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Avoidant personality disorder

Definition

Avoidant personality disorder is a mental health condition in which a person has a lifelong pattern of feeling very 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. Both males and females have the condition equally. The cause is unknown.

Symptoms

People with avoidant personality disorder can't stop thinking about their own shortcomings. They form relationships with other people 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 when people criticize or disapprove of them
  • Hold back too much in intimate relationships
  • Be reluctant to become involved with people
  • Avoid activities or jobs that involve contact with others
  • Be shy in social situations out of fear of doing something wrong
  • Make potential difficulties seem worse than they are
  • Hold the view they are not good socially, not as good as other people, or unappealing

Treatment

Antidepressant medications can often make people less sensitive to rejection. However, talk therapy (psychotherapy) is considered to be the most effective treatment for this condition.

Psychodynamic psychotherapy, which helps patients understand their thoughts and feelings, and cognitive behavioral therapy (CBT) can help. 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

Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and personality disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008;chap 39.


Review Date: 11/23/2010
Reviewed By: Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Michelle Benger Merrill, MD, Instructor in Clinical Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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