Avoidant Personality Disorder

Many individuals feel extremely shy and hesitant to talk with others and avoid any social engagement or new encounters due to being sensitive to rejection or criticism or even feeling embarrassed. Everyone exists somewhere in the spectrum of social anxiety and experiences social awkwardness or fear of rejection among their peer groups. These experiences are normal, and gradually, as an individual tends to get accustomed to their surroundings, they slowly begin to feel at ease. These traits in individuals are usually present for a short period of time. However, when individuals feel reserved and intimidated by social interaction and avoid any chance of it being in one altogether, along with a constant worry and fear of rejection, inadequacy, and feeling inferior to the point that their daily life and activities suffer an impact, then those individuals may be diagnosed to have the personality disorder known as an avoidant personality disorder.

What is the Meaning of Avoidant Personality Disorder?

An avoidant personality disorder is a term used to describe feelings of extreme inadequacy, a pattern of behavior related to social inhibition, sensitivity to rejection, and negative criticism. Avoidant personality disorder causes and impacts an individual that affecting their ability to react with others and maintain their relationships. Individuals who are shy and avoid social situations may have an introverted personality trait. The personality of an individual are characteristics that make them unique. The ten personality disorders are categorized into 3 clusters- A, B, and cluster C. Cluster C personality disorders cause people to be terrified of certain things and often make them avoid confronting those anxieties. This habit causes conflict in inter and intrapersonal interactions.

It consists of −

  • Avoidant personality disorders.

  • Dependent personality disorders.

  • Obsessive compulsive personality disorder.

According to the American Psychological Association, an avoidant personality disorder is "a pattern of severe shyness, feelings of inadequacy, and extreme sensitivity to criticism," People with the disorder frequently avoid relationships with anyone they worry will not like or accept them.

Social Impact when living with AVPD

An avoidant personality disorder is associated with a feeling of significant distress, impairment, and disability. It is a complex and chronic disorder that has an early age on set with lifelong impact. Avoidant personality disorder was originally thought to be associated with social anxiety disorder, and a large number of studies since then have found that in such settings, individuals with avoidant personality disorder did not additionally meet the Diagnostic criteria for social anxiety disorder. Avoidant personality disorder generates a fear of rejection in individuals, making it difficult for them to connect with others. They feel hesitant to form a relationship and may be afraid to share information that is personal or in regards to their feelings. Thus, making it difficult for them to maintain an intimate relationship or a close friend group. The constant worry of being rejected results from a repeated history of disapproval and disappointment in relationships, wherein an individual has internalized its consequences, causing further reduced self-esteem. This low self-esteem can be described as a state of malignant self-regard (MSR). MSR magnifies emotions of guilt, interpersonal inadequacy, and feeling a need for perfectionism.

Co-occurring factors involved in AVPD

People with avoidant personality disorder may suffer from depression, anxiety, eating disorders, and substance abuse. Therefore, due to the co-occurring and negative consequences, early detection of AVPD with aggression management is critical.

Causes and Risk Factors

The cause of avoidant personality disorder is yet unknown, but it is believed that a combination of genetic composition, parental and environmental factors, and social and psychological factors all play an important role in the development of AVPD. Criticism of emotional abuse, lack of affection by a caregiver in childhood, and peer rejection are risk factors in the development of AVPD.

How is avoidant personality disorder diagnosed?

According to DSM 5, a person who is diagnosed with avoidant personality disorders displays at least 4 of the following criteria −

  • Unwilling to be involved in social interaction with people unless they are liked.
  • Avoiding activities involving interpersonal contact due to fear of being criticized, disapproved, or rejected.
  • Inhibition in new interpersonal situations due to a feeling of inadequacy.
  • Preoccupied with fear of being criticized or embarrassed in a social situation.
  • Considering oneself to be socially awkward, unpleasant, or inferior among others.
  • Avoid and reluctant to take risks or engage in new activities.
  • Fear of being disgraced or ridiculed causes restraint in forming intimate relationships.

Common symptoms include a feeling of being hated by everyone, people pleasing, low self-esteem, persistent fear of rejection and social humiliation, resisting social situations, extreme shyness in a social situation, trouble making relationships or friendships, constant fear of embarrassment and rejection, need for social approval, need to be liked, etc.

Etiology and Epidemiology

Avoidant personality disorder ranges from 1.5% to 2.5%, with women slightly predisposed to developing AVPD. Many factors play a role in the development of AVPD, such as genetic predisposition, early childhood, environment, individual attachment styles, and temperament during infancy. Research has shown that the relationship between attachment and temperament of an individual aggravates and intensifies the development of AVPD.

Management strategies

Treatment for avoidant personality disorder helps by managing the symptoms that cause significant distress in personal and occupational life.

Strategies for coping involve self-care, eating nutritious meals, getting enough physical activity, sleeping well, social skills development, seeking out hobbies, avoiding alcohol and substance use, and practicing mindfulness, meditation, and yoga.

Psychotherapy or talk therapy are the first lines of treatment. The main goal of psychotherapy is to change negative and troubling cognitive thoughts and behavioral patterns into manageable and healthy processes.

  • Schema therapy is an integrated approach built on cognitive behavioral therapy and other therapeutic techniques. The key feature of this therapy is "limited reparenting," which helps develop and internalize a healthy parental voice when a client expresses their childhood needs.
  • Emotion focus therapy aims at providing better awareness of an individual's emotions, regulating them, and helping to identify the source of unhealthy emotions and display the right actions towards them.

Medications are usually prescribed to help with the symptoms. Anti-depressant and anti-anxiety medicines help to reduce sensitivity to rejection and help in improving and decreasing anxiety symptoms and fear of rejection.


People with avoidant personality disorder tend to isolate themselves from social situations because they fear being rejected, embarrassed, or criticized. Living in constant fear of rejection and the need to be liked impacts an individual's daily life and causes dysfunctional relationships. The cause of avoidant personality disorder is yet unknown, but several factors, such as genes, environment, personality traits, etc., are known for the cause of AVPD. Treatment for this disorder aims at improving an individual's symptoms and helping them develop the ability to relate to others and form a secure environment for themselves, which further impacts overall well-being and quality of life.


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