AVPD

AVPD, or avoidant personality disorder, is a personality disorder characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. It typically begins in early adulthood and occurs across a range of personal and occupational contexts, often leading to avoidance of social interactions and intimate relationships despite a desire for acceptance.

According to DSM-5, AVPD is diagnosed when a person exhibits a pervasive pattern of social inhibition and feelings of inadequacy, beginning by early adulthood and present in a variety of contexts, as indicated by at least four of the following: avoidance of occupational activities that involve significant interpersonal contact due to fears of criticism or disapproval; unwillingness to get involved with people unless certain of being liked; restraint in intimate relationships because of fear of embarrassment; preoccupation with being criticized or rejected in social situations; inhibition in new interpersonal situations; views self as socially inept, personally unappealing, or inferior; reluctance to take personal risks or engage in new activities due to fear of embarrassment. The pattern causes distress or impairment in social, occupational, or other areas of functioning and is not better explained by another mental disorder.

Etiology is considered multifactorial, involving genetic vulnerability, temperament, and early environmental influences such as attachment disruptions. AVPD frequently co-occurs with other anxiety and mood disorders and with other personality disorders, particularly those involving dependency or avoidance.

Treatment primarily consists of psychotherapy, including cognitive-behavioral approaches, schema therapy, and psychodynamic modalities, aimed at reducing avoidance and improving self-efficacy and social functioning. Pharmacotherapy, such as SSRIs or SNRIs, may be used to address comorbid anxiety or depressive symptoms. Prognosis varies; many individuals improve with long-term therapy, though the disorder can be chronic without treatment.