Avoidant Personality Disorder (AVPD)

AVPD Introduction

Avoidant Personality Disorder (AVPD) is a serious condition which has been found in clinical studies to affect between 1.8% to 6.4% of the general population.

Avoidant Personality Disorder is listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) as a "Cluster C" anxious or fearful disorder.

AVPD is characterized by a pattern of withdrawal, self-loathing and heightened sensitivity to criticism. People who suffer from AVPD often consider themselves socially unsuccessful and tend to remove themselves from social situations in order to avoid the feeling or the risk of feeling rejected by others.

People who live in a relationship with a person who suffers from avoidant personality disorder often recognize that something is not quite right with the behavior of their family member or loved-one but often do not know what to do about it or that there is even a name for it. They may feel trapped in the relationship and frustrated by their loved-one's tendency to pull them away from family, friends and other "everyday" social settings.

People who are in a relationship with a person who suffers from AVPD may also experience pressure to isolate themselves along with them or pressure to protect them from criticism or to create an artificial or dysfunctional "bubble" or ideal environment around them in which they can escape the risk of negative self-thought.

People who suffer from AVPD may use withdrawal as a form of communication or as a form of emotional control over friends, partners and family members.

Alternate Names for AVPD

Avoidant Personality Disorder (AvPD) is described in the World Health Organization's International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) by the alternate name Anxious Personality Disorder or Anxious (Avoidant) Personality Disorder.

Avoidant Personality Disorder (AVPD) - The DSM Criteria

Avoidant Personality Disorder (AvPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as a Cluster C (anxious or fearful) Personality Disorder.

Text in Italics is quoted from the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM-IV-TR)

Avoidant Personality Disorder (AvPD) is defined as:

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of 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 initiating intimate relationships because of the fear of being ashamed, ridiculed, or rejected due to severe low self-worth.
  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.

A formal diagnosis of AvPD requires a mental health professional to identify 4 out of the above 7 criteria as positive. Some people with AvPD may exhibit all 7. Most will exhibit only a few. 

Nobody’s perfect. Even normal healthy people will experience or exhibit a few of the above criteria from time to time. This does not make a person AVPD.

Understanding the clinical criteria for Avoidant Personality Disorder (AVPD) is helpful but learning how to cope with having a loved-one who suffers from AVPD is quite different and is not covered in any psychological manual.

Characteristics of AVPD

The following is a list of some of the more common characteristics & traits of people who suffer from Avoidant Personality Disorder (AVPD). Click on the links to see more information on each trait.

Note that these traits are given as a guideline only and are not intended for diagnosis. People who suffer from AVPD are all unique and so each person will display a different subset of traits. Also, note that everyone displays "avoidant" behaviors from time to time. Therefore, if a person exhibits one or some of these traits, that does not necessarily qualify them for a diagnosis of AVPD. See the DSM Criteria on this page for diagnostic criteria for AVPD.

"Always" and "Never" Statements - "Always" and "Never" Statements are declarations containing the words "always" or "never". They are commonly used but rarely true.

Avoidance - The practice of withdrawing from relationships with other people as a defensive measure to reduce the risk of rejection, accountability, criticism or exposure.

Blaming - The practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.

Catastrophizing - The habit of automatically assuming a "worst case scenario" and inappropriately characterizing minor or moderate problems or issues as catastrophic events.

Circular Conversations - Arguments which go on almost endlessly, repeating the same patterns with no resolution.

Confirmation Bias - The tendency to pay more attention to things which reinforce your beliefs than to things which contradict them.

"Control-Me" Syndrome - This describes a tendency which some people have to foster relationships with people who have a controlling narcissistic, antisocial or "acting-out" nature.

Cruelty to Animals - Acts of Cruelty to Animals have been statistically discovered to occur more often in people who suffer from personality disorders than in the general population.

Denial - Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.

Dependency - An inappropriate and chronic reliance by an adult individual on another individual for their health, subsistence, decision making or personal and emotional well-being.

Depression - People who suffer from personality disorders are often also diagnosed with symptoms of depression.

Escape To Fantasy - Taking an imaginary excursion to a happier, more hopeful place.

Identity Disturbance - A psychological term used to describe a distorted or inconsistent self-view

Imposed Isolation - When abuse results in a person becoming isolated from their support network, including friends and family.

Lack of Object Constancy - An inability to remember that people or objects are consistent, trustworthy and reliable, especially when they are out of your immediate field of vision.

Low Self-Esteem - A common name for a negatively-distorted self-view which is inconsistent with reality.

Magical Thinking - Looking for supernatural connections between external events and one’s own thoughts, words and actions.

