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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

Cause of avoidant personality disorder is unknown. Genes or a physical illness that changed the person's appearance may play a role. About 1% of the population has avoidant personality disorder.

Symptoms

People with this disorder cannot 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 choose to be lonely rather than risk trying to connect with others.

A person with avoidant personality disorder may:

  • Be easily hurt when people criticize or disapprove of them
  • Hold back too much inintimate 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

Signs and tests

Avoidant personality disorder is diagnosed based on a psychological evaluation that assesses the history and severity of the symptoms.

Treatment

Talk therapy is considered to be the most effective treatment for this condition. It helps persons with this disorder be less sensitive to rejection. Antidepressant drugs may be used in addition.

Expectations (prognosis)

People with this disorder may develop some ability to relate to others. With treatment this can be improved.

Complications

Without treatment, a person with avoidant personality disorder may lead a life of near or total isolation. They may go on to develop a second mental health disorder such as substance abuse or a mood disorder such as depression.

Calling your health care provider

See your health care provider or a mental health professional if shyness or fear of rejection overwhelms your ability to function in life and have 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: Elsevier Mosby; 2008;chap 39.


Review Date: 11/17/2012
Reviewed By: Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
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