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You are here : Health.am > Health Centers > Mental Health > Mental Disorders > Personality Disorders > Avoidant Personality Disorder > Avoidant Personality Disorder Treatment

Avoidant Personality Disorder

Avoidant Personality Disorder

Avoidant Personality Disorder Treatment

Suzanne M. Sutherland, M.D.

Treatment Recommendations

In formulating guidelines for the treatment of avoidant personality disorder, it is important to bear in mind that this disorder shares many similarities with the Axis I disorder social phobia, as well as with agoraphobia. Avoidant personality disorder also shares characteristics with other Axis II disorders, particularly dependent personality disorder (Brooks et al. 1989; Widiger 1992). When appropriate treatment is being considered for any individual, the overlapping traits must be taken into account in order to define a specific treatment plan that is appropriate for that individual.

In applying any of these therapies, the clinician should bear in mind two important issues. First, patients with avoidant personality disorder are particularly sensitive to scrutiny, even in a therapy situation. They may be reluctant to openly express their internal experience for fear of criticism from the therapist and also for fear of embarrassment. The first and most immediate goal of therapy should be to establish the rapport necessary for these patients to be able to make a commitment to a course of treatment. If this is not successful, the patient is not likely to return for a second visit. Second, clinicians must determine the length of treatment necessary for the patient to become fully functional. Clinical experience suggests that most therapies require at least a year before the avoidance is no longer significantly maladaptive, even though there may be noticeable improvement in functioning before that. The following paragraphs address the various specific therapies that can be useful in the treatment of avoidant personality disorder once a therapeutic alliance has been established.

Cognitive and Behavior Therapies

Any of several behavior therapies can be effective treatments for social anxiety and avoidant behaviors. These include CBT, rational-emotive therapy, systematic desensitization, and social skills training, in conjunction with exposure techniques, either graduated or flooding. In addition, anxiety management techniques should be provided early in therapy because these patients will predictably begin to experience elevated levels of anxiety as their exposure to feared situations increases during the course of therapy.

Treatment gains may not be impressive immediately after a period of therapy but may become evident after a longer period of exposure to avoidant situations. It may not always be necessary to engage in ongoing therapy after the initial treatment course. Follow-up data have suggested that some patients maintain gains and even improve on some measures several months to years after completing the treatment course (Emmelkamp et al. 1985; Heimberg et al. 1990; Mersch et al. 1991). However, the few data available suggest that for more severely impaired patients, additional treatment is indicated after a brief treatment course (Mersch et al. 1991).

Socially avoidant persons, although improving significantly after behavioral treatments, tend to show limitations in the amount of improvement and may not reach "normal" levels of functioning after treatment (Alden 1989; Cappe and Alden 1986). Stravynski et al. (1982) reported significant improvement on treatment targets for both the social skills training and the cognitive restructuring groups but noted the lack of generalization to in vivo intimate relationships at a 6-month follow-up and suggested the need for some form of intimacy training. In light of this finding, it may be important for many patients with avoidant personality disorder to engage in psychodynamic therapy and/or IPT (see below), either as a primary treatment or as an adjunct to a cognitive-behavioral approach.

The treating clinician also should bear in mind that the internal cognitions of the patient receiving treatment will affect that patient's assessment of any exposure experience and will determine whether the exposure is desensitizing or whether it may be an experience that further reinforces negative cognitions. This is one interpretation of those studies in which long-term follow-up indicated relapse after exposure therapy alone but maintenance and enhancement of gains after CBT.

Typical cognitions of patients with avoidant personality disorder include self-deprecating thoughts such as "I am a social failure" and "Every time I open my mouth, I say something stupid" or "I am a fraud—if I talk freely to others, they will figure out that I'm really not qualified." A second major area is these patients' expectation that others will assess them negatively and will reject them. They may think, for example, "People will think I am bragging if I talk about what I know or if I mention the recognition I have received," and "Nobody wants to be around someone as boring as me" or "I am sure they won't like me." The third major area of distorted cognition in patients with avoidant personality disorder is the belief that unpleasant thoughts and feelings are unbearable. These persons may think "I can't handle feeling this sad" or "I'll lose control if I let myself feel this bad."

