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Avoidant personality disorder

Personality disorder - avoidant

Avoidant personality disorder is a mental condition in which a person has a lifelong pattern of feeling very:

• Shy
• Inadequate
• Sensitive to rejection

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Causes

Causes of avoidant personality disorder are unknown. Genes or a physical illness that changed the person's appearance may play a role.

Symptoms

People with this disorder cannot stop thinking about their own shortcomings. They form relationships with other people only if they believe they will not be rejected. Loss and rejection are so painful that these people choose to be lonely rather than risk trying to connect with others.

A person with avoidant personality disorder may:

• Be easily hurt when people criticize or disapprove of them
• Hold back too much in intimate relationships
• Be reluctant to become involved with people
• Avoid activities or jobs that involve contact with others
• Be shy in social situations out of fear of doing something wrong
• Make potential difficulties seem worse than they are
• Hold the view they are not good socially, not as good as other people, or unappealing

Exams and Tests

Avoidant personality disorder is diagnosed based on a psychological evaluation. The health care provider will consider how long and how severe the person's symptoms are.

Treatment

Talk therapy is considered to be the most effective treatment for this condition. It helps people with this disorder be less sensitive to rejection. Antidepressant medicines may be used in addition.

Outlook (Prognosis)

People with this disorder may develop some ability to relate to others. With treatment this can be improved.

Possible Complications

Without treatment, a person with avoidant personality disorder may lead a life of near or total isolation. They may go on to develop a second mental health disorder, such as substance use or depression and may be at higher risk for suicide.

When to Contact a Medical Professional

See your provider or a mental health professional if shyness or fear of rejection overwhelms your ability to function in life and have relationships.

References

American Psychiatric Association. Avoidant personality disorder. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013:672-675.

Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA, Hopwood CJ. Personality and personality disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 39.

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Review Date: 11/7/2020  

Reviewed By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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