People with avoidant personality disorder are afraid of being rejected, criticized, or embarrassed and thus avoid situations where they may experience such reactions.
Doctors diagnose avoidant personality disorder based on specific symptoms, such as avoiding situations that involve interpersonal contact because of fear of rejection and disapproval or feelings of being socially incompetent, unappealing, or inferior to others.
People with this disorder may benefit from cognitive-behavioral therapy, other psychotherapies, and antianxiety drugs and antidepressants.
Personality disorders Overview of Personality Disorders Personality disorders are long-lasting, pervasive patterns of thinking, perceiving, reacting, and relating that cause the person significant distress and/or impair the person's ability to function... read more are long-lasting, pervasive patterns of thinking, perceiving, reacting, and relating that cause the person significant distress and/or impair the person's ability to function.
People with avoidant personality disorder feel inadequate. They manage these feelings by avoiding situations in which they may be evaluated negatively.
Avoidant personality disorder occurs in over 2% of the general population in the United States. It affects men and women equally.
Other disorders are also often present. They include one or more of the following:
Major depressive disorder Major depressive disorder A short discussion of prolonged grief disorder. Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to... read more or persistent depressive disorder Persistent depressive disorder A short discussion of prolonged grief disorder. Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to... read more
An anxiety disorder Overview of Anxiety Disorders Anxiety is a feeling of nervousness, worry, or unease that is a normal human experience. It is also present in a wide range of psychiatric disorders, including generalized anxiety disorder,... read more , such as panic disorder, particularly social phobia Social Phobia Social phobia is fear or anxiety about certain social or performance situations. These situations are often avoided or endured with much distress. Humans are social animals, and their ability... read more (social anxiety disorder)
Another personality disorder (such as dependent Dependent Personality Disorder Dependent personality disorder is characterized by a pervasive, excessive need to be taken care of, leading to submissiveness and clinging behaviors. People with dependent personality disorder... read more or borderline Borderline Personality Disorder (BPD) Borderline personality disorder is characterized by a pervasive pattern of instability in relationships, self-image, moods, and behavior and hypersensitivity to possible rejection and abandonment... read more )
People who have social phobia and avoidant personality disorder have more severe symptoms and are more disabled than those who have only one of the disorders.
Causes of Avoidant Personality Disorder
Genes and environmental factors may contribute to the development of avoidant personality disorder. For example, people may have an inborn anxiety in social situations, and/or they may experience rejection and marginalization during childhood. Avoidance in social situations has been observed in children as young as about 2 years old.
Symptoms of Avoidant Personality Disorder
Fear of rejection
People with avoidant personality disorder avoid social interaction, even at work, because they fear that they will be criticized or rejected or that people will disapprove of them. For example, they may do the following:
They may refuse a promotion because they fear coworkers will criticize them.
They may avoid meetings.
They may avoid making new friends unless they are sure they will be liked.
People with this disorder assume others will be critical and disapproving until there is clear-cut, indisputable proof to the contrary. Thus, before joining a group and forming a close relationship, people with this disorder require repeated assurances of support and uncritical acceptance.
People with avoidant personality disorder are reluctant to talk about themselves lest they be mocked or humiliated.
People with this disorder are very reluctant to take risks or participate in new activities for similar reasons. In such cases, they tend to exaggerate the dangers and use minimal symptoms or other problems to explain why they are not participating. They may prefer a limited lifestyle because of their need for security and certainty.
Extreme sensitivity to criticism
People with avoidant personality disorder are very sensitive to anything critical, disapproving, or mocking because they constantly think about being criticized or rejected by others. They are vigilant for any sign of a negative response to them. Their tense, anxious appearance may elicit mockery or teasing, thus seeming to confirm their self-doubts.
Other symptoms
Low self-esteem and a sense of inadequacy inhibit these people in social situations, especially new ones. They hold back in interactions with new people because they think of themselves as socially inept, unappealing, and inferior to others. They tend to be quiet and timid because they tend to think that if they say anything, others will say it is wrong.
People with avoidant personality disorder long for social interaction but fear placing their well-being in the hands of others. Because these people with avoidant personality limit their interactions with others, they tend to be relatively isolated and to lack a social network that could help them when they need it.
Diagnosis of Avoidant Personality Disorder
A doctor's evaluation, based on specific criteria
Doctors usually diagnose personality disorders based on criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5 Classification and Diagnosis of Mental Illness In 1980, the American Psychiatric Association published the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), marking the first attempt to approach the diagnosis... read more ), published by the American Psychiatric Association.
For doctors to diagnose avoidant personality disorder, people must persistently avoid social contact, feel inadequate, and be hypersensitive to criticism and rejection, as shown by at least four of the following:
They avoid job-related activities that involve interpersonal contact because they fear that they will be criticized or rejected or that people will disapprove of them.
They are unwilling to get involved with people unless they are sure of being liked.
They are reserved in close relationships because they are afraid of being ridiculed or humiliated.
They are preoccupied with being criticized or rejected in social situations.
They are inhibited in new social situations because they feel inadequate.
They view themselves as socially incompetent, unappealing, or inferior to others.
They are reluctant to take risks or participate in any new activity because they may be embarrassed.
Also, symptoms must have begun by early adulthood.
Treatment of Avoidant Personality Disorder
Cognitive-behavioral therapy that focuses on social skills
Other types of psychotherapy
Antianxiety drugs and antidepressants
General treatment Treatment Personality disorders are long-lasting, pervasive patterns of thinking, perceiving, reacting, and relating that cause the person significant distress and/or impair the person's ability to function... read more of avoidant personality disorder is similar to that for all personality disorders.
People with avoidant personality disorder may avoid treatment.
If people have social phobia and avoidant personality disorder, the following treatments can be effective:
Cognitive-behavioral therapy Psychotherapy Extraordinary advances have been made in the treatment of mental illness. As a result, many mental health disorders can now be treated nearly as successfully as physical disorders. Most treatment... read more that focuses on acquiring social skills, done in groups
Other group therapies if the group consists of other people with the same difficulties
People with avoidant personality disorder benefit from
Individual therapies that are supportive and are considerate of the person's hypersensitivity to rejection and criticism
Psychodynamic psychotherapy Psychodynamic psychotherapy Extraordinary advances have been made in the treatment of mental illness. As a result, many mental health disorders can now be treated nearly as successfully as physical disorders. Most treatment... read more may be helpful. This type of psychotherapy focuses on underlying conflicts.
Antidepressants Drug therapy for depression A short discussion of prolonged grief disorder. Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to... read more , such as selective serotonin reuptake inhibitors (SSRIs), and antianxiety drugs Drugs Used to Treat Anxiety Disorders 
can help reduce anxiety enough to enable people to manage new social situations.