The goal of cognitive therapy should be to alter the patient's self-critical cognitions and expectations of critical assessment by others and to challenge the common belief that any unpleasant emotion or interaction is intolerable. If the patient's tendency to negatively interpret social interactions has been addressed in therapy, then the exposure experiences can positively alter the patient's overall assessment of his or her experience in the world.

Psychodynamic Therapy

Interpretive techniques may be useful either alone or as adjunctive interventions with behavior and exposure therapies. An "uncovering" approach may be used to interpret the unconscious fantasies related to the patient's fear that he or she will lose control of his or her behavior, resulting in criticism from others and causing the patient to feel threatened, shamed, or embarrassed. Patients with avoidant personality disorder are likely to have harsh superegos and also to project their unrealistic expectations of themselves onto others. They avoid interpersonal relationships in order to evade expected criticism and embarrassment.

Gabbard (1994) pointed out that the psychodynamic meaning of the anxiety must be explored in order to understand its origins in the individual patient and that shame is often uncovered as a central affective experience. In the typical patient, shame and self-exposure are intimately connected, and the patient actively withdraws from interpersonal situations in order to avoid experiencing the highly unpleasant affect of shame. Earlier psychoanalytic writings stressed the importance of identifying the unconscious impulse (sexual, aggressive, or dependent) and the fear and guilt it evokes and then tracing the ensuing avoidant defensive pattern in the transference, in outside relationships, and in early life experiences (Fenichel 1945). Patients with avoidant personality disorder may be excellent candidates for various types of psychodynamic treatment, including focal, long-term, and even psychoanalytic treatment. The combination of psychodynamic and exposure therapies can be particularly useful. A psychodynamic approach can be helpful in dealing with issues of shame, guilt, and grief that may arise during the course of CBT, as well as during pharmacotherapy; exposure can increase the usefulness and pertinence of the uncovering enterprise.

Interpersonal Therapy

IPT attempts to provide patients with a healing interpersonal or corrective emotional experience in the therapeutic relationship. This experience may allow them to take chances in this interpersonal relationship that they have been unwilling to take in their lives. As they overcome their fear of interpersonal rejection within the therapeutic setting, these patients can learn to take additional chances outside the treatment, where they may also discover that their behavior is acceptable. Interactional psychotherapy in this context is a treatment in which the patient's maladaptive behavior is dealt with directly in the context of the therapist-patient relationship (Cashdan 1982).

In IPT, the therapist first uses supportive techniques to overcome the patient's timidity and avoidance. As the patient becomes more secure in the treatment relationship, the therapist maintains a sympathetic and protective attitude while directly encouraging assertive behavior. As therapy progresses and the patient becomes more self-confident, the therapist becomes less supportive of the avoidant behavior and withholds the sympathy and protection (Cashdan 1982). The therapist also may bring in significant others or work in a group format in which the patient can actively try out new behaviors.

Psychopharmacological Treatment

There is as yet no compelling evidence for recommending medication as a primary form of treatment of avoidant personality disorder. However, the evidence that several medications are effective in the treatment of generalized social phobia has implications for the utility of these medications in treating avoidant personality disorder. When treatment possibilities are being considered for a patient with avoidant personality disorder, the pattern of heightened psychic pain and diminished psychic pleasure that Millon (1996) described as being at the heart of avoidant personality disorder must be recognized. Although many patients with avoidant personality disorder may engage in such global avoidant behavior that they do not experience the typical physiological symptoms of social anxiety, such as palpitations, blushing, tremor, and sweating, the internal experience of emotional pain may be severe and may be alleviated somewhat with medication. Also, pharmacotherapy, particularly with MAOIs and SSRIs, may affect some of the core dimensional features of avoidant personality disorder, such as shyness, rejection sensitivity, heightened psychic pain, and distorted cognitions related to self-criticism and self-effacement.

