{"id":1729,"date":"2020-09-09T16:42:43","date_gmt":"2020-09-09T16:42:43","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/abnormalpsych\/?post_type=chapter&#038;p=1729"},"modified":"2022-07-26T20:07:03","modified_gmt":"2022-07-26T20:07:03","slug":"avoidant-personality-disorder","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/chapter\/avoidant-personality-disorder\/","title":{"raw":"Avoidant Personality Disorder","rendered":"Avoidant Personality Disorder"},"content":{"raw":"<div class=\"textbox learning-objectives\">\r\n<h3>Learning Objectives<\/h3>\r\n<ul>\r\n \t<li style=\"font-weight: 400;\">Describe the characteristics and diagnosis of avoidant personality disorder<\/li>\r\n<\/ul>\r\n<\/div>\r\nCluster C personality disorders include avoidant, dependent, and obsessive-compulsive personality disorders. Individuals with these disorders often appear anxious, fearful, or clingy (a mnemonic to help remember Cluster C disorders are the three C's\u2014cowardly, clingy, and compulsive). Avoidant personality disorders exhibit a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Dependent personality disorders show a pattern of submissive and clinging behavior that evidence an excessive need to be taken care of. Lastly, obsessive-compulsive personality disorders manifest a preoccupation with orderliness, perfectionism, and control.\r\n<table style=\"width: 741px;\" summary=\"A table provides basic descriptions of the DSM-5 personality disorders and their associated clusters. Cluster A includes Paranoid (harbors a pervasive and unjustifiable suspiciousness and mistrust of others; reluctant to confide in or become close to others; reads hidden demeaning or threatening meaning into benign remarks or events; takes offense easily and bears grudges; not due to schizophrenia or other psychotic disorders), Schizoid (lacks interest and desire to form relationships with others; aloof and shows emotional coldness and detachment; indifferent to approval or criticism of others; lacks close friends or confidants; not due to schizophrenia or other psychotic disorders, not an autism spectrum disorder), and Schizotypal (exhibits eccentricities in thought, perception, emotion, speech, and behavior; shows suspiciousness or paranoia; has unusual perceptual experiences; speech is often idiosyncratic; displays inappropriate emotions; lacks friends or confidants; not due to schizophrenia or other psychotic disorder, or to autism spectrum disorder). Cluster B includes Antisocial (continuously violates the rights of others; history of antisocial tendencies prior to age 15; often lies, fights, and has problems with the law; impulsive and fails to think ahead; can be deceitful and manipulative in order to gain profit or pleasure; irresponsible and often fails to hold down a job or pay financial debts; lacks feelings for others and remorse over misdeeds), Histrionic (excessively overdramatic, emotional, and theatrical; feels uncomfortable when not the center of others\u2019 attention; behavior is often inappropriately seductive or provocative; speech is highly emotional but often vague and diffuse; emotions are shallow and often shift rapidly; may alienate friends with demands for constant attention), Narcissistic (overinflated and unjustified sense of self-importance and preoccupied with fantasies of success; believes he is entitled to special treatment from others; shows arrogant attitudes and behaviors; takes advantage of others; lacks empathy), and Borderline (unstable in self-image, mood, and behavior; cannot tolerate being alone and experiences chronic feelings of emptiness; unstable and intense relationships with others; behavior is impulsive, unpredictable, and sometimes self-damaging; shows inappropriate and intense anger; makes suicidal gestures). Cluster C includes Avoidant (socially inhibited and oversensitive to negative evaluation; avoids occupations that involve interpersonal contact because of fears of criticism or rejection; avoids relationships with others unless guaranteed to be accepted unconditionally; feels inadequate and views self as socially inept and unappealing; unwilling to take risks or engage in new