Abnormal Psychology

Personality Disorders 613

Fearful/Anxious Personality Disorders

The personality disorders in Cluster C—avoidant, dependent, and obsessive-

compulsive personality disorders—share the feature of anxiety or fear. Although

they have this superfi cial commonality, there is little overlap among the diagnostic

criteria for these three disorders; this is in sharp contrast to the disorders within

Cluster A (odd/eccentric) and those within Cluster B (dramatic/erratic), which have

overlapping criteria.

Avoidant Personality Disorder

The predominant characteristic of people with avoidant personality disorder is

social inhibition—extreme shyness—that usually stems from feeling inadequate and

being overly sensitive to negative evaluation (American Psychiatric Association,

2000). People with avoidant personality disorder are of-

ten characterized as shy, isolated, timid, or lonely.

What Is Avoidant Personality Disorder?

The diagnostic criteria for avoidant personality disor-

der (see Table 13.21) all relate to the individual’s pre-

dominant concern about embarrassing himself or herself

during social interactions—perhaps by blushing or

crying—and being socially rejected or humiliated. These

fears, in turn, lead the individual to try to limit social

interactions.

People with avoidant personality disorder are so

reluctant to engage in social interactions that they may

turn down a promotion if the position requires increased

social contact. And they are often hypervigilant for any

indication of criticism or rejection. Unfortunately, their

social fears and anxieties cause them to behave in tense

and fearful ways—for example, not talking about them-

selves for fear of what others might think—when they

admiration. People with this disorder may also feel a sense of

entitlement, behave arrogantly, and have diffi culty understand-

ing other people’s points of view.

• Histrionic and narcissistic personality disorders are theorized
  to arise from a combination of temperament, maladaptive be-
  liefs and behaviors, and social interactions. Patients with these
  personality disorders often drop out of treatment early, in part
  because they are reluctant to shift from viewing others as the
  cause of their problems to viewing or acknowledging their own
  role in creating their problems.

Making a Diagnosis

• Reread Case 13.5 about John, and determine whether or not his
  symptoms meet the criteria for antisocial personality disorder.
  Specifically, list which criteria apply and which do not. If you
  would like more information to determine his diagnosis, what
  information—specifi cally—would you want, and in what ways
  would the information infl uence your decision?
  
  
  • Reread Case 13.6 about Donna, and determine whether or not
    her symptoms meet the criteria for borderline personality dis-
    order. Specifi cally, list which criteria apply and which do not. If
    you would like more information to determine her diagnosis,
    what information—specifi cally—would you want, and in what
    ways would the information infl uence your decision?
  
  
  • Reread Case 13.7 about the 23-year-old woman, and determine
    whether or not her symptoms meet the criteria for histrionic per-
    sonality disorder. Specifi cally, list which criteria apply and which
    do not. If you would like more information to determine her diag-
    nosis, what information—specifi cally—would you want, and in
    what ways would the information infl uence your decision?
  
  
  • Reread Case 13.8 about Patricia, and determine whether or not
    her symptoms meet the criteria for narcissistic personality dis-
    order. Specifi cally, list which criteria apply and which do not. If
    you would like more information to determine her diagnosis,
    what information—specifi cally—would you want, and in what
    ways would the information infl uence your decision?
  
  
  
  

Table 13.21 • DSM-IV-TR Diagnostic Criteria for

Avoidant Personality Disorder

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensi-

tivity to negative evaluation, beginning by early adulthood and present in a variety

of contexts, as indicated by four (or more) of the following:

(1) avoids occupational activities that involve signifi cant interpersonal contact,

because of fears of criticism, disapproval, or rejection.

(2) is unwilling to get involved with people unless certain of being liked.

(3) shows restraint within intimate relationships because of the fear of being

shamed or ridiculed.

(4) is preoccupied with being criticized or rejected in social situations.

(5) is inhibited in new interpersonal situations because of feelings of inadequacy.

(6) views self as socially inept, personally unappealing, or inferior to others.

(7) is unusually reluctant to take personal risks or to engage in any new activities

because they may prove embarrassing

Source: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders,

Text Revision, Fourth Edition, (Copyright 2000) American Psychiatric Association.

Avoidant personality disorder

A personality disorder characterized by

extreme social inhibition (i.e., extreme

shyness) that usually stems from feeling

inadequate and being overly sensitive to

negative evaluation.