What is Personality Disorder Due to Avoidance?

He Personality disorder due to avoidance Is characterized by the sensitivity of the person to the opinions of others and to the consequent avoidance of relationships.

Both fear of rejection and low self-esteem are extreme, making personal relationships limited to people with whom you are very comfortable.

These people do not show a lack of interest in interpersonal relationships - as in Schizoid personality disorder -. On the contrary, they are asocial because they are interpersonally anxious and fear rejection.

People with this disorder often evaluate the movements and expressions of the people they come in contact with. His fearful and tense attitude can provoke the ridicule of others, which in turn confirms his own doubts.

The major problems associated with this disorder occur in social and work functioning.

Low self-esteem And hypersensitivity to rejection are associated with restricted interpersonal contacts, which prevents them from having social support when they need help.

Signs and Symptoms of Avoidance Personality Disorder

These people can choose jobs in which they do not have to interact with other people or with the public on a regular basis.

Because of the need for affection and belonging, they can fantasize about idealized relationships in which they are accepted.

The fear of rejection is so intense that they prefer to be alone than connected with other people and form relationships only if they know they will not be rejected.

They often look down on themselves with contempt and have no ability to identify traits of their own that are generally positive in society.

The most common symptoms are:

• Hypersensitivity to criticism.
• Self-imposed social isolation.
• Extreme shyness or Anxiety in social situations , Although the person feels a strong need for close relationships.
• It avoids physical contact because it has been associated with unpleasant stimuli.
• Feelings of inadequacy.
• Self esteem very low.
• Self-deprecation.
• Distrust to others.
• Very self-conscious.
• Feeling of inferiority .
• Use of fantasy as a way of escape to interrupt painful thoughts.

Diagnosis

DSM-V (APA)

A general pattern of social inhibition, feelings of inferiority, and hypersensitivity to negative evaluation, beginning at the beginning of adulthood and occurring in different contexts, as indicated by four or more of the following items:

1. Avoid jobs or activities that involve significant interpersonal contact because of fear of criticism, disapproval or rejection.
2. He is reluctant to get involved with people if he is not sure he will please.
3. Demonstrate repression in intimate relationships due to fear of being embarrassed or ridiculed.
4. He is concerned about the possibility of being criticized or rejected in social situations.
5. He is inhibited in new interpersonal situations because of feelings of inferiority.
6. He sees himself as socially inept, personally uninteresting, or inferior to others.
7. It is extremely reluctant to take personal risks or to get involved in new activities because they may be compromising.

ICD-10 (WHO)

The ICD-10 of the World Health Organization classifies the avoidant personality disorder as an anxious personality disorder. It is characterized by at least four of the following:

1. Persistent and apprehensive feelings of tension and apprehension.
2. Belief that one is socially inept, personally unattractive or inferior to others.
3. Excessive concern with being criticized or rejected in social situations.
4. Lack of willingness to get involved with people unless you are sure to like them.
5. Restrictions on lifestyle due to the need for physical security.
6. Avoidance of social or work activities that require significant interpersonal contact for fear of criticism, disapproval or rejection.

Differential diagnosis

Research suggests that people with this disorder over-observe their internal reactions when they are in a social interaction, as do people with social phobia.

This extreme self-observation can provoke a hesitant, low-pitched voice.

However, unlike social phobics, they also over-observe the reactions of other people with whom they interact.

Avoidance personality disorder is especially prevalent in people with anxiety disorders.

Research suggests that approximately 10-15% of people with panic disorder with agoraphobia have an avoidant disorder, as do 20-40% of people with social phobia.

Other studies have reported a prevalence of up to 45% in people With generalized anxiety And up to 56% in people with obsessive-compulsive disorder.

Causes

According to Millon (1981) these people can be born with a temperament or with complicated personality characteristics.

As a result, their parents may refuse them or not give them enough affection from an early age. This rejection would lead to low self-esteem and social isolation, situations that would persist into adulthood.

Meyer and Carrer (2000) found that people with this personality disorder were more likely to mention experiences of isolation, rejection, or conflict with others.

Millon Subtypes

According to psychologist Theodore Millon, four types of personality disorder are identified by avoidance:

• Phobic (Including dependent characteristics): negativistic characteristics and passive-aggressive behavior, with ambivalent feelings towards themselves and others. Discord and internal opposition; Fear of dependency and independence; Dubious, unstable, confused; Tormented, bitter, unable to resolve their anguish.
• Troubled (Includes negativistic characteristics): suspicious, cautious, alternately panicked, terrified, nervous, timorous, petulant, fussy.
• Hypersensitive (Includes paranoid characteristics): apprehensive, anticipate and avoid all that they fear. Scrupulosity, and nervousness symbolized by repugnant and horrible circumstances or events.
• Self-deserters (Includes paranoid characteristics): fragmented self-consciousness. They suppress painful images and memories. They discard unbearable thoughts and impulses. Finally they deny themselves (suicidal).

Treatment

There are several well-controlled studies with therapeutic methods for people with this disorder.

Because the problems of people with this disorder are very similar to those with social phobia, the same treatments are usually applied.

Intervention techniques for anxiety, systematic desensitization, behavioral testing and Social skills training Have been successful.

Cognitive-behavioral therapy

The goal of Cognitive-behavioral psychotherapy Is to identify the person's unconscious beliefs and how others see it.

It also has the goal of improving social, personal and work performance.

It uses techniques such as systematic desensitization, social skills training or behavioral testing.

Medication

The medication should be seen as ancillary treatment and only if it is necessary to use it.

It may help decrease the symptoms of sensitivity to rejection.

Complications

Without treatment, a person with avoidance personality disorder may be in social isolation or develop a mental disorder such as substance abuse or depression.