activities if they may prove embarrassing), Dependent (allows others to take over and run her life; is submissive, clingy, and fears separation; cannot make decisions without advice and reassurance from others; lacks self-confidence; cannot do things on her own; feels uncomfortable or helpless when alone), and Obsessive-Compulsive (pervasive need for perfectionism that interferes with the ability to complete tasks; preoccupied with details, rules, order, and schedules; excessively devoted to work at the expense of leisure and friendships; rigid, inflexible, and stubborn; insists things be done his way; miserly with money).\"><caption>Table 1. DSM-5 Personality Disorders<\/caption>\r\n<tbody>\r\n<tr style=\"height: 52px;\">\r\n<td style=\"height: 52px; width: 69px;\"><strong>Avoidant<\/strong><\/td>\r\n<td style=\"height: 52px; width: 627px;\">socially inhibited and oversensitive to negative evaluation; avoids occupations that involve interpersonal contact because of fears of criticism or rejection; avoids relationships with others unless guaranteed to be accepted unconditionally; feels inadequate and views self as socially inept and unappealing; unwilling to take risks or engage in new activities if they may prove embarrassing<\/td>\r\n<td style=\"height: 52px; width: 45px;\">C<\/td>\r\n<\/tr>\r\n<tr style=\"height: 26px;\">\r\n<td style=\"height: 26px; width: 69px;\">Dependent<\/td>\r\n<td style=\"height: 26px; width: 627px;\">allows others to take over and run their life; is submissive, clingy, and fears separation; cannot make decisions without advice and reassurance from others; lacks self-confidence; cannot do things on their own; feels uncomfortable or helpless when alone<\/td>\r\n<td style=\"height: 26px; width: 45px;\">C<\/td>\r\n<\/tr>\r\n<tr style=\"height: 39px;\">\r\n<td style=\"height: 39px; width: 69px;\">Obsessive-Compulsive<\/td>\r\n<td style=\"height: 39px; width: 627px;\">pervasive need for perfectionism that interferes with the ability to complete tasks; preoccupied with details, rules, order, and schedules; excessively devoted to work at the expense of leisure and friendships; rigid, inflexible, and stubborn; insists things be done a certain way; miserly with money<\/td>\r\n<td style=\"height: 39px; width: 45px;\">C<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<h2>Avoidant Personality Disorder<\/h2>\r\nPeople with avoidant personality disorder (AvPD) often consider themselves to be socially inept or personally unappealing and avoid social interaction for fear of being ridiculed, humiliated, rejected, or disliked. They often avoid becoming involved with others unless they are certain they will be liked.\u00a0As the name suggests, the main\u00a0coping\u00a0mechanism of those with avoidant personality disorder (AvPD) is\u00a0avoidance of feared stimuli.<sup id=\"cite_ref-who.int_1-0\" class=\"reference\"><\/sup>\r\n\r\nThose affected display a pattern of severe\u00a0social anxiety,\u00a0social inhibition, feelings of inadequacy and\u00a0inferiority,\u00a0extreme sensitivity to negative evaluation\u00a0and\u00a0rejection, and avoidance of\u00a0social interaction\u00a0despite a strong desire for intimacy.<sup id=\"cite_ref-DSM-5-general_personality_disorder2_2-0\" class=\"reference\"><\/sup>\r\n\r\nAccording to the\u00a0DSM-5<em>,<\/em>\u00a0avoidant personality disorder (AvPD) diagnosis refers to a widespread pattern of inhibition around people, feeling inadequate, and being very sensitive to negative evaluation. Symptoms begin by early adulthood and occur in a range of situations.\r\n\r\n[caption id=\"attachment_4325\" align=\"alignright\" width=\"186\"]<img class=\"wp-image-4325\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/09\/13064456\/kevin-kosi-nappy--215x300.jpeg\" alt=\"A person in deep thought squatting with their hands clasped.\" width=\"186\" height=\"260\" \/> <strong>Figure 1.<\/strong> People with AvPD often have a negative perception of themselves.