255 Avoidant Personality Disorder
DSM-IV-TR criteria
A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety o contexts, as indicated by four (or more) of the following:
- 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
- views self 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
Associated features
- People with Avoidant Personality Disorder often appraise every movement and expression of those whom they are around. They can be fearful and tense which can elicit the ridicule of others which confirm preconceived self-doubts. They tend to be very anxious thinking that they will react to criticism with crying or blushing. Others describe them as “shy,” “lonely,” “timid,” and “isolated.” Their major problems are in social and occupational functioning. Their low self-esteem and hypersensitivity to rejection can restrict interpersonal contacts. Individuals may become isolated and do not usually have a large social support network to help them. They want affection and acceptance and fantasize over idealized relationships. The avoidance behaviors also adversely affect occupational functioning because of the fear the individuals have of social situations. They may try to avoid situations that are important for jobs and advancements.
- These individuals are fearful of the possibility of criticism, rejection, or disapproval and therefore, will usually not engage in social relationships unless they are assured of being liked. However, these individuals desire affection and thus are often lonely and bored. They may even go to the extreme where they avoid work situations that involve a lot of interpersonal situations and contacts. Being alone is not enjoyed and is caused by their inability to relate to others, which causes extreme anxiety and often leads to low self-esteem and being excessively self-conscious. Ridicule and rejection are seen when in fact none exists. Also, they also tend to say or do little when they have to be involved in social situations because they are fearful that they will say something silly or foolish. They see themselves as being incompetent, inferior to other people, and are not risk takers. They generally do not get involved in or with new activities.
- Co-morbidity is often displayed with Dependent Personality Disorder. This occurs because when a friend or friends are made, they become