability to experience pleasure as well. The disorder is more commonly diagnosed in women, with a prevalence of around 2 to 3 percent.

From a clinical perspective, avoidant personality disorder looks a lot like schizoid personality disorder. Both types of people are socially isolated. However, the key difference is that individuals with schizoid personality disorder have little desire to form close relationships, while those with avoidant personality disorder want interpersonal contact but are shy, insecure, and hypersensitive to criticism (Hooley et al., 2019).

A much less clear distinction is that between avoidant personality disorder and social anxiety disorder (social phobia). Numerous studies have found substantial overlap between these two disorders, leading some investigators to conclude that avoidant personality disorder may simply be a somewhat more severe manifestation of generalized social anxiety disorder that does not warrant a separate diagnosis. This is consistent with the finding that there are cases of a social anxiety disorder without avoidant personality disorder but very few cases of avoidant personality disorder without a social anxiety disorder.

Some research suggests that avoidant personality may have its origins in an innate “inhibited” temperament that leaves the infant and child shy and inhibited in novel and ambiguous situations. A large twin study in Norway has shown that traits prominent in avoidant personality disorder show a modest genetic influence and that the genetic vulnerability for avoidant personality disorder is at least partially shared with that for social anxiety disorder. Moreover, there is also evidence that the fear of being negatively evaluated, which is prominent in avoidant personality disorder, is moderately heritable; introversion and neuroticism are also both elevated, and they too are moderately heritable. This genetically and biologically based inhibited temperament may often serve as the diathesis that leads to avoidant personality disorder in some children who experience emotional abuse, rejection, or humiliation from parents who are not particularly affectionate.

In conclusion, avoidant personality disorder is a complex condition characterized by extreme social inhibition and introversion. It can be difficult to distinguish from other disorders such as schizoid personality disorder and social anxiety disorder. However, understanding the key features of this condition can help individuals affected by it to seek appropriate treatment and support.

References

Hooley, J. M., Nock, M. K., & Butcher, J. N. (2019). Abnormal Psychology (18th ed.). Pearson Education (US). https://bookshelf.vitalsource.com/books/9780135191033