Avoidant Personality Disorder Test, Symptoms, and AVPD Treatment

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Avoidant Personality Disorder Test, Symptoms, and AVPD TreatmentAvoidant personality disorder is one of 10 personality disorders identified in the Diagnostic and Statistical Manual of Mental Disorders (DSM) V. Learn what the symptoms look like, how it is diagnosed, different treatment options, a case study and how to find a qualified therapist for help.

Avoidant Personality Disorder Definition

Man with avoidant personality disorder facing the ocean

Avoidant personality disorder is a psychiatric condition characterized by long-standing and enduring patterns of behaving in ways that appear to others as extreme shyness, social ineptitude/awkwardness, and low self-esteem.

Avoidant Definition – Personality Definition: Psychology Terms

Being avoidant as a personality trait means that the individual characteristically avoids social interaction. Intimacy will be highly uncomfortable for an avoidant individual and they typically have few close relationships.

Socially Inept Meaning

The social ineptitude that is a hallmark of the disorder can be described as having little skill in social interactions or being clumsy in all interpersonal interactions.

Avoidant Personality Disorder Statistics: How Many Suffer from this Disorder?

According to the DSM V avoidant personality disorder is seen in approximately 2.4% of the population.

Demographics

Statistics report that the disorder occurs equally between males and females with no specific cultural/race differences noted.

Avoidant personality disorder DSM V: What Does This Mean for Everyday Life?

The sufferer experiences feelings of inadequacy, heightened fear of rejection and preoccupation with how they do not measure up in comparison to others. The individual will often struggle with work and school attendance as they find it too painful to show up for their commitments.

Poor social skills can be seen in the individual’s limited ability to read body language, recognize conversational cues or interpret the meaning behind what’s actually being said. If an individual struggling with avoidant personality disorder does show up for a social event, they would be perceived as highly awkward in the environment. Their own experience of that event would likely be one in which they were highly uncomfortable as they considered the various ways in which they were being judged and not fitting in.

More Than Being Socially Awkward

However, this social awkwardness that is seen on the outside and experienced by others goes much deeper for the sufferer of the disorder. The individual is highly sensitive to rejection and can easily misinterpret a social cue as a rejection. They tend to show excessive amounts of restraint in intimate relationships, leading to a limited depth in relationships. The low self-esteem inherent in a sufferer of avoidant personality disorder can only be intensified when they have such limited social contact and the contact they do have is often clumsy and awkward.

Avoidant Personality Disorder Symptoms Include:

  • Preoccupation with thoughts and feelings of being inadequate in comparison to others
  • Low self-esteem
  • No close, intimate relationships/friendships
  • Clear avoidance of social/occupational activities
  • Aversion to taking personal risks
  • Socially awkward/inept

What are the Common Behaviors/Characteristics?

This individual may miss work and school commitments because the pain of the rejection and the low self-esteem is so alive and monumental for them that they feel as though they cannot show up. This avoidance creates a succession of social consequences, including financial issues,  housing issues, and work issues.

Causes of Avoidant Personality Disorder

It is likely that the cause of avoidant personality disorder is a  combination of genetic/biological conditions, social factors and psychological factors that include a person’s personality and temperament. There does not appear to be one clear, definitive, single causative factor, although some research suggests a smaller increase in prevalence in families where a parent has the diagnosis.

How is AVPD diagnosed/Avoidant Personality Disorder Test?

Avoidant personality disorder is diagnosed by a qualified mental health professional comparing the symptoms and life history noted above.

Avoidant Personality Criteria

A diagnosis is made based on whether the individual meets the criteria of the diagnosis as listed in the DSM V. The DSM V code for avoidant personality disorder as F60.6 and four of seven specific criteria should be present for diagnosis, which includes the following:

  1. Avoids occupational activities that involve significant  interpersonal contact, because of fears of criticism, disapproval, or  rejection
  2. Is unwilling to get involved with people unless certain of being liked
  3. Shows restraint within intimate relationships because of the fear of being shamed or ridiculed
  4. Is preoccupied with being criticized or rejected in social situations
  5. Is inhibited in new interpersonal situations because of feelings of inadequacy
  6. Views self as socially inept, personally unappealing, or inferior to others
  7. Is unusually reluctant to take a personal risk or to engage in any new activities because they may prove embarrassing

Avoidant Personality Disorder vs Social Anxiety

It can be challenging to discern the differences between social anxiety and avoidant personality disorder. They are similar in that there is a significant preoccupation with what others will think of them and intense fear of rejection. Personality disorders, such as avoidant, are usually noticed in childhood and persist into adulthood. This may not be the case with social anxiety.

Avoidant personality disorder may be at the end of a spectrum of social disorders of the mind and emotions. The sufferer will appear to have more symptoms in avoidant personality disorder and those symptoms will be more severe.

Additionally, social anxiety may intensify in certain social situations and be less intense in others, where avoidant personality disorder is consistent in its intensity across all settings.

Related Conditions

Avoidant Personality Disorder falls within the cluster C personality disorders in the DSM V along with two other personality disorders. You will find dependent personality disorder and obsessive-compulsive personality disorder in this cluster. All of these disorders share the feature of high anxiety.