[\/caption]\r\n\r\nFour of the following seven specific symptoms should be present:<sup id=\"cite_ref-DSM-5-general_personality_disorder2_2-1\" class=\"reference\"><\/sup>\r\n<ul>\r\n \t<li>avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection<\/li>\r\n \t<li>is unwilling to get involved with people unless certain of being liked<\/li>\r\n \t<li>shows restraint within intimate relationships because of the fear of being shamed or ridiculed<\/li>\r\n \t<li>is preoccupied with being criticized or rejected in social situations<\/li>\r\n \t<li>is inhibited in new interpersonal situations because of feelings of inadequacy<\/li>\r\n \t<li>views self as socially inept, personally unappealing, or inferior to others<\/li>\r\n \t<li>is unusually reluctant to take personal risk or to engage in any new activities because they may prove embarrassing<\/li>\r\n<\/ul>\r\n<h3><span id=\"Differential_diagnosis\" class=\"mw-headline\">Differential Diagnosis<\/span><\/h3>\r\nIn contrast to\u00a0social anxiety disorder, a diagnosis of AvPD also requires that the\u00a0general criteria for a personality disorder\u00a0are met.\u00a0According to DSM-5, AvPD must be differentiated from similar personality disorders such as\u00a0dependent,\u00a0paranoid,\u00a0schizoid, and\u00a0schizotypal. But these disorders can also occur together; this is particularly likely for AvPD and dependent personality disorder. Thus, if criteria for more than one personality disorder are met, all can be diagnosed.\u00a0<sup id=\"cite_ref-DSM-5-general_personality_disorder2_2-2\" class=\"reference\"><\/sup>There is also an overlap between avoidant and schizoid personality traits, and AvPD may have a relationship to the\u00a0schizophrenia spectrum.\r\n<h3><span id=\"Comorbidity\" class=\"mw-headline\">Comorbidity<\/span><\/h3>\r\nAvPD is reported to be especially prevalent in people with\u00a0anxiety disorders, although estimates of\u00a0comorbidity\u00a0vary widely due to differences in (among others) diagnostic instruments. Research suggests that approximately 10\u201350% of people who have\u00a0panic disorder\u00a0with\u00a0agoraphobia\u00a0have avoidant personality disorder, as well as about 20\u201340% of people who have social anxiety disorder. In addition, AvPD is more prevalent in people who have comorbid social anxiety disorder and generalized anxiety disorder than in those who have only one of the aforementioned conditions.\u00a0<sup id=\"cite_ref-sciencedirect_12-0\" class=\"reference\"><\/sup>Some studies report prevalence rates of up to 45% among people with generalized anxiety disorder and up to 56% of those with\u00a0obsessive-compulsive disorder. Post-traumatic stress disorder\u00a0is also commonly comorbid with avoidant personality disorder.\r\n<h2>Epidemiology<\/h2>\r\nData from the 2001\u20132002 National Epidemiologic Survey on Alcohol and Related Conditions indicates a\u00a0prevalence\u00a0rate of 2.36% in the American general population.\u00a0It appears to occur with equal frequency in males and females.\r\n<h2>Etiology<\/h2>\r\n[caption id=\"attachment_4327\" align=\"alignright\" width=\"300\"]<img class=\"wp-image-4327 size-medium\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/09\/13065142\/sad-girl-300x200.jpg\" alt=\"Small sad girl sitting on the sand beach.\" width=\"300\" height=\"200\" \/> <strong>Figure 2.<\/strong> Childhood neglect is a risk factor for AvPD.[\/caption]\r\n\r\nCauses of AvPD are not clearly defined,\u00a0but appear to be influenced by a combination of social, genetic, and psychological factors. The disorder may be related to\u00a0temperamental\u00a0factors that are inherited.<sup id=\"cite_ref-20\" class=\"reference\"><\/sup>\r\n\r\nChildhood emotional neglect\u00a0(in particular, the rejection of a child by one or both parents) and peer group rejection are associated with an increased risk for its development; however, it is possible for AvPD to occur without any notable history of abuse or neglect.\r\n<h2>Treatment<\/h2>\r\nTreatment of avoidant personality disorder can employ various techniques, such as\u00a0social skills training, psychotherapy,\u00a0cognitive therapy, exposure treatment to gradually increase social contacts,\u00a0group therapy\u00a0for practicing social skills, and sometimes\u00a0drug therapy.