- What is Personality?
- What is Personality Disorder?
- 3 Cluster Types of Personality Behavior
- What is Avoidant Personality Disorder?
- Causes of Avoidant Personality Disorder
- Risk Factors
- Signs and Symptoms
- How to Diagnose Avoidant Personality Disorder?
- Treatment for Avoidant Personality Disorder
- What is Psychotherapy?
- Psychotherapy for Avoidant Personality Disorder
Different people in the world possess different kinds of behavior in physical, emotional, moral, or spiritual aspects. A disturbance in one’s behavior may lead to severe problem. Common diseases arise in certain ways by which classified into different diagnosis.
Today we will tackle about the disease so-called Avoidant Personality Disorder, the cause, signs and symptoms, risk factors, treatment, etc.
What is Personality?
Personality is the sum of all the inherited and acquired physical, mental, and emotional traits of a person as this interacts with the environment in a unique and distinctive way. Personality is also all of those permanent traits, dispositions or characteristics within an individual that provide some measure of consistency to that individual behavior and affective experience. 
What is Personality Disorder?
Personality Disorder is the alteration of a human’s ability to perceive and sense a situation in relation to people, situation, and most especially to your own self. It is also a group of mental illness that shows unhealthy manners and behavior to people around you. The signs and symptoms vary depending on what cluster it is.
3 Cluster Types of Personality Behavior
According to Diagnostic and Statistical Manual (DSM-IV-TR), there are three clusters of personality behaviors.
|Cluter A (Odd)||Cluster B (Dramatic)||Cluster C (Anxious)|
*Deleted from the official list are depressive, sadistic and self-defeating which is not specified on the list.
What is Avoidant Personality Disorder?
Avoidant Personality Disorder sometimes referred to as Anxious Personality Disorder, or Avoidant is under the category of Cluster C or Anxious according to the Diagnostic and Statistical Manual (DSM-IV-TR), which is used to define mental health.
It is a mental health condition that occurs in infancy that worsens in adulthood. These people may exhibit extreme shyness and social withdrawal, feelings of apprehension, insecurity, and inferiority.
Prevalence: The prevalence of Avoidant Personality Disorder is about 10% to outpatient psychiatric patients and 0.5% up to 10% in the general population. 
Comorbidity: Research shows that the people with panic disorder have avoidant personality disorder and accounts to 10-50%. People with social phobia or social anxiety disorder accounts to have 20-40%. With general anxiety disorder is 45% and Obsessive Compulsive Disorder is about 56%. 
Causes of Avoidant Personality Disorder
Researches show that the cause of this disorder is unknown. There is no clear view of what is the real cause of this disorder. Some scientist and researcherssays that genes and biological factor plays an important role in transmitting the disorder but it is not understood clearly. Physical illness can be a cause that transformed a man’s appearance. Peer groups and family relationship is seen as another cause of avoidant personality disorder. [2, 5]
- Childhood Experiences – as a child there are different experience that a child may have; gaining trust with other person is an important key in order for him not to be rejected. Either there is feeling of rejection or fears that this child, this goes the time that the child is afraid to deal with somebody else and develops this extreme shyness which predisposes him to withdraw into the social world.
- Illness – a man with a severe illness or a chronic illness can be at risk especially if the disease can disturbed one’s body image. This man thinks that people will reject him rather than help him to gain respect. The people will criticize him always that his wellbeing is being disturbed.
- Temperament -a person with an extreme irritability or sensitiveness predisposes to avoidant personality disorder by this, he chooses to live on his own way without entering the social because of fear that the people will gain attention to him and avoid them so that he will not get words that may hurt his feelings.
- Broken Family – without the help of your parents or having a single mom or dad you can never be treated the same way. You will always saw them quarreling with each other and that will give you a sense of unhappy feeling.
- Peer Pressures – peers can be good or bad but this time peer pressure can be factor that a man can have this disorder, since peers is in the social world. A man can be frequently get bullied by the peer which then can hurt a man’s feeling to retire to social world.
Signs and Symptoms
- Feeling of inferior to other
- Severe low self esteem
- Self-imposed social isolation
- Sever shyness
- Hypersensitivity to refection and criticism
- Feelings of inadequacy
- Reluctant to join new activity
- Unwilling to involve with people
- Reluctant to take personal risks
- Mistrust of others [1, 7, 8]
- Social phobia
- Substance abuse
- Major depression
- Social and occupational withdrawal
- Schizophrenia 
How to Diagnose Avoidant Personality Disorder?