Manipulation - The practice of steering an individual into a desired behavior for the purpose of achieving a hidden personal goal.

Masking - Covering up one's own natural outward appearance, mannerisms and speech in dramatic and inconsistent ways depending on the situation.

Neglect - A passive form of abuse in which the physical or emotional needs of a dependent are disregarded or ignored by the person responsible for them.

Objectification - The practice of treating a person or a group of people like an object.

Obsessive-Compulsive Behavior - An inflexible adherence to arbitrary rules and systems, or an illogical adherence to cleanliness and orderly structure.

Panic Attacks - Short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as hyperventilating, shaking, sweating and chills.

Parentification - A form of role reversal, in which a child is inappropriately given the role of meeting the emotional or physical needs of the parent or of the family’s other children.

Passive-Aggressive Behavior - Expressing negative feelings in an unassertive, passive way.

Perfectionism - The maladaptive practice of holding oneself or others to an unrealistic, unattainable or unsustainable standard of organization, order, or accomplishment in one particular area of living, while sometimes neglecting common standards of organization, order or accomplishment in other areas of living.

Sabotage - The spontaneous disruption of calm or status quo in order to serve a personal interest, provoke a conflict or draw attention.

Selective Competence - Demonstrating different levels of intelligence, memory, resourcefulness, strength or competence depending on the situation or environment.

Self-Loathing - An extreme hatred of one's own self, actions or one's ethnic or demographic background.

Self-Victimization - Casting oneself in the role of a victim.

Splitting - The practice of regarding people and situations as either completely "good" or completely "bad".

Testing - Repeatedly forcing another individual to demonstrate or prove their love or commitment to a relationship.

Thought Policing - Any process of trying to question, control, or unduly influence another person's thoughts or feelings.

Tunnel Vision - The habit or tendency to only see or focus on a single priority while neglecting or ignoring other important priorities.

AVPD Statistics

Refer to our page on Personality Disorder Statistics for More Information.

Avoidant Personality Disorder has been found in separate clinical studies to affect anywhere from 1.8% to 5.2% of the general population.

People who are diagnosed with Avoidant Personality Disorder also frequently meet the criteria for other personality disorders.

The table below shows statistically how likely it is that a person who is diagnosed with AVPD will also meet the criteria for another personality disorder. The more positive the number, the more likely it is that a person will be diagnosed with the second personality disorder listed. The more negative the number, the less likely it is that a person will be diagnosed with the second personality disorder in the table.

Personality Disorder Comorbidity Odds-Ratio
Paranoid Personality Disorder 0.70
Schizoid Personality Disorder 0.55
Schizotypal Personality Disorder 0.53
Antisocial Personality Disorder 0.05
Borderline Personality Disorder 0.54
Dependent Personality Disorder 0.70
Obsessive-Compulsive Personality Disorder 0.63

Source: Lenzenweger et al, 2007 - DSM-IV personality disorders in the National Comorbidity Survey Replication

UK Hospital Admission Statistics in 2006/2007 show that 43% of those admitted with a diagnosis of AVPD were male and 57% female.

AVPD Treatment & Causes

The precise causes of AVPD are not well understood. Genetic traits and child abuse or neglect are most often associated with the disorder, but no conclusive study exists.

Most people who suffer from Avoidant Personality Disorder are, by nature, reluctant to seek out treatment and programs such as individual therapy, couples therapy and group therapy are likely to make someone with AVPD feel very uncomfortable. As a result, most cases of AVPD go undiagnosed and untreated and it is left to spouses, partners and family members and friends to do the best they can.

For those who have sought treatment, some symptoms of AVPD have been found to be reduced through prescription of SSRI antidepressants. Therapy programs typically involve social skills training, cognitive behavioral therapy and group therapy.

Movies Portraying Avoidant Personality Disorder (AvPD)

The Remains of the Day - The Remains of the Day is a 1993 Columbia Pictures Release, starring Anthony Hopkins & Emma Thompson which portrays the life of a head butler in an English Manor who manifests some of the traits of schizoid personality disorder.

Zelig - Zelig is a 1983 movie written and directed by Woody Allen who portrays a man who avoids revealing his own self by adapting his personality to mirror anyone whom he is interacting with.

AVPD Support Groups & Links:

Out of the FOG Support Forum - Support for family members and loved-ones here at Out of the FOG.

https://www.bigtent.com/groups/avoidant - Active Avoidant Personality Disorder Community

http://www.avoidantpersonality.com - Avoidant Personality Disorder Support Site.

http://groups.msn.com/AvoidantPersonalityG...ssageboard.msnw- MSN Avoidant Personality Group.

Psychforums AVPD forum - Psychforums Site