What Is Avoidant Personality Disorder?

Avoidant personality disorder (AVPD) is a personality disorder that is characterized by extensive avoidance of social interaction. People with this condition may have difficulty engaging in social situations and forming relationships due to feelings of inadequacy and a sensitivity to rejection. It affects approximately 2.5% of the population.

This article will discuss the characteristics of AVPD, as well as how the condition is diagnosed and treated.

What Are Symptoms of Avoidant Personality Disorder?

Avoidant personality disorder (AVPD) is classified as a personality disorder. It is characterized by avoidance of social interaction and difficulty forming and maintaining relationships because of fears of rejection and feelings of personal inadequacy.

People with AVPD assume others will reject them, regardless of whether this is based in reality. In addition to this preconceived expectation, they believe this perceived rejection reflects inferiority or inadequacy on their part. They believe the rejection is warranted, even when the rejection does not objectively exist.

People with AVPD are highly sensitive to criticism. In an attempt to manage this, they engage in widespread avoidance of social interaction, often even in existing relationships.

People with AVPD may also suppress their emotions, both positive and negative ones, in an attempt to protect themselves from rejection. This emotional suppression often occurs in and out of close relationships.

This pattern of behavior makes it very difficult for people with AVPD to form and maintain relationships (including friendships). It can impact other areas of their life such as employment or education.

The hallmark characteristics of AVPD are:

• Social inhibition
• Feelings of inadequacy
• Sensitivity to criticism or rejection

People with AVPD:

• Are oversensitive and become hurt easily by criticism, disapproval, or rejection
• Have difficulty making and maintaining friendships and relationships and are hesitant to interact with people without being certain of acceptance
• Avoid activities or jobs that involve being around others due to the extreme anxiety and fear they feel in social settings and in relationships
• Are typically shy, awkward, and self-conscious in social situations because they worry they will do or say something wrong or be embarrassed
• Often exaggerate potential problems
• Rarely take chances or try new things
• Have a negative self-image, seeing themselves as inadequate and inferior to others

For a person to meet the criteria of avoidant personality disorder, the symptoms have to be severe, chronic and persistent. The symptoms must also exist outside of any period of depression or other mood episode.

What Causes AVPD?

An exact cause of AVPD isn't known, but it's believed to be a combination of genetic and environmental factors.

Some studies suggest risk factors for AVPD include negative childhood experiences, childhood/adolescent anxiety disorders, or an illness that changes physical appearance.

One 2015 study suggests that abuse and/or neglect during childhood is also a risk factor for AVPD.

Temperament and attachment styles may also contribute to the development of AVPD.

How Is AVPD Diagnosed?

Symptoms of AVPD often appear in childhood and may become more intrusive in adolescence, but AVPD is not typically diagnosed before age 18.

The first point of contact for a diagnosis of AVPD is usually a primary healthcare provider.

Typically, a healthcare provider will:

• Talk to you about your symptoms and ask you related questions
• Ask for your personal medical and family history
• Do a physical exam
• Run other tests to look for or rule out a physical reason for the symptoms, if warranted
• Make a referral to a mental health professional, if necessary

A mental health professional is able to use more specialized assessment tools such as interviews and evaluations. This can help with a more precise diagnosis.

Treatment for AVPD

Research is lacking when it comes to treatment for AVPD. Currently, psychotherapy (talk therapy) is the go-to treatment for AVPD.

• Cognitive behavioral therapy (CBT): This is the most used therapy for AVPD. It involves recognizing and identifying problematic thinking processes and behavior patterns, then changing them into healthy, productive ones
• Schema therapy: This type of therapy is emerging as a potentially effective treatment for AVPD. It's based on the principles of CBT but uses cognitive, behavioral, and emotion-focused techniques to change long-held, entrenched, self-defeating life patterns.

Both therapies can be done in an individual setting, a group setting, or a combination of both.

Prognosis for AVPD

With a commitment to treatment, symptoms of AVPD can improve. It is a long process and is more successful when the person is willing to seek out treatment and stick with it.

Treatment is more likely to be successful when the person's family members are involved and supportive during the process.

Without treatment, a person with AVPD may become increasingly isolated from society. This may cause ongoing or long-term problems in relationships, employment, or social interaction.

Without treatment, people with AVPD are at an increased risk of developing other conditions such as depression. They are also at risk for substance use disorder and suicidal thoughts and actions.

Coping With AVPD

In addition to professional treatment, there are ways to take care of yourself, such as:

• Practice healthy habits: Eat a diet rich in healthy foods, exercise, and get plenty of quality sleep
• Work on developing social skills: In addition to therapy, classes are available to help practice and develop social skills. Ask your therapist for recommendations
• Take it slowly: Working on improving AVPD symptoms will come with some uneasiness as you leave your comfort zone, but it's okay to ease into it. Work with your therapist on a plan that works toward your goal but is manageable for you.
• Look for activities you enjoy: Engaging with other people who have a shared interest, while doing something you like, can decrease the stress involved. It's also a built-in conversation starter
• Stick with your treatment plan: Although it will feel difficult at times, staying with your treatment plan is the best way to reach success. If you are struggling or have a problem with your treatment, discuss your concerns with your healthcare provider or mental health professional
  

Summary

AVPD is a personality disorder characterized by social avoidance and sensitivity to rejection. It often appears in childhood or adolescence but is usually diagnosed in early adulthood.

AVPD is believed to be caused by a combination of genetic and environmental factors.

Treatment for AVPD is typically psychotherapy. Medication is not usually prescribed for AVPD unless there is a comorbid condition that needs to be addressed.

A Word From Verywell

AVPD can be difficult to treat, but improvement in your symptoms is possible. If you are experiencing social anxiety and avoidance, see your healthcare provider for a diagnosis and an action plan.