Researchers believe up to five percent of the population lives with a condition called avoidant personality disorder (AVPD), a chronic disorder that affects both men and women in equal numbers. An intense hypersensitivity to rejection and feelings of inadequacy characterize AVPD. Although experts think this mental illness has both genetic and environmental factors, doctors rarely diagnose it in those younger than 18 years of age. Without treatment, individuals may limit social interaction to the point that it inhibits their ability to function day to day.

Symptoms of AVPD

Children as young as 2 years old may exhibit symptoms of AVPD. Shyness, social isolation, and avoidance of strangers and new places are repeated behaviors that often begin in childhood and evolve into typical patterns as young people age. Those with AVPD tend to be extremely sensitive and fear criticism or disapproval by others. They may feel inept and inadequate in the presence of others. Individuals with AVPD have an intense fear of rejection and may avoid social interactions altogether. Shyness and social awkwardness are common behavioral traits.

Causes of AVPD

Researchers have yet to identify a specific cause of AVPD and consider it an underrecognized and poorly studied condition. However, most agree that the condition develops in early life. Many of those diagnosed with AVPD relate similar early interactions with parents, starting at a young age. These individuals often describe their parents as being less affectionate toward them, not only failing to show them encouragement but also rejecting them on a regular basis. A doctor may diagnose the disorder in adults who experienced abuse or neglect as children. Adoptees develop not only AVPD but other personality disorders at double the rate of children who grew up in their biological home.

Cluster C Personality Disorders

There are ten personality disorder types, broken down into three categories: Cluster A, Cluster B, and Cluster C. AVPD belongs to a group of personality disorders characterized by fear or anxiousness — Cluster C. Also included in Cluster C are obsessive-compulsive disorder (OCPD) and dependent personality disorder (DPD). Psychiatric experts associate AVPD more closely with DPD than with other Cluster C disorders. Individuals with DPD also experience feelings of worthlessness, but seek out a caregiver to fulfill their needs.

Genetics Behind Cluster C Personality Disorders

According to genetic epidemiologic research, all ten types of personality disorders have modest to moderate chances of genetic inheritance. Studies on families, and those focusing on twins, found a significant occurrence of the disorders within families. The chances of inheriting AVPD was 28 percent, but the chances were higher for DPD, at 57 percent. Researchers found a 77 percent chance of passing on OCPD through the family gene pool. Those who share these genes may be more vulnerable to personality disorders. Introversion is an additional genetic risk factor among those diagnosed with AVPD. Variations in the COMT gene also contribute to the genetic risk. This gene is responsible for creating an enzyme that controls stress and other aspects of human personality.

AVPD and Social Anxiety

Although individuals with social anxiety disorder (SAD) or AVPD share common symptoms, they are not the same condition. The medical community once believed that an individual could not have AVPD unless he or she also had SAD. Findings now indicate that the symptoms of AVPD are more severe day-to-day than those associated with SAD. People experience anxiety with all areas of their lives, not just social situations, as commonly occurs with SAD. However, it is not unusual for individuals with AVPD to also have SAD, OCPD, depression, or other anxiety disorders.

AVPD vs. Schizoid and Schizotypal Personality Disorders

Social isolation is also a symptom of schizoid and schizotypal personality disorders. The difference is, individuals with AVPD may have relationships, but they feel inadequate and anxious about them due to their feelings of inadequacy. Those with schizoid or schizotypal disorders completely isolate themselves from social connections. Characterizations of both schizoid and schizotypal personality disorders include cognitive deficits and eccentric behavior similar to those experienced by people with schizophrenia.

Complications with the AVPD Diagnosis

AVPD goes well beyond the normal feelings of self-doubt and fear many people experience when entering new relationships and unfamiliar surroundings, for instance. Once avoidant characteristics begin to have long-term, negative effects, the issue begins to meet the criteria for a personality disorder. AVPD can mask symptoms associated with other mood or anxiety disorders. It can also cause other conditions — for example, the security and isolation triggered by AVPD can lead to depression.

Psychotherapy as Treatment for AVPD

An individual experiencing symptoms of APVD often requires a diagnostic evaluation. Psychotherapy is the primary treatment for AVPD. It focuses on improving and building social skills and teaching the individual how to control the negative thought patterns that occur with the disorder. Learning to control the internal conflicts caused by AVPD, and to reducing the lifelong patterns that interrupt day-to-day life, is essential to the success of the treatment.

Medications and AVPD Treatment

Cognitive therapy is a more successful method of treatment for AVPD than medication, according to many therapists. Because there has been little research into the effectiveness of medications in treating AVPD, many doctors prefer using psychotherapy instead. Overall, medications tend to be a less-effective treatment and may interfere with cognitive therapy. However, a physician may prescribe medications to treat specific symptoms of the condition such as depression or anxiety.

When to Seek Help for AVPD

An illness preventing an individual from carrying out a daily routine, social interactions, or work obligations is a serious one. AVPD is a mental health condition that requires professional intervention. Additionally, there is a higher incidence of substance abuse among those people with AVPD, who may use drugs and alcohol to ease anxiety and deal with depression and other symptoms. An individual should immediately seek medical attention or call a hotline if he or she considers self-harm or suicide.