Avoidant personality disorder, abbreviated as AvPD, is sometimes referred to as Anxious personality disorder, and it is believed to affect men and women in equal numbers. Estimates of its prevalence range from two to five percent of the adult population.
For people who suffer with AvPD extreme shyness and fear of rejection make it extremely difficult to interact with others socially and professionally. These individuals are not simply shy; they are crippled by extreme feelings of inadequacy and self-loathing. Their feelings of inadequacy have permeated every aspect of their lives leaving them lonely, depressed, and often isolated.
People with AvPD are uncomfortable and restrained in social situations, overwhelmed by feelings of inadequacy, and extremely sensitive to negative criticism. They are often so fearful of being rejected that they give no one an opportunity to reject or accept them. People with this disorder believe themselves to be unappealing or inferior to others. They exaggerate the potential difficulties of new situations and seldom take risks or try new activities. They often feel alone and depressed. As a result, some people with this personality disorder develop an inner world of fantasy and imagination.
In order to receive a diagnosis of AvPD the Psychiatric DSM 4th edition states that at least four of the following seven criteria must be met:
- Avoids activities that involve interpersonal contact
- Avoids getting involved due to a fear of not being liked by others
- Restraint in intimate relationships due to a fear of shame or ridicule
- Marked preoccupation of being rejected or criticized by others
- Stays away from new interpersonal situations due to feelings of inadequacy
- Views oneself as inferior, socially inept, or personally unappealing
- Takes few if any personal risks in the engagement of new activities, for a fear of being embarrassed
The cause of Avoidant Personality Disorder is unknown. However, like other personality disorders it is believed to have a genetic, a psychological, and a social component. Many people diagnosed with AvPD have had painful early experiences of chronic parental criticism or rejection. A combination of genetic traits and child abuse/neglect is most often associated with the disorder, but no conclusive study exists.
Like all personality disorders, the long-term outlook for these patients is not good. However, antidepressant and anti-anxiety medications can often provide symptom relief and reduce the sensitivity to rejection. Psychotherapy, particularly cognitive-behavioral approaches, can also be helpful. A combination of medication and talk therapy may be more effective than either treatment alone. Avoidant personality disorder is perhaps the most responsive to treatment of all of the personality disorders.
Examples of movie/film characters who display Avoidant personality disorder:
- Woody Allen as Leonard Zelig, Zelig, 1983
- Andie MacDowell as Ann Bishop Mullany, Sex Lies and Videotape, 1989
Source material: APA 2000, DSM-IV, IMDB.com