Psychiatria pre prax 4/2004

Evasive personality disorder – diagnosis and cognitive-behavioral therapy

Avoidant personality disorder shows pervasive patterns of social hypersensitivity, inhibition, timidity and inadequacy. These persons may have a strong desire to develop close, personal relationships but feel too insecure to approach others or to express their feelings. This disorder appears to be an extreme variant of the fundamental personality traits of introversion and neuroticism. These inheritant traits might be exacerbated further in childhood through overprotection and excessive cautiousness. The normal child experiences of rejection, denigrating, embarrassment and devaluation, will be particularly devastating to the persons who is already lacking of self-confidence or is temperamentally passive, inhibited, or introverted. Avoidant personality disorder may be diagnosed in only 1–2% of the general population, but as much as 5–25% of patients in clinical setting. Patients with avoidant personality disorder initially seek treatment for symptoms of anxiety, particularly social phobia, or depression. Social skills training, exposure therapy to feared social situations has been shown to be useful in the treatment of this disorder. Many persons with avoidant personality disorder will respond to antidepressants.

Keywords: avoidant personality disorder, diagnostics, pharmacotherapy, cognitive-behavioral therapy, cognitive schemas, group psychotherapy.