Abnormal Psychology

614 CHAPTER 13

do interact with other people. This anxious way of relating to others may inadver-

tently elicit a mild version of the very reaction they fear—that others will evaluate

them in a negative light. Among all people with personality disorders, those with

avoidant personality disorder report the lowest quality of life (Cramer, Torgersen, &

Kringlen, 2003; Wilberg et al., 2009). Table 13.22 provides additional facts about

this disorder, and Case 13.9 describes one individual’s experience.

CASE 13.9 • FROM THE OUTSIDE: Avoidant Personality Disorder

Marcus is a 33-year-old man who recently divorced.

His marriage deteriorated over several years and primarily as the result of his wife’s increas-

ing frustration with his unwillingness to do anything to improve his situation. He is employed

as a warehouse manager and has held the same position for 9 years. He sees others doing

more with their lives and wishes that he could as well. Although he hates that his wife chose

to leave the marriage, he cannot blame her for doing so. Each evening after work he is fi lled

with feelings of self-contempt and anguish. He would like to go out and be with other people,

but he is certain that no one wants his company. He fi nds that drinking alcohol and watching

television usually takes his mind off this unfulfi lling life. Marcus thinks of committing suicide

frequently.

(Rasmussen, 2005, p. 201)

Prevalence

• Approximately 0.5–2.5% of the general American population has avoidant personality disorder
  (American Psychiatric Association, 2000; Grant, Hasin, et al., 2004).


• Up to 10% of those seen in outpatient clinics have this disorder.
  Comorbidity


• Common comorbid Axis I disorders are mood disorders or anxiety disorders.


• Because the diagnostic criteria overlap with those of social phobia, comorbidity between the
  two disorders is very high (Shea et al., 2004; Skodol, 2005; Skodol et al., 1995); in one study,
  43% of people diagnosed with social phobia were also diagnosed with avoidant personality
  disorder (Faravelli et al., 2000).


• Common comorbid Axis II personality disorders are dependent personality disorder (because
  patients are dependent on the few friends they have), borderline personality disorder, and the
  Cluster A (odd/eccentric) personality disorders.
  Onset


• Based on the diagnostic criteria, symptoms such as shyness or a fear of strangers or new situ-
  ations must emerge by early adulthood.
  Course


• Two years after diagnosis, approximately 50% of people with avoidant personality disorder
  improve enough with treatment that their symptoms no longer meet the criteria (Grilo et al.,
  2004).
  Gender Differences


• Men and women do not consistently differ in their prevalence rates for avoidant personality
  disorder (Torgersen, 2005).
  Source: Unless specifi cally noted, citations are to American Psychiatric Association, 2000.

Table 13.22 • Avoidant Personality Disorder Facts at a Glance

Distinguishing Between Avoidant Personality

Disorder and Other Disorders

If you’re thinking that you’ve read about a disorder that seems similar to avoidant

personality disorder earlier in this textbook, you’re correct. Avoidant personality

disorder has much in common with social phobia (Chapter 7), and the symptoms

Dependent personality disorder
A personality disorder characterized by
submissive and clingy behaviors, based on
fear of separation.