Tag Archives: Avoidant Personality Disorder

Avoidant Personality Disorder (AvPD) #Write31Days

31 Days of Mental Health

Welcome to day 16 in the 31-day writing challenge on mental health. I am still tired and a lot is on my mind today. Still, I am resuming my writing on personality disorders today. After we’ve discussed the cluster B personality disorders (well, all except for borderline personality disorder, since I’ve discussed that a lot before), it’s now time to move on to cluster C. (I will discuss the personality disorders in cluster A after I write about psychosis and schzophrenia later this month.) People with cluster C personality disorders are predominately anxious or fearful. The most well-known personality disorder in this cluster, which I’ll discuss today, is avoidant personality disorder.

Avoidant personality disorder (AvPD) referst o a pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to criticism. People with AvPD meet four or more of the followign criteria:


  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 personal risks or to engage in any new activities because they may prove embarrassing.


Individuals with avoidant personality disorder avoid work, school or other activities that might lead them to be embarrassed or criticized. As a result, they often live an isolated life. When they do engage in social interacitons, they are often hypervigilant to the actions of others. This may in turn elicit criticism or ridicule, which then worsens the AvPD sufferer’s hypervigilance. For clarity’s sake: AvPD sufferers do want to have friends and often feel extremely lonely. The problem is they feel too anxious to attempt to make friends.

Avoidant personality disorder occurs in 2.4% of the population. It commonly co-occurs with social anxiety disorder (social phobia). It is not clear in fact whether social phobia and avoidant personality disorder are distinct conditions or essentially fall on the same spectrum.

Avoidant personality disorder may also co-occur with or be confused with panic disorder with agoraphobia, major depression, or dependent personality disorder, which I’ll discuss later on. It is often confused with autism spectrum disorders. After all, people with AvPD, especially if they already had social phobia when growing up, may have developed social skills problems because of their lack of involvement in social situations.

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What Are Personality Disorders? #Write31Days

31 Days of Mental Health

Welcome to day 10 in the #Write31Days challenge on mental health. Today, I will discuss the broad category of disorders I’ve been diagnosed with: personality disorders. Though there is some debate as to whether borderline personality disorder should be conceptualized as a personality disorder, it currently is.

A personality disorder is a pervasive pattern of dysfunctional thought, behavior and emotion that is stable across time and across situations. It is out of line with cultural expectations and causes distress or impairment. It usually emerges in early adulthood, though adolescents may be diagnosed as being at risk for developing a personality disorder. In fact. when I attended a conference on BPD in 2013, a psychiatrist specializing in this said that BPD can be reliably diagnosed from age sixteen on. In other disorders, such as antisocial personality disorder, there is a specific age requirement of being over eighteen.

The Diagnostic and Statisticla Manual of Mental Disorders, both DSM-IV and DSM-5, divides specific personality disorders into three subcategories, called clusters. These are:


  • Cluster A includes paranoid, schizoid and schizotypal personality disorders. Individuals exhibiting these disorders often appear odd or eccentric. The disorders in this cluster can precede schizophrenia. I tend to think of cluster A personality disorders as “psychosis light”.

  • Cluster B includes antisocial, narcissistic, borderline and histrionic personality disorders. Individuals with disorders in this cluster are often seen as dramatic, emotional or erratic. People with cluster B personality disorders are often perceived as among the most difficult people to get along with. When peope think of personality disorders in general, they mostly mean cluster B disorders. The same goes for treatment programs focused on personality disorders.

  • Cluster C includes avoidant, dependent and obsessive-compulsive personality disorders. Individuals with cluster C personality disorders tend to be anxious or fearful.


In DSM-5, it is stated clearly that the clustering of personality disorders, while it has some merit, may not be very useful in clinical practice. After all, many people exhibit traits of personality disorders across clusters. When a person has features of more than one personality disorder but doesn’t teet the full criteria of any, they may be diagnosed with an unspecified personality disorder. People with other specified personality disorder display behavior that is seen as a personality disorder but isn’t listed specifically in DSM-5. Examples include passive-aggressive and self-defeating personality disorder.

There are some clear gender differences in how commonly personality disorders occur. Antisocial personality disorder occurs far more often in males than females. Borderline, histrionic and dependent personality disorder occur more in females. Though this may reflect real gender differences, it is also likely that stereotypical views shape clinicians’ diagnoses. For example, I once read that BPD is really about as common in males as in females but is overdiagnosed in women and underdiagnosed in men. Women misdiagnosed with BPD are often later found to have ADHD, which interestingly used to be seen as a typical male disorder.

diagnosticians always need to be aware of a patient’s cultural background and life history. After all, in some cultures, behavior that is seen as disordered in the western world may be normal. People who experienced extreme stress or trauma may also exhibit long-lasting dysfunctional behavior patterns and be misdiagnosed with personality disorders when they really have PTSD. Veterans are disproportionately often diagnosed with personality disorders, for example.