Information about avoidant personality disorder – its presentation, symptoms and treatment options.

Beliefs, emotions and behaviour

A person with an avoidant personality is likely to hold strong beliefs that they are defective, inadequate or different. They have a fear that others will reject them or laugh at them if they show their real selves. Individuals have a poor self concept and have learnt to manage their thoughts through avoidance.

Missing Interpersonal Ability:

Self Confidence.

This personality is characterised by high levels of social anxiety.  The person wants others to like them and to have relationships, but are too sensitive to the possibility of criticism, rejection, or disapproval.  Therefore they are fearful to enter into relationships unless they are sure they will be liked. 

An individual with this personality may avoid employment that involves a lot of contact with others.  They will be quiet and introverted in social situations as they are scared of embarrassing themselves and are likely to come across as shy and awkward.  

How does avoidant personality disorder differ from generalised anxiety disorder?

There are several similarities between avoidant personality disorder and generalised anxiety disorder. Both include social fears, high levels of social anxiety and social avoidance.  Research suggests that individuals who have a diagnosis of both disorders are likely to have greater symptoms and distress and more impairment in their ability to do things.  This means that avoidant PD has a greater impact on a persons life than anxiety disorders.   

An individual with an avoidant personality is likely to show significant fears of rejection and feelings of inadequacy which leads to avoidant behaviour. Someone with social anxiety disorder may not have these beliefs and behaviour.  Also, individuals with a social anxiety disorder may have periods where they become better, or it may be a shorter-term reaction to stress. Avoidant PD is seen as being persistent and personality driven.

Jada drinks excessively when she goes out to social events and drinks at home alone as well.  She has a few friends that she has known since childhood but struggles to know what to say when she meets new people, fearful that they will not like her. 

She works as a shop assistant, a job which means she doesn’t need to speak to others very often.  As a child, Jada was shy and quiet, with a strict mother who would only give her affection when she behaved perfectly.  She describes always being on the outskirts of things. There are lots of activities that she would like to try but is too scared to in case other people judge her.  

As an adult, she is good at her job but is quiet and timid which makes it hard for others to get to know her.  She feels this as a rejection, so goes into herself even more.  Jada has had some boyfriends but has stopped the relationship when it has started to become more serious as she is scared of embarrassing herself.  She would love to have a partner but is too scared to take this step, in case she gets hurt.

example presentation

DSM V Criteria

For someone to be diagnosed with Avoidant Personality Disorder, they would need to show four of the seven items below to a degree that they caused long term, pervasive problems in their life:

• Avoids occupational activities involving significant interpersonal contact, due to fears of criticism, disapproval, or rejection
• Is unwilling to get involved with people unless certain of acceptance
• Shows restraint within intimate relationships due to fears of shame or ridicule
• Preoccupied with fears of receiving criticism or rejection in social situations
• Inhibited in new interpersonal situations due to feelings of inadequacy
• Considers self as inferior to others, socially inept, or personally unappealing
• Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing

What is the treatment for Avoidant Personality Disorder?

If you think you may have this Personality Disorder, please contact your GP in the first instance to discuss treatment options. There are currently no formal recommendations around the treatment of avoidant PD.  However, there is some emerging research in this area.

People with avoidant PD may benefit from therapy that addresses their symptoms around anxiety.  As such, CBT for anxiety/ depression is one option.   For individuals who feel that they want to understand their avoidance in more depth, Schema Therapy can be helpful.  Other therapies could include mentalisation based therapy, as individuals with avoidant PD have been found to have limits in their ability to mentalise. 

Medication may be given that treats the anxiety aspect of this disorder, although there are no specific recommended medical treatments at present. 

Further Information

Information on the DSM V criteria of avoidant PD

Youtube clip explaining avoidant PD