Avoidant Personality Disorder
Monday, November 26, 2012
Avoidant personality disorder (APD) is considered to be an active-detached personality pattern, meaning that people with APD purposefully avoid people due to fears of humiliation & rejection. It is thought to be a pathological extension of the "normal inhibited" personality, which is characterized by a watchful behavioural appearance, shy interpersonal conduct, a preoccupied cognitive style, uneasy affective expression & a lonely self-perception. The avoidant pattern seems to range in varying degrees along a continuum of symptoms from mild to extreme. In mild cases, a person may be said to be normally shy, whereas extreme cases indicate personality disorder.
The symptoms of APD overlap with those of generalized social anxiety disorder (GSAD) . It has been demonstrated that GSAD and APD are based on the same underlying pathology and differ primarily in the severity of social anxiety & social functioning, with APD being the more severe disorder. The evidence that most people diagnosed with APD will also meet the diagnostic criteria for GSAD, but people with GSP do not necessarily have APD supports this view.
A. Significant impairments in personality functioning manifest by:
1. Impairments in self functioning (a or b):
a. Identity: Low self-esteem associated with self-appraisal socially inept, personally unappealing, or inferior; excessive feelings of shame or inadequacy.
b. Self-direction: Unrealistic standards for behavior associated with reluctance to pursue goals, take personal risks, or engage in new activities involving interpersonal contact.
2. Impairments in interpersonal functioning (a or b):
a. Empathy: Preoccupation with, and sensitivity to, criticism or rejection, associated with distorted inference of others‟ perspectives as negative.
b. Intimacy: Reluctance to get involved with people unless being certain of being liked; diminished mutuality within intimate relationships because of fear of being shamed or ridiculed.
B. Pathological personality traits in the following domains:
1. Detachment, characterized by:
a. Withdrawal: Reticence in social situations; avoidance of social contacts and activity; lack of initiation of social contact.
b. Intimacy avoidance: Avoidance of close or romantic relationships, interpersonal attachments, and intimate sexual relationships.
c. Anhedonia: Lack of enjoyment from, engagement in, or energy for life‟s experiences; deficits in the capacity to feel pleasure or take interest in things.
2. Negative Affectivity, characterized by:
a. Anxiousness: Intense feelings of nervousness, tenseness, or panic, often in reaction to social situations; worry about the negative effects of past unpleasant experiences and future negative possibilities; feeling fearful, apprehensive, or threatened by uncertainty; fears of embarrassment.
Job seeking for someone with APD can be very challenging because it triggers the individual’s basic concerns. The individual will often have a great deal of difficulty effectively presenting their skills and qualifications. They will be awkward and uncomfortable in a job interview (or not show up).
In employment they may have a great deal of trouble in new or changing situations. They will have trouble with interpersonal relationships and public speaking. They will tend to be perfectionists but downplay their skills, abilities and accomplishments. They will have a great deal of difficulty with any job that requires them to "sell" or even present their work to a potential customer, or even other co-workers. Since their standard practice is to avoid situations that elicit their anxiety, they may just not attend important meetings, or be unable to participate in team discussions because they cannot allow themselves to feel part of a team.
Accommodating a person with APD shares similar strategies to accommodating persons with other anxiety disorders. Some options are to:
- Allow reports and presentations to be submitted via writing, rather than orally
- Take quick breaks during the day to grab fresh air and step away from the rush of work
- Flexible arrival times (and then leaving times) to mitigate the stress of getting to work on time or to avoid rush hour transit situations
- Taking time away from work to visit your doctor or therapist
- Having a desk away from the main entrance or out of the busy traffic of the office