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Avoidant Personality Disorder Introduction

Avoidant personality disorder was added to DSM-III (American Psychiatric Association 1980) in 1980 and has a shorter history in the psychiatric literature than most of the other personality disorders. The research literature on avoidant personality disorder remains quite sparse, with only a few references available of an empirical nature. However, avoidant personality disorder shares many elements with the Axis I disorder social phobia (social anxiety disorder), which also was first defined in DSM-III, as well as with other personality disorders. The growing belief is that this personality disorder may be on a continuum with the two subtypes of social anxiety disorder as opposed to a separate Axis II construct.

This issue is discussed, and the known effective treatments for social phobia are summarized, with particular attention given to those findings that specifically address avoidant personality traits. The alternative view that the personality disorder represents a unique disorder, albeit with many elements in common with its Axis I counterpart, remains the prevailing viewpoint. Empirical evidence and differential responses to treatment reported in the developing body of research literature are reviewed. The historical development of avoidant personality disorder and the changes in diagnostic criteria over the past two decades are presented, along with a summary of the existing literature on treatment of this disorder. Finally, treatment recommendations based on this review and informed by better-documented treatments for social phobia are presented.