For those patients nonresponsive to the above-mentioned antidepressants, the newer agent venlafaxine may be helpful. Data are also emerging in support of other agents with anxiolytic and mood-stabilizing properties, which may be used alone or in conjunction with an antidepressant. The high-potency benzodiazepine clonazepam has been shown to be effective for generalized social phobia, and recent data indicated little difficulty in withdrawal after months of treatment (Connor et al. 1998). The clinician should balance the issue of possible substance dependence with findings that patients with generalized social phobia and panic disorder tend to require lower doses or to become drug-free over time (Davidson et al. 1991; Rickels et al. 1993).

The well-tolerated anticonvulsant gabapentin also may be useful. In a two-center trial of outpatients with DSM-IV social phobia, the benefits were most apparent in those patients with more severe symptoms and with agoraphobic features (Pande et al. 1999).

The patients may need frequent visits for support during the minimum 6-week trial period for medication, and encouragement from the clinician is generally necessary for the patient to initiate changes in behavior. Exposure to avoided situations is critical to the healing process, as well as a course of drug treatment that is at least several months' duration.

Group Therapy

Group therapy can be extremely beneficial, although particularly anxiety-provoking for patients with avoidant personality disorder, and is recommended after a period of individual treatment. Individual cognitive therapy in preparation can improve the likelihood of participation in group therapy and also will allow the individual to make better use of this modality. New attitudes and skills can then be learned in a benign and accepting social environment. Group treatment can also serve as a corrective emotional experience that may allow the patient to pursue intimate relationships outside the therapy setting. A group that is psychodynamically oriented also may provide valuable empathic support and appreciation of the courage needed for these patients to expose themselves to social situations. It can provide the positive experience that these patients may find necessary before they are willing to apply newly learned behaviors to in vivo situations.

Family Therapy

It is common for the avoidant behavior of the patient with avoidant personality disorder to be reinforced by a family context that is analogous to the workings of the phobic partnerships formed by patients with Axis I agoraphobia. Family members may become overprotective with the intent of being helpful but in fact may help to maintain the patient's unwillingness to take chances (Carson 1982; Kiesler 1982). The clinician may find it useful to engage family members in the treatment process by educating them about the importance of behavior changes in the patient. Family members may become extremely helpful in encouraging the patient to engage in social situations and also may be able to give emotional support while prodding the patient to seek out new experiences.

Medications

For individuals with AvPD, drugs and alcohol provide escape/avoidance of painful feelings and the situations that elicit these feelings. Drug use assists in modulating hyperarousal and self-deprecatory thoughts. Some individuals with AvPD prefer mild hallucinogens over other drugs, perhaps because they facilitate fantasy. However, sedatives and antianxiety agents are usually the drugs of choice for most clients with AvPD (Richards, 1993, p. 269). While sedative-hypnotics calm anxiety, stimulants or PCP can provide a sense of strength or reduced vulnerability. The drug of choice for these individuals will be whatever gives them a sense of efficacy or allows them to believe that they can be attractive and effective interpersonally.

Many individuals with AvPD also develop compulsive behaviors that relate to appearance enhancement, fantasy, and self-comfort. They may enter treatment with compulsive shopping, compulsive sexual behaviors, and eating disorders in place as well as with drug or alcohol addiction. Abstinence, to be effective, will need to address all self-destructive behaviors as well as drug and alcohol use.

Conclusions

Avoidant personality disorder is a disorder that is being increasingly recognized as one that is fairly prevalent and that causes much impairment in both social and occupational functioning. Although some initial treatment data show some improvement with the various forms of treatment described here, the small body of literature does not enable us to make a conclusive statement regarding a definitive form of treatment. However, there is growing optimism that this personality disorder may be highly treatable with good long-term prognosis. Clearly, this disorder warrants further research, including further study of its management with CBT and medication, alone and in combination. Finally, all of these therapies need to be evaluated in the various formats of individual, group, and family therapy.

