Avoidant Personality Disorder: Expanding Social Skills

Michelle Pugle
·5 min read
3

Medically reviewed by Kira Graves, PhD

Avoidant personality disorder (AVPD) is a personality disorder listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Symptoms or traits include feelings of inadequacy, fear of criticism or rejection, social anxiety, and avoiding or severely restricting social interactions and new life experiences.

Psychiatrists diagnose personality disorders, but other mental health professionals working under social health models may provide different diagnoses and perspectives.

This article discusses AVPD, including nuances of high functioning AVPD. We’ll also cover the standard treatment options for AVPD, and offer a trauma-informed lens to understanding the characteristic signs and symptoms of AVPD.

<p>SDI Productions / Getty Images</p>

SDI Productions / Getty Images

Related:

Official Avoidant Personality Disorder Diagnostic Criteria

Avoidant personality disorder is said to lead to distress, impairment, and disability. Getting a diagnosis can help determine next steps for treatment. The criteria for an official avoidant personality disorder diagnosis involve assessing whether or not a person meets at least four of the seven characteristic traits of avoidant personality disorder.

Psychiatrists may provide an official avoidant personality disorder diagnosis after asking a series of questions about:

  • Your social patterns and relationship history

  • Your feelings about self-worth and core relationships

  • How you cope with criticism and rejection (and particularly if you avoid social situations or experience fear leading to increased isolation

During the diagnostic process, a physical and medical exam will also rule out other underlying conditions contributing to behavior changes or deviations.

Related: Mental Health

Symptoms and Traits of Someone With AVPD

Signs of personality disorders typically start to present in adolescence or early adulthood.



7 Traits of AVPD

According to the DSM-5, the seven traits associated with AVPD include:

  • Avoiding work activities that require lots of collaboration or interpersonal contact due to your fears of being criticized or rejected

  • Not engaging with others unless you feel confident that the others will accept or like you

  • Being driven by fear of shame and scrutiny or ridicule, ultimately limiting someone’s ability to be fully present and engaged

  • Feeling anxious in social settings due to the persistent fear of rejection or disapproval.

  • Having feelings of inadequacy or unworthiness that keep you from being involved in new social settings

  • Having low feelings of self-worth or a strongly negative perception of your own social skills, personality, and adequacy

  • Feeling fear so strongly that you may be highly reluctant to take personal risks or try out new activities





Social Anxiety Disorder or AVPD?


Some mental health models see avoidant personality disorder as an extreme expression or severe variant of social anxiety disorder (SAD). Research suggests the core overlap of social anxiety disorder and avoidant personality disorder is nonassertiveness; the difference is social anxiety disorder is associated with lower levels of social distress than avoidant personality disorder and higher levels of phobic anxiety.



Related: Anxiety Disorders

Causes: What Does AVPD Stem From?

Avoidant personality disorder is said to be caused by genetic factors and environmental factors, including exposure to trauma. The causes of personality disorders are complex partly because personality is a social and cultural concept. Personality disorders may be diagnosed when someone deviates from cultural norms or expectations. Depending on perspective, this deviation is seen as a psychological disorder or disability or as a trauma response.



AVPD or PTSD-C (CPTSD)?


There is an established link between personality disorders and exposure to trauma. Some mental health professionals may talk about symptoms or traits of complex post-traumatic stress disorder (PTSD-C) instead of avoidant personality disorder. However, a defining feature of PTSD-C includes emotional flashbacks of the trauma and distressing, vivid nightmares. These are not part of the diagnostic criteria for avoidant personality disorder.



Medications to Help With AVPD

There are no medications to treat avoidant personality disorder. However, if someone is experiencing social anxiety, generalized anxiety, or depression. In addition to avoidant personality disorder, they may be prescribed antianxiety or antidepressant medication to help reduce symptom severity.

Related: Prozac (Fluoxetine) vs. Zoloft (Sertraline): Which Is Right For You?

How to Address AVPD in Therapy

Addressing avoidant personality disorder in therapy can help to determine what's triggering your symptoms and prepare you with tools for expanding their social skills and building self-esteem and confidence.

Cognitive behavioral therapy (CBT) is the most common method for addressing avoidant personality disorder symptoms and traits. CBT is about gaining new insight into your thinking patterns and how they may have affected your work or school, relationships, health, and more. Then, it’s about learning new tools and strategies for shifting the thinking that influences the behavior and helps develop deeper self-confidence.

In addition to talk therapy, eye movement desensitization and reprocessing therapy (EMDR) is an option for trauma processing, which can help reduce symptoms of traumatic stress and chronic traumatic stress.

Related: Best Online Therapy for Anxiety

Support and Resources

The following support and resources may be helpful for someone experiencing symptoms and traits of avoidant personality disorder, anxiety and depression, or PTSD-C:



Takeaway

If you or a loved one is struggling with AVPD, anxiety, depression, or PTSD-C, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database.




Summary

Avoidant personality disorder is characterized by extreme social anxiety, shame, feelings of inadequacy, fear of criticism and rejection, and avoidance of social interactions. These symptoms can be distressing and disabling. Causes include genetic and environmental factors, including exposure to trauma.

Therapy can help someone gain insight into their thought and behavioral patterns in order to make desired life changes. Medication can help reduce symptoms like anxiety and depression. If you are experiencing signs or symptoms of AVPD, consulting with your healthcare provider or mental health professional can help shed light on potential causes and treatment options.

Read the original article on Verywell Health.