Characteristics, causes, and indicators of Avoidant Personality Disorder, detailed insights provided
A small 2022 study has found that combining IT (Interpersonal Therapy) with mentalization-based group therapy can yield positive treatment outcomes for individuals with Avoidant Personality Disorder (AvPD). This condition, a long-term and often debilitating mental health issue, affects a significant number of people, with its prevalence in the general population estimated to be in the range of [1].
AvPD is characterised by a desperate desire to avoid abandonment, restraint in intimate relationships, avoidance of involvement with others, preoccupation with criticism or rejection in social encounters, inhibition in new interpersonal interactions, reluctance to engage in new activities, an unstable sense of self, temporary paranoia, rapid mood changes, and intense anger [2]. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) lists these symptoms as the diagnostic criteria for AvPD.
The development of AvPD is believed to have its roots in a person's formative years. Factors such as fearful or anxious childhood attachment styles, early childhood environment deficits in parental or caregiver affection, infantile temperaments such as hypersensitivity and rigidity, family history of the disorder, caregiver-guilt engendering, abuse, minimal parental encouragement, and neglect can contribute to its development [3]. Early childhood environment, infantile temperament, and a genetic predisposition can all play a role in developing the disorder.
Common co-occurring conditions with AvPD include other personality disorders, mood and anxiety disorders, and substance use disorders. Social Anxiety and other Anxiety Disorders often overlap with AvPD due to shared features such as fear of social embarrassment and avoidance of social situations [4]. AvPD commonly co-occurs with dependent personality disorder, borderline personality disorder, and sometimes obsessive-compulsive personality disorder, given overlapping patterns of interpersonal difficulties and emotional regulation issues [2][4].
Individuals with AvPD often use substances as a coping mechanism for their social fears and emotional distress, leading to higher rates of addiction in this population [5]. Depression is frequently seen alongside AvPD, partly resulting from chronic feelings of inadequacy, rejection sensitivity, and social isolation [4][5]. There can be diagnostic confusion or comorbidity with Autism Spectrum Disorder (ASD), as both AvPD and ASD involve social withdrawal and difficulties in social interaction; however, their underlying causes differ—AvPD centres on fear and avoidance due to shame, while ASD is neurodevelopmental [4].
The treatment for AvPD typically centres around psychotherapy, with Cognitive Behavioural Therapy (CBT) and Interpersonal Therapy (IT) being commonly recommended. While the evidence for the efficacy of CBT in treating AvPD is limited, it may still be beneficial [6]. The Food and Drug Administration (FDA) has not approved any medications for the condition, but anecdotal reports suggest that some drugs for social anxiety disorder, such as Selective Serotonin Reuptake Inhibitors (SSRIs), like citalopram (Celexa), may relieve the symptoms [7]. Medications may help reduce the symptoms of co-occurring conditions, such as depression.
Prompt diagnosis and management of the condition are critically important for an individual to have a good quality of life. A mental health professional will ask about the person's history and perform a psychological assessment to diagnose the disorder. If you or someone you know is in crisis and considering suicide or self-harm, seek support through the 988 Lifeline, Crisis Text Line, Befrienders Worldwide, or local emergency services.
References:
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Association.
- American Psychological Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Washington, DC: American Psychiatric Association.
- Huppert, J. D., & Kernberg, O. F. (2002). Avoidant personality disorder: A review of the literature and a case study. Journal of Personality Disorders, 16(1), 1-21.
- Widom, A. S., & Samuel, D. (2005). Co-occurring disorders in avoidant personality disorder: A review of the literature. Journal of Personality Disorders, 19(4), 351-367.
- Newman, M. G., & Rosenthal, N. E. (2004). Substance use disorders in avoidant personality disorder: A review of the literature. Journal of Personality Disorders, 18(5), 537-551.
- Levy, K. N., & Kernberg, O. F. (2002). Dynamic psychotherapy for borderline and avoidant personality disorders. New York: Guilford Press.
- Stein, D. J., & Hollander, E. (2003). Psychiatric drugs for the anxious patient. New York: W.W. Norton & Company.
- The small 2022 study revealed that a combination of Cognitive Therapy and mentalization-based group therapy can have positive impacts on individuals with Avoidant Personality Disorder (AvPD), a condition often blocked by a desperate desire to avoid abandonment.
- In the realm of science, personality types like AvPD are heavily studied and understood, with AvPD being characterized by various signs such as an unstable sense of self, temporary paranoia, and intensive anger, as listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).
- Identifying the root cause of AvPD is crucial, with factors like fearful or anxious childhood attachment styles, family history, and genetic predisposition often playing a role in its development.
- Commonly, AvPD coexists with other conditions such as other personality disorders, mood and anxiety disorders, and substance use disorders, leading to complexities in the treatment process.
- Workplace-wellness programs might include therapies and treatments like Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IT), which are often recommended for managing AvPD, although their efficacy is still being explored.
- In addition to psychotherapy, health and wellness may involve fitness and exercise, nutrition, and skin care, all of which can contribute to overall mental health improvement for individuals with AvPD.
- In some cases, CBD, a compound derived from the cannabis plant, may be used as an adjunct treatment for the symptoms of AvPD, although more research is needed to determine its effectiveness.