\r\n<div class=\"textbox key-takeaways\">\r\n<h3>Key Takeaways:\u00a0avoidant personality disorder<\/h3>\r\n<iframe title=\"57. Avoidant personality disorder\" src=\"https:\/\/lumenlearning.h5p.com\/content\/1291236016212332098\/embed\" width=\"1088\" height=\"595\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><script src=\"https:\/\/lumenlearning.h5p.com\/js\/h5p-resizer.js\" charset=\"UTF-8\"><\/script>\r\n\r\n<\/div>\r\n<div class=\"textbox exercises\">\r\n<h3>Case Study: Avoidant Personality Disorder<\/h3>\r\nThe patient was 35-year-old, unmarried data technician William, referred to a specialized treatment program for personality disorders from an outpatient drug addiction service. His personality pathology was considered more devastating than his substance abuse. Presenting complaints included low self-esteem, loneliness, a sense of emptiness, suicidal ideation, social isolation, substance abuse, and general dissatisfaction with life. Present complaints had been chronic in nature, dating back to childhood.\r\n\r\nWilliam recalled having daily suicidal thoughts for several years in his early youth. His avoidant behavior was more prominent than his level of experienced anxiety. William's most prominent feature was a pervasive fear of being ridiculed when interacting with others, and he was diagnosed with avoidant personality disorder.\r\n\r\nIn a group-based treatment program lasting for 20 weeks, he was a regular, but somewhat detached participant. The therapists encountered a series of problems related to passivity: he postponed most of his obligations, resisted sorting out practical affairs, did not pay his bills, and avoided contacting people who could be helpful.\r\n\r\n<\/div>\r\n<div class=\"textbox examples\">\r\n<h3>Watch It<\/h3>\r\nWatch this video to learn more about behaviors associated with avoidant personality disorder.\r\n\r\n<iframe src=\"\/\/plugin.3playmedia.com\/show?mf=5576415&amp;p3sdk_version=1.10.1&amp;p=20361&amp;pt=375&amp;video_id=fFNA4De2mAc&amp;video_target=tpm-plugin-s0xav0bi-fFNA4De2mAc\" width=\"800px\" height=\"450px\" frameborder=\"0\" marginwidth=\"0px\" marginheight=\"0px\"><\/iframe>\r\n\r\nYou can view the <a href=\"https:\/\/course-building.s3-us-west-2.amazonaws.com\/Abnormal+Psychology\/transcripts\/AvoidantPersonalityDisorderWhatIsIt_transcript.txt\" target=\"_blank\" rel=\"noopener\">transcript for \"Avoidant Personality Disorder.. What is it?\" here (opens in new window)<\/a>.\r\n\r\n<\/div>\r\n<div class=\"textbox tryit\">\r\n<h3>Try It<\/h3>\r\nhttps:\/\/assess.lumenlearning.com\/practice\/8ea044de-9d19-46b0-8c0c-018a882ae549\r\n\r\n<\/div>\r\n<div class=\"textbox learning-objectives\">\r\n<h3>Glossary<\/h3>\r\n<strong>avoidant personality disorder:<\/strong>\u00a0personality disorder characterized by patterns of social withdrawal, inadequacy, and fear of criticism\r\n\r\n<\/div>","rendered":"<div class=\"textbox learning-objectives\">\n<h3>Learning Objectives<\/h3>\n<ul>\n<li style=\"font-weight: 400;\">Describe the characteristics and diagnosis of avoidant personality disorder<\/li>\n<\/ul>\n<\/div>\n<p>Cluster C personality disorders include avoidant, dependent, and obsessive-compulsive personality disorders. Individuals with these disorders often appear anxious, fearful, or clingy (a mnemonic to help remember Cluster C disorders are the three C&#8217;s\u2014cowardly, clingy, and compulsive). Avoidant personality disorders exhibit a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Dependent personality disorders show a pattern of submissive and clinging behavior that evidence an excessive need to be taken care of. Lastly, obsessive-compulsive personality disorders manifest a preoccupation with orderliness, perfectionism, and control.