According to the WHO and the American Psychiatric Association, patients with avoidant personality disorder have 7 characteristics, in terms of the patient's behavior:
- Avoid activities that involve interpersonal contact for fear of rejection in its various forms.
- It is not deeply related to people for the same reason.
- This fear affects intimate relationships .
- The possibility of social rejection is a frequent concern , although the person is usually alone.
- If you meet new people, you often feel inferior .
- The perception of oneself is that of being uninteresting and incapable in the relationship with others.
- Apart from social relations, it is not involved in new activities in case they compromise it.
As in the other personality disorders, biological factors influence. These factors are still in the initial phase of study, although it seems that the noradrenergic system is involved.
On the other hand, psychosocial factors also influence, among which are the expectations of devaluation and / or rejection in childhood and the intense fear of the possibility of separating from parents (even for a short time, even minutes).. It occurs more in immigrants who have to adapt to a new culture.
The personality disorder by avoidance is developed in the adolescence and first stage of the youth, that is when the character is constituted. In the cases in which there is a cerebral injury, toxic consumption, continued severe depression or post-traumatic stress, the previous personality can transform and appear this disorder at later ages.
It consists mainly of psychotherapy , behavioral cognitive, interpersonal, psychodynamic (based on psychoanalysis but with some differences, psychodrama individually, etc.).
It should start in an individual format, but as it is basic that the patient can adapt in social relationships, so it is important to continue with group psychotherapy.
The medication is given if anxious or depressive symptoms appear, being useful antidepressants, anxiolytics and, if necessary, hypnotics; although it is important to clarify that drugs do not modify the essence of the way of being; This goal is exclusive of psychotherapy.
Since psychotherapy is the essential treatment, investigations to determine prognosis are more difficult than in disorders in which medication is the basis of treatment. That is why it is risky to give percentages , although if we compare the personality disorder by avoidance with serious personality disorders (limit, paranoid etc), the prognosis in this case is better.