Avoidant Personality Disorder PDF

3/27/24, 9:40 PM Print Preview Chapter 12: Personality Disorders: 12-4a Avoidant Personality Disorder Book Title: Psychopathology: An Integrative Approach to Mental Disorders Printed By: Wefae Ali ([email protected]) © 2023 Cengage Learning, Inc., Cengage Learning, Inc. 12-4a Avoidant Personality Di...

3/27/24, 9:40 PM Print Preview Chapter 12: Personality Disorders: 12-4a Avoidant Personality Disorder Book Title: Psychopathology: An Integrative Approach to Mental Disorders Printed By: Wefae Ali ([email protected]) © 2023 Cengage Learning, Inc., Cengage Learning, Inc. 12-4a Avoidant Personality Disorder As the name suggests, people with avoidant personality disorder (Cluster C (anxious or fearful) personality disorder featuring a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to criticism.) are extremely sensitive to the opinions of others, and although they desire social relationships, their anxiety leads them to avoid such associations. Their extremely low self-esteem—coupled with a fear of rejection—causes them to be limited in their friendships and dependent on those they feel comfortable with (Lerner, Teitelbaum, & Meehan, 2020). Consider the case of Jane. Jane… Not Worth Noticing Jane was raised by a mother with alcohol use disorder who had borderline personality disorder and who abused her verbally and physically. As a child, she made sense of her mother’s abusive treatment by believing that she (Jane) must be an intrinsically unworthy person to be treated so badly. As an adult in her late 20s, Jane still expected to be rejected when others found out that she was inherently unworthy and bad. Jane was highly self-critical and predicted that she would not be accepted. She thought that people would not like her, that they would see she was a loser, and that she would not have anything to say. She became upset if she perceived that someone in even the most fleeting encounter was reacting negatively or neutrally. If a newspaper vendor failed to smile at her, or a sales clerk was slightly curt, Jane automatically thought it must be because she (Jane) was somehow unworthy or unlikable. She then felt quite sad. Even when she was receiving positive feedback from a friend, she discounted it. As a result, Jane had few friends and certainly no close ones. Source: Case and excerpt reprinted, with permission, from A.T. Beck & A. Freeman, 1990, Cognitive therapy of personality disorders, Guilford Press. ©1990 Guilford Press. Clinical Description Theodore Millon (1981), who initially proposed this diagnosis, notes that it is important to distinguish between individuals who are asocial because they are apathetic, affectively flat, and relatively uninterested in interpersonal relationships (comparable to what DSM-5 terms schizoid personality disorder) and individuals who are asocial because they are https://ng.cengage.com/static/nb/ui/evo/index.html?deploymentId=607607251305910651374883797&eISBN=9780357657881&id=1993194890&nbId… 1/2 3/27/24, 9:40 PM Print Preview interpersonally anxious and fearful of rejection. The latter fit the criteria of avoidant personality disorder (Millon & Martinez, 1995). These individuals feel chronically rejected by others and are pessimistic about their future. Causes Some evidence has found that avoidant personality disorder is related to other subschizophrenia-related disorders, occurring more often in relatives of people who have schizophrenia (Lerner et al., 2020). A number of theories have been proposed that integrate biological and psychosocial influences as the cause of avoidant personality disorder. Millon (1981), for example, suggests that these individuals may be born with a difficult temperament or personality characteristics. As a result, their parents may reject them or at least not provide them with enough early, uncritical love. This rejection, in turn, may result in low self-esteem and social alienation, conditions that persist into adulthood. Limited support does exist for psychosocial influences in the cause of avoidant personality disorder. For example, Stravynski, Elie, and Franche (1989) questioned a group of people with avoidant personality disorder and a group of control participants about their early treatment by their parents. Those with the disorder remembered their parents as more rejecting, more guilt engendering, and less affectionate than the control group, suggesting parenting may contribute to the development of this disorder. Similarly, research has consistently found that these individuals are more likely to report childhood experiences of neglect, isolation, rejection, and conflict with others (Eikenaes, Egeland, Hummelen, & Wilberg, 2015; Meyer & Carver, 2000). Treatment In contrast to the scarcity of research into most other personality disorders, there are a number of well-controlled studies on approaches to therapy for people with avoidant personality disorder (Leahy & McGinn, 2012). Behavioral intervention techniques for anxiety and social skills problems have had some success (Lerner et al., 2020). Because of the similarity between avoidant personality disorder and social phobia (see Chapter 5), research has looked at medical interventions for anxiety (several benzodiazepines, selective serotonin reuptake inhibitors, and monoamine oxidase inhibitors) and found that they were effective in treating avoidant personality disorder (Lerner et al., 2020). Therapeutic alliance —the collaborative connection between therapist and client—appears to be an important predictor for treatment success in this group (Strauss et al., 2006). Chapter 12: Personality Disorders: 12-4a Avoidant Personality Disorder Book Title: Psychopathology: An Integrative Approach to Mental Disorders Printed By: Wefae Ali ([email protected]) © 2023 Cengage Learning, Inc., Cengage Learning, Inc. © 2024 Cengage Learning Inc. All rights reserved. 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