Case Example for AVPD

Mark is a 28-year-old male who recently graduated college from an online university. He comes to treatment because he has been trying to find a job, but is struggling with the interview and the process. Mark reports that he had a girlfriend in high school but hasn’t really dated since. He states that girls always laugh at him and he can’t tolerate the feelings he has when he sees women laughing at him.

He says that this happens everywhere he goes and he is less likely lately to go out and interact with people because he always leaves feeling angry, rejected, sad, hurt and overwhelmed.

Mark denies any prior treatment but reports that he has always felt this way, as long as he can remember. He says the older he gets the meaner people to treat him. He had a job at Subway for a short while, but he kept getting passed over for promotions and his coworkers were always excluding him from the fun things they were doing outside of work. He says he tried a couple of times to get involved, but they ignored him and he gave up because he feels like most people are smarter and more fun than he is and that he has very little to offer.

Donny Osmond and Kim Basinger both suffer from avoidant personality disorder and report that they experience extreme fear and anxiety when having to perform.

AVPD Leave Policies

Each employer will have a particular policy for leave as it relates to mental illness and that policy would extend to avoidant personality disorder. An individual suffering from avoidant personality disorder should contact their human resource department for medical leave specifics.

How to Deal with Avoidant Personality Disorder

If you have a loved one struggling with the disorder, you can help them by gently addressing some of the symptoms you noticed and encouraging them to find help. The behaviors exhibited may leave you feeling out of sorts about the relationship. Just know that the way the sufferer behaves stems from significant sensitivity about themselves in the world and relationship and not about you.

Look out for These Complications/Risk Factors

If the disorder is complicated by a co-occurring disorder (substance abuse or other mental illness), those issues must be managed in a  therapeutic setting as well.

Avoidant Personality Disorder Treatment

The most effective treatment for personality disorders is psychotherapy. Based on the nature of this disorder, group therapy may present many obstacles that may be hard for the individual to overcome. Short term, individual treatment focused on creating skills and strategies to manage the feelings of rejection and avoidant behaviors have the most value. Cognitive Behavioral Therapy (CBT) has been found to be one of the most effective therapies for this population, providing insights into thinking patterns and plans for managing symptoms.

Possible Medications

Medications such as anti-depressants and anti-anxiety medication would be helpful if the sufferer has a co-morbid diagnosis of either depression or anxiety only.

Home Remedies to Help Manage Avoidant Personality Disorder and Social Inhibition

Most people, including those suffering from avoidant personality disorder, would benefit from a practice of self-care.

In tuning in to our own needs, the potential for turning out looking for the world’s acceptance or rejection of us may be limited. Using strategies that can be done in the privacy of the home such as gratitude practices, loving-kindness meditations, and gentle yoga may be approaching that can begin to shift perspective or focus without the addition of social navigation.

Some individuals with avoidant personality disorder may find grace and peace in a spiritual or religious practice with a message of acceptance.

Living with Avoidant Personality Disorder

Dealing with avoidant personality disorder will take patience,  curiosity, and persistence. A healthy dose of self-compassion will go a  long way in the sufferer’s own ability to continue to seek out treatment and other forms of help.

Insurance Coverage

When seeking treatment, it is important to determine whether insurance covers personality disorders and if they are covered the available services should include:

  • Diagnostic assessment and evaluation
  • Treatment planning
  • Individual, group and family therapy
  • Medication management
  • Crisis intervention
  • Case Management

How to Find a Therapist

Therapist taking down notes and listening to a patient with avoidant personality disorder

You can find a qualified therapist through word of mouth, your insurance company or through directories on the internet.

What I Should be Looking for in a Licensed Mental Health Provider

When seeking help, as with any mental health disorder, it is important to find a qualified professional that has experience successfully helping the sufferer with creating strategies and coping skills to have a more fully functional experience.

Questions to ask a mental health professional to determine appropriateness are:

  • Do you offer a consultation session – this would be important to create some safety, security for an individual to determine a good therapeutic fit.
  • What types of goals are people with this disorder achieving in your care?
  • Estimation of time on how long the care will last.
  • How long have you worked with people with avoidant personality disorder?
  • Will my insurance cover our work together?
  • How often do I need to attend session?
  • Do you offer tele-mental health services – this may be a critical question for avoidant personality sufferers. This would allow the individual to remain in a safe place while getting the benefit of therapy and may limit perceived rejection by the therapist.
  • How would you handle my sensitivity to people and perceived rejection?

Over time, treatment should improve the quality as well as the depth of relationships. With continued effort, the sufferer can begin to manage some of the negative, anxious thinking that is a hallmark of the disorder.

Avoidant Personality Disorder Support Hotline

The National Alliance on Mental Illness (NAMI) has a national hotline for sufferers of mental illness 800-950-6264.

About the Author:

Lydia Kickliter, LPC, LMHC has a private practice in Asheville, NC where she treats women’s issues including trauma related to domestic violence and sexual assault. Lydia also treats trauma survivors residing in the states of Georgia, Florida and North Carolina through tele-mental health services. Lydia is contracted with Certapet where she provides evaluations for emotional support animals. Go to therapyforshowingup.com for more information on her work.

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