<\/p>\n<table style=\"width: 741px;\" summary=\"A table provides basic descriptions of the DSM-5 personality disorders and their associated clusters. Cluster A includes Paranoid (harbors a pervasive and unjustifiable suspiciousness and mistrust of others; reluctant to confide in or become close to others; reads hidden demeaning or threatening meaning into benign remarks or events; takes offense easily and bears grudges; not due to schizophrenia or other psychotic disorders), Schizoid (lacks interest and desire to form relationships with others; aloof and shows emotional coldness and detachment; indifferent to approval or criticism of others; lacks close friends or confidants; not due to schizophrenia or other psychotic disorders, not an autism spectrum disorder), and Schizotypal (exhibits eccentricities in thought, perception, emotion, speech, and behavior; shows suspiciousness or paranoia; has unusual perceptual experiences; speech is often idiosyncratic; displays inappropriate emotions; lacks friends or confidants; not due to schizophrenia or other psychotic disorder, or to autism spectrum disorder). Cluster B includes Antisocial (continuously violates the rights of others; history of antisocial tendencies prior to age 15; often lies, fights, and has problems with the law; impulsive and fails to think ahead; can be deceitful and manipulative in order to gain profit or pleasure; irresponsible and often fails to hold down a job or pay financial debts; lacks feelings for others and remorse over misdeeds), Histrionic (excessively overdramatic, emotional, and theatrical; feels uncomfortable when not the center of others\u2019 attention; behavior is often inappropriately seductive or provocative; speech is highly emotional but often vague and diffuse; emotions are shallow and often shift rapidly; may alienate friends with demands for constant attention), Narcissistic (overinflated and unjustified sense of self-importance and preoccupied with fantasies of success; believes he is entitled to special treatment from others; shows arrogant attitudes and behaviors; takes advantage of others; lacks empathy), and Borderline (unstable in self-image, mood, and behavior; cannot tolerate being alone and experiences chronic feelings of emptiness; unstable and intense relationships with others; behavior is impulsive, unpredictable, and sometimes self-damaging; shows inappropriate and intense anger; makes suicidal gestures). Cluster C includes Avoidant (socially inhibited and oversensitive to negative evaluation; avoids occupations that involve interpersonal contact because of fears of criticism or rejection; avoids relationships with others unless guaranteed to be accepted unconditionally; feels inadequate and views self as socially inept and unappealing; unwilling to take risks or engage in new activities if they may prove embarrassing), Dependent (allows others to take over and run her life; is submissive, clingy, and fears separation; cannot make decisions without advice and reassurance from others; lacks self-confidence; cannot do things on her own; feels uncomfortable or helpless when alone), and Obsessive-Compulsive (pervasive need for perfectionism that interferes with the ability to complete tasks; preoccupied with details, rules, order, and schedules; excessively devoted to work at the expense of leisure and friendships; rigid, inflexible, and stubborn; insists things be done his way; miserly with money).\">\n<caption>Table 1. DSM-5 Personality Disorders<\/caption>\n<tbody>\n<tr style=\"height: 52px;\">\n<td style=\"height: 52px; width: 69px;\"><strong>Avoidant<\/strong><\/td>\n<td style=\"height: 52px; width: 627px;\">socially inhibited and oversensitive to negative evaluation; avoids occupations that involve interpersonal contact because of fears of criticism or rejection; avoids relationships with others unless guaranteed to be accepted unconditionally; feels inadequate and views self as socially inept and unappealing; unwilling to take risks or engage in new activities if they may prove embarrassing<\/td>\n<td style=\"height: 52px; width: 45px;\">C<\/td>\n<\/tr>\n<tr style=\"height: 26px;\">\n<td style=\"height: 26px; width: 69px;\">Dependent<\/td>\n<td style=\"height: 26px; width: 627px;\">allows others to take over and run their life; is submissive, clingy, and fears separation; cannot make decisions without advice and reassurance from others; lacks self-confidence; cannot do things on their own; feels uncomfortable or helpless when alone<\/td>\n<td style=\"height: 26px; width: 45px;\">C<\/td>\n<\/tr>\n<tr style=\"height: 39px;\">\n<td style=\"height: 39px; width: 69px;\">Obsessive-Compulsive<\/td>\n<td style=\"height: 39px; width: 