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

 

 

 Triggers

The Importance of Identifying Addiction Triggers

Addiction is a complex disease that can be triggered by a variety of factors. These triggers can be internal or external, and they can be physical, emotional, or environmental.

Internal triggers are those that come from within the individual. They can include things like negative emotions, such as stress, anxiety, or boredom; physical cravings; and thoughts about using drugs or alcohol.

External triggers are those that come from the environment. They can include things like being around people who use drugs or alcohol, going to places where drugs or alcohol are used, or seeing or hearing things that remind the individual of using drugs or alcohol.

Triggers can be very powerful, and they can make it difficult to resist the urge to use drugs or alcohol. For people in recovery, it is important to identify their triggers and develop strategies for coping with them.

The contextual analysis: Learn about your triggers

Think of anything that you are trying to quit such as smoking, drinking, certain behavior, etc...

Ask yourself these six questions:

1. What are your expectations or what do you hope to gain with whatever you are trying to quit?
1. Examples include relaxation, sleeping better, weight loss, improving social interactions, or just feeling better.
2. What internal things cause you to do the thing that you are trying to quit or cut down on?
1. 
   Examples include your emotions, thoughts, cravings, and unpleasant withdrawal symptoms.
3. What external things cause you to do the thing that you are trying to quit or cut down on?
1. Examples include certain people, places, songs, seeing needles, etc...
4. What are your immediate reinforcers? Or what do you perceive to be the immediate benefit of what you are trying to quit?
1. Examples include feeling relaxed, escaping, or feeling high.
5. Does what you are trying to quit or cut down on have any positive aspects?
1. Examples include making friends, feeling good, productivity, and enhanced pleasure.
6. What are the negative aspects of that thing you are trying to quit?
1. Examples include expenses, hangovers, loss of employment, and interpersonal problems.

Here are some additional things to keep in mind:

Triggers can change over time, so it is important to be constantly vigilant.

There is no one-size-fits-all approach to coping with triggers. What works for one person may not work for another.

It is important to be patient and persistent. Coping with triggers takes time and effort.

• Using the information you learn from the six questions formulate a plan of action. If you are having difficulty dealing with any of your answers or formulating your plan of action, then work with someone you trust or your therapist. 
  

 

If you are struggling to cope with your triggers, please reach out for help. There are many resources available to you, including your therapist, counselor, or support group. You are not alone.




References

Capuzzi, D., & Stauffer, M. D. (2019). Foundations of Addictions Counseling (4th ed.). Pearson Education (US). https://bookshelf.vitalsource.com/books/9780135169858













 

Antisocial Personality Disorder and Psychopathy

 

Antisocial Personality Disorder and Psychopathy: Understanding the Differences

The term Antisocial Personality Disorder (ASPD) was first introduced in 1980 when personality disorders entered the DSM (in DSM-III). However, prior to that time, clinicians and researchers had been interested in a syndrome that was initially called sociopathic personality but is now usually referred to as psychopathy.

Psychopathy was first identified in the nineteenth century when terms such as manie sans delire (insanity without delirium), moral weakness, or moral insanity were used to describe it. The most comprehensive early description of psychopathy was made by Cleckley in the 1940s. In his book, The Mask of Sanity, Cleckley provided detailed case studies of people he identified as psychopaths and outlined 21 core traits of psychopathy, which were later revised and reduced to 16 traits.

The prevalence of psychopathy is unknown because no epidemiological studies have assessed this. However, for males in North America, the prevalence is estimated to be about 1 to 2 percent. Rates for women are estimated to be much lower (well under 1 percent).

It is important to note that the features of DSM-5 ASPD do not fully map onto the construct of psychopathy as originally described. This was done deliberately in an attempt to increase the reliability of the ASPD diagnosis. However, many researchers expressed concern that reliability was being emphasized at the expense of validity and that many key features of psychopathy were not included in the diagnostic criteria. This has raised questions about whether the ASPD construct is the same as psychopathy. It is generally accepted that there is a good deal of overlap, although the diagnosis of ASPD is more inclusive and reflects a lot of criminality, whereas the diagnosis of psychopathy is more narrow and much more focused on personality structure.

References

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