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Avoidant personality disorder

Definition

Avoidant personality disorder is a psychiatric condition in which a person has a lifelong pattern of feeling extremely shy, inadequate, and sensitive to rejection.

Alternative Names

Personality disorder - avoidant

Causes, incidence, and risk factors

Personality disorders are lifelong patterns of behavior that cause problems with work and relationships.

About 1% of the population has avoidant personality disorder. It is equally divided between males and females. The cause is unknown.

Symptoms

People with avoidant personality disorder are preoccupied with their own shortcomings. They form relationships with others only if they believe they will not be rejected. Loss and rejection are so painful that these people will choose to be lonely rather than risk trying to connect with others.

Signs and tests

A person with avoidant personality disorder may:

  • Be easily hurt by criticism or disapproval
  • Hold back too much in intimate relationships
  • Be reluctant to become involved with people
  • Avoid activities or occupations that involve contact with others
  • Be shy in social situations out of fear of doing something wrong
  • Exaggerate potential difficulties
  • Hold the view they are socially inept, inferior,or unappealing to other people

Treatment

Antidepressant medications can often reduce sensitivity to rejection. Psychotherapy, particularly cognitive-behavioral approaches, may be helpful. A combination of medication and talk therapy may be more effective than either treatment alone.

Expectations (prognosis)

People with this disorder may develop some ability to relate to others, and this can be improved with treatment.

Complications

Without treatment, a person with avoidant personality disorder may become resigned to a life of near or total isolation. They may go on to develop a second psychiatric disorder such as substance abuse or a mood disorder such as depression.

Calling your health care provider

See your health care provider or a psychiatrist if shyness or fear of rejection overwhelms your ability to function in life and relationships.

References

Moore DP, Jefferson JW. Avoidant personality disorder. In: Moore DP, Jefferson JW, eds. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004: chap 141.


Review Date: 10/17/2008
Reviewed By: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Timothy A. Rogge, MD, private practice in Psychiatry, Kirkland, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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