627px;\">pervasive need for perfectionism that interferes with the ability to complete tasks; preoccupied with details, rules, order, and schedules; excessively devoted to work at the expense of leisure and friendships; rigid, inflexible, and stubborn; insists things be done a certain way; miserly with money<\/td>\n<td style=\"height: 39px; width: 45px;\">C<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>Avoidant Personality Disorder<\/h2>\n<p>People with avoidant personality disorder (AvPD) often consider themselves to be socially inept or personally unappealing and avoid social interaction for fear of being ridiculed, humiliated, rejected, or disliked. They often avoid becoming involved with others unless they are certain they will be liked.\u00a0As the name suggests, the main\u00a0coping\u00a0mechanism of those with avoidant personality disorder (AvPD) is\u00a0avoidance of feared stimuli.<sup id=\"cite_ref-who.int_1-0\" class=\"reference\"><\/sup><\/p>\n<p>Those affected display a pattern of severe\u00a0social anxiety,\u00a0social inhibition, feelings of inadequacy and\u00a0inferiority,\u00a0extreme sensitivity to negative evaluation\u00a0and\u00a0rejection, and avoidance of\u00a0social interaction\u00a0despite a strong desire for intimacy.<sup id=\"cite_ref-DSM-5-general_personality_disorder2_2-0\" class=\"reference\"><\/sup><\/p>\n<p>According to the\u00a0DSM-5<em>,<\/em>\u00a0avoidant personality disorder (AvPD) diagnosis refers to a widespread pattern of inhibition around people, feeling inadequate, and being very sensitive to negative evaluation. Symptoms begin by early adulthood and occur in a range of situations.<\/p>\n<div id=\"attachment_4325\" style=\"width: 196px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4325\" class=\"wp-image-4325\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/09\/13064456\/kevin-kosi-nappy--215x300.jpeg\" alt=\"A person in deep thought squatting with their hands clasped.\" width=\"186\" height=\"260\" \/><\/p>\n<p id=\"caption-attachment-4325\" class=\"wp-caption-text\"><strong>Figure 1.<\/strong> People with AvPD often have a negative perception of themselves.<\/p>\n<\/div>\n<p>Four of the following seven specific symptoms should be present:<sup id=\"cite_ref-DSM-5-general_personality_disorder2_2-1\" class=\"reference\"><\/sup><\/p>\n<ul>\n<li>avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection<\/li>\n<li>is unwilling to get involved with people unless certain of being liked<\/li>\n<li>shows restraint within intimate relationships because of the fear of being shamed or ridiculed<\/li>\n<li>is preoccupied with being criticized or rejected in social situations<\/li>\n<li>is inhibited in new interpersonal situations because of feelings of inadequacy<\/li>\n<li>views self as socially inept, personally unappealing, or inferior to others<\/li>\n<li>is unusually reluctant to take personal risk or to engage in any new activities because they may prove embarrassing<\/li>\n<\/ul>\n<h3><span id=\"Differential_diagnosis\" class=\"mw-headline\">Differential Diagnosis<\/span><\/h3>\n<p>In contrast to\u00a0social anxiety disorder, a diagnosis of AvPD also requires that the\u00a0general criteria for a personality disorder\u00a0are met.\u00a0According to DSM-5, AvPD must be differentiated from similar personality disorders such as\u00a0dependent,\u00a0paranoid,\u00a0schizoid, and\u00a0schizotypal. But these disorders can also occur together; this is particularly likely for AvPD and dependent personality disorder. Thus, if criteria for more than one personality disorder are met, all can be diagnosed.\u00a0<sup id=\"cite_ref-DSM-5-general_personality_disorder2_2-2\" class=\"reference\"><\/sup>There is also an overlap between avoidant and schizoid personality traits, and AvPD may have a relationship to the\u00a0schizophrenia spectrum.