It is based on psychological evaluation of patient. The patient may ask by the doctor about the history and severity of signs and symptoms and the behavior that this person possess in the past from childhood up to present. There are no laboratory tests or tool to diagnose this disorder. Although there are two categories release by WHO and APA to classify this disorder.
World Health Organization (WHO) ICD-10, the person can have at least four of the signs and symptoms to be diagnose to have Avoidant Personality Disorder.
American Psychiatry Association (APA) DSM-IV-TR, same as in WHO-ICD-10 the patient should at least met four out of 7 criteria to be diagnosed to have Avoidant Personality Disorder.
Treatment for Avoidant Personality Disorder
Avoidant personality disorder is treated with long term psychotherapy along with medications and most important the willingness of the patient to get rid of this problem. Support from families and friends are also beneficial to treat the disorder.
What is Psychotherapy?
It is a process by which a person is given a chance to learn for their moods, behavior, performance, and manner. This is done by a psychotherapists or a psychiatric. This focuses on the way a patient how to handle problems which arise in different situations. This helps to learn how to respond in specific controls and challenge of life that will be given by the therapists.
- Specific psychotherapy will be given to patient depending on the behavior and problems seen by the therapist to the patient.
- This is sometimes referred as talk therapy, psychosocial therapy, counseling 
Psychotherapy for Avoidant Personality Disorder
- Cognitive and Behavioral Therapy – in behavioral therapy the patient was be given time to perform social skills training along with social desensitization. The treatment will not be as effective in the early stage of therapy but seen for a longer period. In addition, anxiety management techniques should be provided early in therapy because these patients will predictably begin to experience elevated levels of anxiety as their exposure to feared situations. Many patients with this problem show improvement but not in the point that the person will manifest a normal wellbeing in the social world.
- Interpersonal Therapy – this therapy focuses in the use of supportive techniques to overcome the patient’s withdrawal to others. The therapist will maintain a positive regard to the patient showing tender loving care to them. Soon after the trust is established this time the therapists will lessen the sympathy in order to cope the patient on his own way.
- Family Therapy – the value of family will support the patient for his rights. Family members will help the patient to overcome the behavior that he manifests, they give emotional support to the patient and encourage him to join the social world to seek for new experience and learning.
- Group Therapy – this therapy is applicable when the patient develops trust to the therapies and officially completed the task in cognitive therapy where a one on one individual therapy. It is beneficial to the patient for it gives positive attitude to one another by sharing some thoughts of experience. This also gives encouragement to one another and shows empathy for the benefits of the patient. A good strategy is met when the patient marked improvement in this kind of therapy. [1, 10]
Anxiolytics and sedatives are the drug of choice for the patient with Avoidant Personality Disorder. Although some research shows that the patient is longing for alcohol in order for them to forget what the behavior that they have is, but alcohol shows many complications that influence them to become aggressive type.
The most important is to have an appointment with a psychiatrist to prescribe the effective treatments for the disorder. Psychiatrist and clinicians says that the combination and psychotherapy will help to correct behaviors. 
Here are some medications listed that works on Avoidant Personality Disorder.
- Klonopin is an effective anti-anxiety drug that is used in combination with other medications for the treatment of personality disorder. Klonopin is a benzodiazepines.
- Beta-blockers are also known to be effective in dealing with avoidant personality disorder.
- Monoamine Oxidase Inhibitors (MAO) like Parnate, Marplan, and Nardil.
- Selective Serotonin Reuptake Inhibitor (SSRI)
- Sertraline Hydrochloride
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
Avoidant personality disorder is a disorder is characterized by extreme withdrawal to the social world is increasingly recognized for its debilitating effect in society both in occupational and social functioning of a person. There are treatments that was observed and given to the patients but this was given in proper combination in conjunct with the other one. The cause of the disease is difficult to know and studies shows that knowing it is still on process and a lot more experiments will be taken in order to know the real causes of the disease.
Further study for the management will be done to complete and make the person function as normal being before he was diagnosed to have the disease and to be able to back in the social world and to perform his duties and responsibilities with his occupational functions. Family is the start to develop trust and I think this will be the one to address the problem.
Cognitive behavioral therapy is effective for its desensitization in order for a man to start his new life and experience again. This article shows much important to address this type of disorder and looking forward for new studies for proper management.
- Students Guide for Psychiatric and Mental Health Nursing Practice