Definition, Causes, Symptoms & Treatment

Definition

Avoidant personality disorder is a psychiatric condition characterized by a lifelong pattern of extreme shyness, feelings of inadequacy and sensitivity to rejection. Personality disorders are long-lived patterns of behavior that cause problems with work and relationships. An estimated 30.8 million American adults (14.8 percent) meet standard diagnostic criteria for at least one personality disorder as defined in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV), according to the results of the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). In 2001 to 2002 an estimated 4.9 million people (2.4 percent) had avoidant personality disorder.

Symptoms

Some common signs of avoidant personality disorder include:

Easily hurt by criticism or disapproval
Has no close friends
Reluctant to become involved with people
Avoids activities or occupations that involve contact with others
Shy in social situations out of fear of doing something wrong
Exaggerates potential difficulties


Causes

The cause of avoidant personality disorder is unknown. People with avoidant personality disorder form relationships with others only if they believe they will not be rejected. They are preoccupied with their own shortcomings. Loss and rejection are so painful that these individuals will choose loneliness rather than risk trying to connect with others.


Treatment

Antidepressant medications can often reduce sensitivity to rejection. Psychotherapy, particularly cognitive/behavioral approaches, may be helpful. A combination of medication and talk therapy may be more effective than either treatment alone.

People with this disorder may have some ability to relate to others, and this can be improved with treatment. Without treatment, a person with avoidant personality disorder may become resigned to a life of near or total isolation. See your health care provider or a psychiatrist if shyness or fear of rejection overwhelms your ability to function in life and relationships.

I used to have information posted on this forum and other forums around the site, and they've been lost awhile back when we had issues from the site, so gonna post some again when I remember what they were... anyways here's some info on treatment of AVPD and a link that I think gives out some great information.

Treatment

Medical Care

Avoidant personality disorder (APD) alone is rarely a cause for inpatient psychiatric hospitalization. Evaluation and treatment can be conducted on an outpatient basis. border= border=
Consultations.

A complete child/adolescent mental health evaluation is recommended, especially to evaluate for other anxiety disorders or depressive disorders.
Diet

No special diet is required.

Activity

Encourage patients with APD to participate in as many social activities as can be tolerated. After careful selection and child preparation, take care to ensure that the child is not set up for repeated failure or excessive anxiety. However, physicians should remember that parents of children with APD also often have personal social difficulties; these have the potential to create treatment obstacles. Some children find that social encounters can be better tolerated and even enjoyed if they have a specific role to play.


Medication

No medications have been specifically tested or approved by the US Food and Drug Administration (FDA) for children and adolescents with avoidant personality disorder (APD). Selective serotonin reuptake inhibiters (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) have been found to be effective for social anxiety disorder. In addition, some studies have reported that benzodiazepines, monamine oxidase inhibitors (MAOIs), and the anticonvulsant gabapentin are effective in the treatment of social anxiety in adults with APD.
Selective serotonin reuptake inhibitors

These agents initially block the presynaptic reuptake of serotonin, thereby allowing more of the neurotransmitter to be available in the synapse. Although no medications are approved by the FDA to treat APD, the SSRIs paroxetine (Paxil) and sertraline (Zoloft) and the SNRI venlafaxine (Effexor) are FDA-approved to treat social anxiety disorder.

SSRIs are greatly preferred over the other classes of antidepressants. Because the adverse effect profile of SSRIs is less prominent, improved compliance is promoted. SSRIs do not have the cardiac arrhythmia risk associated with tricyclic antidepressants. Arrhythmia risk is especially pertinent in cases of overdose, and suicide risk must always be considered when treating a child or adolescent with mood disorder.

Physicians are advised to be aware of the following information and use appropriate caution when considering treatment with SSRIs and SNRIs in the pediatric population.

All antidepressants now carry a black box warning regarding elevated rates of suicidal behavior (4% versus 2% on placebo) in short-term studies of children with depressive and anxiety disorders. Current recommendations include close monitoring of suicidality when starting or increasing any antidepressant. This potential risk is hotly debated within the research community.

Sertraline (Zoloft)

Zoloft and other SSRI medications are considered first-line treatment for APD and social phobia. Benefits of SSRIs include relatively high tolerance, ease of administration, and relative safety in overdose.

Benzodiazepines

These agents bind to a specific benzodiazepine receptor on the gamma-aminobutyric acid (GABA) receptor complex, thereby increasing GABA affinity for its receptor. They also increase the frequency of chlorine channel opening in response to GABA binding. GABA receptors are chlorine channels that mediate postsynaptic inhibition, resulting in postsynaptic neuron hyperpolarization. The final result is a sedative-hypnotic and anxiolytic effect. High-potency benzodiazepines are likely to be effective in treating social phobia in adults.

Clonazepam (Klonopin)

Used clinically to treat social anxiety in children and adolescents, although no controlled studies have been conducted in this population to document its efficacy. This medication is believed to work at the GABAa receptor in the brain, particularly the limbic areas.

Information taken from:
http://emedicine.medscape.com/article/913360-diagnosis[/b]