References

  • Alden L: Short-term structured treatment for avoidant personality disorder. J Consult Clin Psychol 56:756-764, 1989
  • Alden LE, Capreol MJ: Avoidant personality disorder: interpersonal problems as predictors of treatment response. Behavior Therapy 24:357-376, 1993
  • Allgulander C: Paroxetine in social anxiety disorder: a randomized, placebo-controlled study. Acta Psychiatr Scand 100:193-198, 1999
  • Alnaes R, Torgersen S: Personality and personality disorders predict development and relapses of major depression. Acta Psychiatr Scand 95:336-342, 1997
  • Alpert JE, Uebelacker LA, McLean NE, et al: Social phobia, avoidant personality disorder and atypical depression: co-occurrence and clinical implications. Psychol Med 27:627-633, 1997
  • Altamura AC, Pioli R, Vitto M, et al: Venlafaxine in social phobia: a study in selective serotonin reuptake inhibitor non-responders. Int Clin Psychopharmacol 14:239-245, 1999
  • American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition. Washington, DC, American Psychiatric Association, 1980
  • American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, Revised. Washington, DC, American Psychiatric Association, 1987
  • American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Washington, DC, American Psychiatric Association, 1994
  • Baillie AJ, Lampe LA: Avoidant personality disorder: empirical support for DSM-IV revisions. J Personal Disord 12:23-30, 1998
  • Baldwin D, Bobes J, Stein DJ, et al: Paroxetine in social phobia/social anxiety disorder. Br J Psychiatry 175:120-126, 1999
  • Barber JP, Muenz LR: The role of avoidance and obsessiveness in matching patients to cognitive and interpersonal psychotherapy: empirical findings from the Treatment for Depression Collaborative Research Program. J Consult Clin Psychol 64:951-958, 1996
  • Barber JP, Morse JQ, Krakauer ID, et al: Change in obsessive-compulsive and avoidant personality disorders following time-limited supportive-expressive therapy. Psychotherapy 34:133-143, 1997
  • Beck AT, Freeman A: Cognitive Therapy of Personality Disorders. New York, Guilford, 1990
  • Blomhoff S, Huag TT, Humble M, et al: Treatment of generalized social phobia. Paper presented at the annual meeting of the American Psychiatric Association, Washington, DC, May 1999
  • Brooks RB, Baltazar PL, Munjack DJ: Co-occurrence of personality disorders with panic disorder, social phobia, and generalized anxiety disorder: a review of the literature. J Anxiety Disord 3:259-285, 1989
  • Brown EJ, Heimberg RG, Juster HR: Social phobia subtype and avoidant personality disorder: effect on severity of social phobia, impairment, and outcome of cognitive-behavioral treatments. Behavior Therapy 26:467-486, 1995
  • Cappe RF, Alden LE: A comparison of treatment strategies for clients functionally impaired by extreme shyness and social avoidance. J Consult Clin Psychol 54:796-801, 1986
  • Carson R: Self-fulfilling prophecy, maladaptive behavior and psychotherapy, in Handbook of Interpersonal Psychotherapy. Edited by Anchin J, Kiesler D. New York, Pergamon, 1982, pp 64-77
  • Cashdan S: Interactional psychotherapy: using the relationship, in Handbook of Interpersonal Psychotherapy. Edited by Anchin J, Kiesler D. New York, Pergamon, 1982, pp 215-226
  • Chambless DL, Tran GQ, Glass CR: Predictors of response to cognitive-behavioral group therapy for social phobia. J Anxiety Disord 11:221-240, 1997
  • Connor KM, Davidson JRT, Potts NS, et al: Discontinuation of clonazepam in the treatment of social phobia. J Clin Psychopharmacol 18:373-378, 1998
