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Avoidant Personality Disorder

 

Personality disorder is a matter of false judgments of value. Listed below are the false value judgments that are at the root of Avoidant Personality Disorder.


False Good

False Bad

Personality Disorder

acceptance; exclusive interpersonal contact with familiars criticism, disapproval, rejection; significant interpersonal contact with non-familiars fears criticism, disapproval, or rejection; avoids occupational activities that involve significant interpersonal contact
to be liked being disliked unwilling to get involved unless certain of being liked
to be restrained in intimate relations attempts to shame or ridicule them fears being shamed or ridiculed; shows restraint within intimate relationships
for the familiar; habit, repetition, routine new interpersonal situations feelings of inadequacy; inhibited in new interpersonal situations
to be socially adept and personally appealing being seen as socially inept or personally unappealing views self as socially inept, personally unappealing, or inferior
familiar, routine activities new activities and personal risk; being embarrassed is reluctant to take personal risks or to engage in any new activities because they may be embarrassing
approval and acceptance in social situations being criticized or rejected in social situations preoccupied with being criticized or rejected in social situations



Perspectives q.v.





The Disease Perspective

Proposed Revision | APA DSM-5 New!

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association, 1994, pp. 664-665) describes Avoidant Personality Disorder 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:
  • avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection;

  • is unwilling to get involved with people unless certain of being liked;

  • shows restraint within intimate relationships because of the fear of being shamed or ridiculed;

  • is preoccupied with being criticized or rejected in social situations;

  • is inhibited in new interpersonal situations because of feelings of inadequacy;

  • views self as socially inept, personally unappealing, or inferior to others;

  • is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.




The Dimensional Perspective

Here is a hypothetical profile, in terms of the five-factor model of personality, for Avoidant Personality Disorder (speculatively constructed from McCrae, 1994, pg. 306):



High Neuroticism
Chronic negative affects, including anxiety, fearfulness, tension, irritability, anger, dejection, hopelessness, guilt, shame; difficulty in inhibiting impulses: for example, to eat, drink, or spend money; irrational beliefs: for example, unrealistic expectations, perfectionistic demands on self, unwarranted pessimism; unfounded somatic concerns; helplessness and dependence on others for emotional support and decision making.

Low Extraversion
Social isolation, interpersonal detachment, and lack of support networks; flattened affect; lack of joy and zest for life; reluctance to assert self or assume leadership roles, even when qualified; social inhibition and shyness.

High Openness
Preoccupation with fantasy and daydreaming; lack of practicality; eccentric thinking (e.g., belief in ghosts, reincarnation, UFOs); diffuse identity and changing goals: for example, joining religious cult; susceptibility to nightmares and states of altered consciousness; social rebelliousness and nonconformity that can interfere with social or vocational advancement.

High Agreeableness
Gullibility: indiscriminate trust of others; excessive candor and generosity, to detriment of self-interest; inability to stand up to others and fight back; easily taken advantage of.

High Conscientiousness
Overachievement: workaholic absorption in job or cause to the exclusion of family, social, and personal interests; compulsiveness, including excessive cleanliness, tidiness, and attention to detail; rigid self-discipline and an inability to set tasks aside and relax; lack of spontaneity; overscrupulousness in moral behavior.





The Behavior Perspective





The Life Story Perspective



Childhood



Cognitive Effects

Basic Belief: I may get hurt. [Strategy]: Avoidance (Beck, Freeman & associates, pg. 26).

The "idealized self is made up of beliefs about how we should feel, think, or act" (Tamney, pg. 32).

In Cognitive Therapy of Personality Disorders, Aaron T. Beck, Arthur Freeman, and associates (1990) list typical beliefs associated with each specific personality disorder. According to my view, the beliefs and attitudes rationalize and reinforce the idealized image and the compulsive attachments and aversions. They are analogous to Karen Horney's "shoulds" and "neurotic claims." Here are the typical beliefs that they have listed (pp. 359-360) for Avoidant Personality Disorder:

  • I am socially inept and socially undesirable in work or social situations.
  • Other people are potentially critical, indifferent, demeaning, or rejecting.
  • I cannot tolerate unpleasant feelings.
  • If people get close to me, they will discover the "real" me and reject me.
  • Being exposed as inferior or inadequate will be intolerable.
  • I should avoid unpleasant situations at all costs.
  • If I feel or think something unpleasant, I should try to wipe it out or distract myself�for example, think of something else, have a drink, take a drug, or watch television.
  • I should avoid situations in which I attract attention, or I should be as inconspicuous as possible.
  • Unpleasant feelings will escalate and get out of control.
  • If others criticize me, they must be right.
  • It is better not to do anything than to try something that might fail.
  • If I don't think about a problem, I don't have to do anything about it.
  • Any signs of tension in a relationship indicate the relationship has gone bad; therefore, I should cut it off.
  • If I ignore a problem, it will go away.


Beck's Cognitive Therapy for Personality Disorders







American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed. Washington: Author.

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed., text revision. Washington: Author.

Beck, Aaron T. and Freeman, Arthur M. and Associates (1990). Cognitive Therapy of Personality Disorders. New York : Guilford Press.

Beck, Aaron T. and Freeman, Arthur M. and Associates (2003). Cognitive Therapy of Personality Disorders, 2nd ed. New York : Guilford Press.

Cooper, Terry D. (2003). Sin, Pride, and Self-Acceptance: The Problem of Identity in Theology and Psychology. Downers Grove, IL: InterVarsity Press.

Gunderson, John G. and Philips, Katherine A. (1995). Personality Disorders. Comprehensive Textbook of Psychiatry/VI, Vol. 2. Eds. Harold I. Kaplan and Benjamin J. Sadock. Baltimore: Williams & Wilkins.

McCrae, Robert R. (1994). "A Reformulation of Axis II: Personality and Personality-Related Problems." Costa, Paul T., Jr., Widiger, Thomas A., editors. Personality Disorders and the Five-Factor Model of Personality. Washington, D.C.: The American Psychological Association.

(1989). Personality Disorders: Avoidant Personality Disorder. Treatments of Psychiatric Disorders, Vol. 3. American Psychiatric Association. Task Force on Treatments of Psychiatric Disorders. Washington, DC : American Psychiatric Association.

Stone, Michael H. (1993). Abnormalities of personality: within and beyond the realm of treatment. New York: W.W. Norton.

Tamney, Joseph B. (2002). The Resilience of Conservative Religion. New York: Cambridge UP.



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