<\/p>\n<h3><span id=\"Comorbidity\" class=\"mw-headline\">Comorbidity<\/span><\/h3>\n<p>AvPD is reported to be especially prevalent in people with\u00a0anxiety disorders, although estimates of\u00a0comorbidity\u00a0vary widely due to differences in (among others) diagnostic instruments. Research suggests that approximately 10\u201350% of people who have\u00a0panic disorder\u00a0with\u00a0agoraphobia\u00a0have avoidant personality disorder, as well as about 20\u201340% of people who have social anxiety disorder. In addition, AvPD is more prevalent in people who have comorbid social anxiety disorder and generalized anxiety disorder than in those who have only one of the aforementioned conditions.\u00a0<sup id=\"cite_ref-sciencedirect_12-0\" class=\"reference\"><\/sup>Some studies report prevalence rates of up to 45% among people with generalized anxiety disorder and up to 56% of those with\u00a0obsessive-compulsive disorder. Post-traumatic stress disorder\u00a0is also commonly comorbid with avoidant personality disorder.<\/p>\n<h2>Epidemiology<\/h2>\n<p>Data from the 2001\u20132002 National Epidemiologic Survey on Alcohol and Related Conditions indicates a\u00a0prevalence\u00a0rate of 2.36% in the American general population.\u00a0It appears to occur with equal frequency in males and females.<\/p>\n<h2>Etiology<\/h2>\n<div id=\"attachment_4327\" style=\"width: 310px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4327\" class=\"wp-image-4327 size-medium\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/09\/13065142\/sad-girl-300x200.jpg\" alt=\"Small sad girl sitting on the sand beach.\" width=\"300\" height=\"200\" \/><\/p>\n<p id=\"caption-attachment-4327\" class=\"wp-caption-text\"><strong>Figure 2.<\/strong> Childhood neglect is a risk factor for AvPD.<\/p>\n<\/div>\n<p>Causes of AvPD are not clearly defined,\u00a0but appear to be influenced by a combination of social, genetic, and psychological factors. The disorder may be related to\u00a0temperamental\u00a0factors that are inherited.<sup id=\"cite_ref-20\" class=\"reference\"><\/sup><\/p>\n<p>Childhood emotional neglect\u00a0(in particular, the rejection of a child by one or both parents) and peer group rejection are associated with an increased risk for its development; however, it is possible for AvPD to occur without any notable history of abuse or neglect.<\/p>\n<h2>Treatment<\/h2>\n<p>Treatment of avoidant personality disorder can employ various techniques, such as\u00a0social skills training, psychotherapy,\u00a0cognitive therapy, exposure treatment to gradually increase social contacts,\u00a0group therapy\u00a0for practicing social skills, and sometimes\u00a0drug therapy.<\/p>\n<div class=\"textbox key-takeaways\">\n<h3>Key Takeaways:\u00a0avoidant personality disorder<\/h3>\n<p><iframe loading=\"lazy\" title=\"57. Avoidant personality disorder\" src=\"https:\/\/lumenlearning.h5p.com\/content\/1291236016212332098\/embed\" width=\"1088\" height=\"595\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><script src=\"https:\/\/lumenlearning.h5p.com\/js\/h5p-resizer.js\" charset=\"UTF-8\"><\/script><\/p>\n<\/div>\n<div class=\"textbox exercises\">\n<h3>Case Study: Avoidant Personality Disorder<\/h3>\n<p>The patient was 35-year-old, unmarried data technician William, referred to a specialized treatment program for personality disorders from an outpatient drug addiction service. His personality pathology was considered more devastating than his substance abuse. Presenting complaints included low self-esteem, loneliness, a sense of emptiness, suicidal ideation, social isolation, substance abuse, and general dissatisfaction with life. Present complaints had been chronic in nature, dating back to childhood.<\/p>\n<p>William recalled having daily suicidal thoughts for several years in his early youth. His avoidant behavior was more prominent than his level of experienced anxiety. William&#8217;s most prominent feature was a pervasive fear of being ridiculed when interacting with others, and he was diagnosed with avoidant personality disorder.<\/p>\n<p>In a group-based treatment program lasting for 20 weeks, he was a regular, but somewhat detached participant. The therapists encountered a series of problems related to passivity: he postponed most of his obligations, resisted sorting out practical affairs, did not pay his bills, and avoided contacting people who could be helpful.<\/p>\n<\/div>\n<div class=\"textbox examples\">\n<h3>Watch It<\/h3>\n<p>Watch this video to learn more about behaviors associated with avoidant personality disorder.