Avoidant personality

Avoidant personality disorder (AvPD) is a Cluster C personality disorder. Those affected display a pattern of severe social anxiety, social inhibition, feelings of inadequacy and inferiority, extreme sensitivity to negative evaluation and rejection, and avoidance of social interaction despite a strong desire for intimacy. The behavior is usually noticed by early adulthood and occurs in most situations. Avoidant personality disorder (AvPD) is a Cluster C personality disorder. Those affected display a pattern of severe social anxiety, social inhibition, feelings of inadequacy and inferiority, extreme sensitivity to negative evaluation and rejection, and avoidance of social interaction despite a strong desire for intimacy. The behavior is usually noticed by early adulthood and occurs in most situations. People with AvPD often consider themselves to be socially inept or personally unappealing and avoid social interaction for fear of being ridiculed, humiliated, rejected, or disliked. They generally avoid becoming involved with others unless they are certain they will be liked. As the name suggests, the main coping mechanism of those with AvPD is avoidance of feared stimuli. Childhood emotional neglect (in particular, the rejection of a child by one or both parents) and peer group rejection are associated with an increased risk for its development; however, it is possible for AvPD to occur without any notable history of abuse or neglect. Some researchers have theorized certain cases of AvPD may occur when individuals with innately high sensory processing sensitivity (characterized by deeper processing of physical and emotional stimuli, alongside high levels of empathy) are raised in abusive, negligent or otherwise dysfunctional environments, which inhibits their ability to form secure bonds with others. Avoidant individuals often choose jobs of isolation so that they do not have to interact with the public regularly, due to their anxiety and fear of embarrassing themselves in front of others. Some with this disorder may fantasize about idealized, accepting and affectionate relationships, due to their desire to belong. Individuals with the disorder tend to describe themselves as uneasy, anxious, lonely, unwanted and isolated from others. They often feel themselves unworthy of the relationships they desire, so they shame themselves from ever attempting to begin them. If they do manage to form relationships, it is also common for them to preemptively abandon them due to fear of the relationship failing. People with AvPD are preoccupied with their own shortcomings and form relationships with others only if they believe they will not be rejected. Loss and social rejection are so painful that these individuals will choose to be alone rather than risk trying to connect with others. They often view themselves with contempt, while showing an increased inability to identify traits within themselves that are generally considered as positive within their societies. AvPD is reported to be especially prevalent in people with anxiety disorders, although estimates of comorbidity vary widely due to differences in (among others) diagnostic instruments. Research suggests that approximately 10–50% of people who have panic disorder with agoraphobia have avoidant personality disorder, as well as about 20–40% of people who have social anxiety disorder. In addition to this, AvPD is more prevalent in people who have comorbid social anxiety disorder and generalised anxiety disorder than in those who have only one of the aforementioned conditions. Some studies report prevalence rates of up to 45% among people with generalized anxiety disorder and up to 56% of those with obsessive-compulsive disorder. Posttraumatic stress disorder is also commonly comorbid with avoidant personality disorder. Avoidants are prone to self-loathing and, in certain cases, self-harm. In particular, avoidants who have comorbid PTSD have the highest rates of engagement in self-harming behavior, outweighing even those with borderline personality disorder (with or without PTSD). Substance use disorders are also common in individuals with AvPD—particularly in regard to alcohol, benzodiazepines and heroin—and may significantly affect a patient's prognosis. Earlier theorists proposed a personality disorder with a combination of features from borderline personality disorder and avoidant personality disorder, called 'avoidant-borderline mixed personality' (AvPD/BPD).