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Avoidant Personality Disorder – Criteria – Symptoms – Definition – Treatment

According to the DSM-5, approximately 2.4% of the population of the United States suffers from this mental disorder. That translates to roughly 1 in 40 people, which mean that the average person has regular contact with at least one (possibly more than one) person suffering from this disorder. Despite that, in good part due to the symptoms of the disorder, this mental disorder remains a hidden disorder that few are aware of or able to identify people who suffer from it.


It is a mental disorder that is characterized by a continuing pattern of feelings of inadequacy, social inhibition, and high levels of concern with how the person is viewed by other individuals.

  • In layman’s terms, APD represents extreme shyness in any and all social situations that lasts for a period of no shorter than a year and usually for decades.

What makes this a disorder is that this social inhibition directly interferes with the ability to engage in normal activities and often causes social harm, and potentially economic harm, to the person suffering from the disorder.


The DSM-5 identifies seven symptoms that are commonly associated with APD. Any particular individual suffering from the disorder may not show all of these symptoms, but will show a majority of them. These symptoms are:

  1. Avoidance of activities, in both work and school, which require all but the most trivial amounts of social interactions, due to a fear of negative feedback
  2. Refusal to interact with people unless clear signs of acceptance or invitation have been given in advance
  3. Keeping feelings and emotions highly in check when interacting in a close relationships for fear of ridicule
  4. Overwhelming fear of any type of criticism while engaged in common social activities
  5. Allows feelings of inadequacy to interfere with ability to interact with others during initial social interactions
  6. Is actively self deprecating and has a negative opinion of self and own accomplishments
  7. Shows extreme reluctance to take risks or engage in new activities due to the fear of looking bad or being embarrassed

These symptoms interfere with all aspects of life. The most harmful effects from these symptoms are interference with gaining an education, interference with obtaining a job, and making it particularly difficult to engage in healthy romantic relationships.

Substance Abuse

In a study done in 2012, a study of personality disorders in first-admission patients with substance use disorders) discovered 46% of the substance abuse (SUD) patients had at least one Personality Disorder (16% antisocial [males only]; 13% borderline; and 8% paranoid, avoidant, and obsessive-compulsive, respectively).

Cluster C disorders were as prevalent as Cluster B disorders. SUD patients with PDs were younger at the onset of their first SUD and at admission; used more illicit drugs; had more anxiety disorders, particularly social phobia; had more severe depressive symptoms; were more distressed; and less often attended work or school.


According to clinical studies, the prevalence of personality disorders with alcoholism ranges from as low as 22-40% to as high as 58-78%. The studies have focused primarily on antisocial and borderline personality disorders, however, almost the whole spectrum of personality disorders can be encountered in alcohol dependence, such as the dependent, avoidant, paranoid and others.

An Oxford study indicated 40% or alcohol use disorder clients had at least 1 personality disorder. For more in-depth information, see this research alcohol & personality disorders.


Avoidant personality disorder can be diagnosed by a mental health professional after a thorough psychological evaluation. By asking the right questions, a professional can determine whether a person suffers any of the previously noted symptoms. If the person has continuously suffered from at least four of them for at least a year, then a diagnosis of avoidant personality disorder is appropriate.


The most effective treatment for avoidant personality disorder is psychotherapy performed by a mental health professional that is familiar with the disorder. Because people suffering from this disorder are so fearful of any negative feedback, therapists must be particularly careful to not seem disapproving or judgmental during therapy.

Successful therapy will increase self-confidence, help the patient learn to take greater risks, and soothe inhibitions in the patient that prevent them from building relationships. While this is a difficult process, there is plenty of evidence that it can succeed.

Famous People

The best success stories are arguably Kim Basinger and Donny Osmond. Both are actors who have publicly admitted they suffer from APD, yet are able to make public appearances and speeches due to years of therapy.

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