<\/p>\n<p><iframe loading=\"lazy\" src=\"\/\/plugin.3playmedia.com\/show?mf=5576415&amp;p3sdk_version=1.10.1&amp;p=20361&amp;pt=375&amp;video_id=fFNA4De2mAc&amp;video_target=tpm-plugin-s0xav0bi-fFNA4De2mAc\" width=\"800px\" height=\"450px\" frameborder=\"0\" marginwidth=\"0px\" marginheight=\"0px\"><\/iframe><\/p>\n<p>You can view the <a href=\"https:\/\/course-building.s3-us-west-2.amazonaws.com\/Abnormal+Psychology\/transcripts\/AvoidantPersonalityDisorderWhatIsIt_transcript.txt\" target=\"_blank\" rel=\"noopener\">transcript for &#8220;Avoidant Personality Disorder.. What is it?&#8221; here (opens in new window)<\/a>.<\/p>\n<\/div>\n<div class=\"textbox tryit\">\n<h3>Try It<\/h3>\n<p>\t<iframe id=\"assessment_practice_8ea044de-9d19-46b0-8c0c-018a882ae549\" class=\"resizable\" src=\"https:\/\/assess.lumenlearning.com\/practice\/8ea044de-9d19-46b0-8c0c-018a882ae549?iframe_resize_id=assessment_practice_id_8ea044de-9d19-46b0-8c0c-018a882ae549\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:300px;\"><br \/>\n\t<\/iframe><\/p>\n<\/div>\n<div class=\"textbox learning-objectives\">\n<h3>Glossary<\/h3>\n<p><strong>avoidant personality disorder:<\/strong>\u00a0personality disorder characterized by patterns of social withdrawal, inadequacy, and fear of criticism<\/p>\n<\/div>\n\n\t\t\t <section class=\"citations-section\" role=\"contentinfo\">\n\t\t\t <h3>Candela Citations<\/h3>\n\t\t\t\t\t <div>\n\t\t\t\t\t\t <div id=\"citation-list-1729\">\n\t\t\t\t\t\t\t <div class=\"licensing\"><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Original<\/div><ul class=\"citation-list\"><li>Modification, adaptation, and original content. <strong>Authored by<\/strong>: Julie Manley for Lumen Learning. <strong>Provided by<\/strong>: Lumen Learning. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Shared previously<\/div><ul class=\"citation-list\"><li>Textbook of Psychiatry. <strong>Provided by<\/strong>: Wikibooks. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikibooks.org\/wiki\/Textbook_of_Psychiatry\/Print_version#Avoidant_Personality_Disorder\">https:\/\/en.wikibooks.org\/wiki\/Textbook_of_Psychiatry\/Print_version#Avoidant_Personality_Disorder<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Avoidant Personality Disorder.. What is it?. <strong>Provided by<\/strong>: Psych2go. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.youtube.com\/watch?v=fFNA4De2mAc&#038;feature=emb_logo\">https:\/\/www.youtube.com\/watch?v=fFNA4De2mAc&#038;feature=emb_logo<\/a>. <strong>License<\/strong>: <em>Other<\/em>. <strong>License Terms<\/strong>: Standard YouTube License<\/li><li>Sad. <strong>Authored by<\/strong>: Kevin Kosi. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.nappy.co\/?s=sad\">https:\/\/www.nappy.co\/?s=sad<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/about\/cc0\">CC0: No Rights Reserved<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">Public domain content<\/div><ul class=\"citation-list\"><li>Sad girl. <strong>Authored by<\/strong>: Martin Vorel . <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/libreshot.com\/small-sad-girl-on-the-beach\/\">https:\/\/libreshot.com\/small-sad-girl-on-the-beach\/<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/about\/pdm\">Public Domain: No Known Copyright<\/a><\/em><\/li><\/ul><\/div>\n\t\t\t\t\t\t <\/div>\n\t\t\t\t\t <\/div>\n\t\t\t <\/section>","protected":false},"author":29,"menu_order":13,"template":"","meta":{"_candela_citation":"[{\"type\":\"cc\",\"description\":\"Textbook of Psychiatry\",\"author\":\"\",\"organization\":\"Wikibooks\",\"url\":\"https:\/\/en.wikibooks.org\/wiki\/Textbook_of_Psychiatry\/Print_version#Avoidant_Personality_Disorder\",\"project\":\"\",\"license\":\"cc-by-sa\",\"license_terms\":\"\"},{\"type\":\"original\",\"description\":\"Modification, adaptation, and original content\",\"author\":\"Julie Manley for Lumen Learning\",\"organization\":\"Lumen Learning\",\"url\":\"\",\"project\":\"\",\"license\":\"cc-by\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Avoidant Personality Disorder.. 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