People with avoidant personality disorder experience long-standing feelings of inadequacy and are extremely sensitive to what others think about them. These feelings of inadequacy lead the person to be socially inhibited and feel socially inept. Because of these feelings of inadequacy and inhibition, the person with avoidant personality disorder will regularly seek to avoid work, school, and any activities that involve socializing or interacting with others.
Individuals with avoidant personality disorder often vigilantly appraise the movements and expressions of those with whom they come into contact. Their fearful and tense demeanor may elicit ridicule from others, which in turn confirms their self-doubts. They are very anxious about the possibility that they will react to criticism with blushing or crying. They are described by others as being shy, timid, lonely, and isolated.
The major problems associated with this disorder occur in social and occupational (work) functioning. The low self-esteem and hypersensitivity to rejection often cause a person with this condition to restrict personal, social, and work contacts.
These individuals may become relatively isolated and usually do not have a large social support network that can help them weather crises. Despite their isolation, a person with avoidant personality disorder actually does desire affection and acceptance. They may even fantasize about idealized relationships with others.
The avoidant behaviors can also adversely affect their functioning at work because these individuals try to avoid the types of social situations that may be important for meeting the basic demands of the job or for advancement. For instance, they may avoid meetings as much as possible, and any social interactions with their co-workers or boss.
A personality disorder is an enduring pattern of inner experience and behavior that deviates from the norm of the individual’s culture. The pattern is seen in two or more of the following areas: cognition; affect; interpersonal functioning; or impulse control. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. It typically leads to significant distress or impairment in social, work, or other areas of functioning. The pattern is stable and of long duration, and its onset can be traced back to early adulthood or adolescence.
Avoidant personality disorder typically manifests itself by early adulthood and includes a majority of the following symptoms:
- Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection
- Is unwilling to get involved with people unless certain of being liked
- Shows restraint within intimate relationships because of the fear of being shamed or ridiculed
- Is preoccupied with being criticized or rejected in social situations
- Is inhibited in new interpersonal situations because of feelings of inadequacy
- Regards themself as socially inept, personally unappealing, or inferior to others
- Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing
Because personality disorders describe long-standing and enduring patterns of behavior, they are most often diagnosed in adulthood. It is uncommon for them to be diagnosed in childhood or adolescence, because a child or teen is under constant development, personality changes, and maturation. However, if it is diagnosed in a child or teen, the features must have been present for at least 1 year.
Avoidant personality disorder appears to occur in 2.4 percent in the general population, according to 2002 NESARC research.
Like most personality disorders, avoidant personality disorder typically will decrease in intensity with age, with many people experiencing few of the most extreme symptoms by the time they are in their 40s or 50s.
Personality disorders such as avoidant personality disorder are typically diagnosed by a trained mental health professional, such as a psychologist or psychiatrist. Family physicians and general practitioners are generally not trained or well-equipped to make this type of psychological diagnosis. So while you can initially consult a family physician about this problem, they should refer you to a mental health professional for diagnosis and treatment. There are no laboratory, blood, or genetic tests that are used to diagnose avoidant personality disorder.
Many people with avoidant personality disorder don’t seek out treatment. People with personality disorders, in general, do not often seek out treatment until the disorder starts to significantly interfere or otherwise impact a person’s life. This most often happens when a person’s coping resources are stretched too thin to deal with stress or other life events.
A diagnosis for avoidant personality disorder is made by a mental health professional comparing your symptoms and life history with those listed here. They will make a determination whether your symptoms meet the criteria necessary for a personality disorder diagnosis.
Researchers today don’t know what causes avoidant personality disorder, though there are many theories, about possible causes. Most professionals subscribe to a biopsychosocial model of causation — that is, the causes are likely due to biological and genetic factors, social factors (such as how a person interacts in their early development with their family and friends and other children), and psychological factors (the individual’s personality and temperament, shaped by their environment and learned coping skills to deal with stress). This suggests that no single factor is responsible — rather, it is the complex and likely intertwined nature of all three factors that are important.
If a person has this personality disorder, research suggests that there is a slightly increased risk for this disorder to be “passed down” to their children.
Treatment of avoidant personality disorder typically involves psychotherapy with a therapist that has experience in treating this disorder. While some people with a personality disorder may be able to tolerate long-term therapy, most people with such concerns typically go into therapy only when they feel overwhelmed by stress, which usually exacerbates the symptoms of the personality disorder. Such shorter-term therapy will typically focus on the immediate problems in the person’s life, giving them some additional coping skills and tools to help. Once the problem that brought the person into therapy is resolved, a person will typically leave treatment.