  • Davidson JRT, Ford SM, Smith RD, et al: Long-term treatment of social phobia with clonazepam. J Clin Psychiatry 52 (11, suppl):16-20, 1991
  • Deltito JA, Stam M: Psychopharmacology treatment of avoidant personality disorder: Compr Psychiatry 30:498-504, 1989
  • Emmelkamp PMG, Mersch PP, Vissia E: Social phobia: a comparative evaluation of cognitive and behavioral interventions. Behav Res Ther 23:365-369, 1985
  • Fenichel O: The Psychoanalytical Theory of the Neurosis. New York, WW Norton, 1945
  • Feske U, Chambless DL: Cognitive behavioral versus exposure only treatment for social phobia: a meta-analysis. Behavior Therapy 26:695-720, 1995
  • Feske U, Perry KJ, Chambless DL, et al: Avoidant personality disorder as a predictor for severity and treatment outcome among generalized social phobics. J Personal Disord 10:174-184, 1996
  • Gabbard GO: Cluster C personality disorders, in Psychodynamic Psychiatry in Clinical Practice: The DSM-IV Edition. Washington, DC, American Psychiatric Association, 1994, pp 601-608
  • Greenberg D, Stravynski A: Social phobia. Br J Psychiatry 143:526-527, 1983
  • Heimberg RG: Specific issues in the cognitive-behavioral treatment of social phobia. J Clin Psychiatry 54 (suppl):36-45, 1993
  • Heimberg RG: Social phobia, avoidant personality disorder, and the multiaxial conceptualization of interpersonal anxiety, in Key Trends in Cognitive and Behavioral Therapies. Edited by Salkovskis P. Chichester, UK, Wiley, 1996, pp 103-112
  • Heimberg RG, Dodge GS, Hope DA, et al: Cognitive behavioral treatment for social phobia: comparison to a credible placebo group. Cognitive Therapy and Research 14:1-23, 1990
  • Herbert JD, Hope DA, Bellack AS: Validity of the distinction between generalized social phobia and avoidant personality disorder. J Abnorm Psychol 101:332-339, 1992
  • Holt CS, Heimberg RG, Hope DA: Avoidant personality disorders and the generalized subtype of social phobia. J Abnorm Psychol 101:318-325, 1992
  • Hope DA, Herbert JD, White C: Diagnostic subtype, avoidant personality disorder, and efficacy of cognitive-behavioral group therapy for social phobia. Cognitive Therapy and Research 19:399-417, 1995
  • Horney K: Our Inner Conflicts. New York, WW Norton, 1945
  • Horney K: Neurosis and Human Growth. New York, WW Norton, 1950
  • Jung CG: Psychological types (1936), in Collected Works of C. G. Jung, Vol 6. Edited by McGuire W. Princeton, NJ, Princeton University Press, 1974, pp 550-553
  • Katzelnick DJ, Kobak KA, Greist JH, et al: Sertraline for social phobia: a double-blind, placebo-controlled crossover study. Am J Psychiatry 152:1368-1371, 1995
  • Kelsey JE: Venlafaxine in social phobia. Psychopharmacol Bull 31:767-771, 1995
  • Kessler RC, McGonagle KA, Zheo S, et al: Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry 51:8-19, 1994
  • Kiesler D: Interpersonal theory for personality and psychotherapy, in Handbook of Interpersonal Psychotherapy. Edited by Anchin J, Kiesler D. New York, Pergamon, 1982, pp 3-24
  • Liebowitz MR, Schneier F, Capneas R, et al: Phenelzine vs. atenolol in social phobia, a placebo controlled comparison. Arch Gen Psychiatry 49:290-300, 1992
  • Maier W, Lichterman D, Klinger T, et al: Prevalences of personality disorder (DSM-III-R) in the community. J Personal Disord 6:187-196, 1992
  • Marzillier JS, Lambert C, Kellett J: A controlled evaluation of systematic desensitization and social skills training for socially inadequate psychiatric patients. Behav Res Ther 14:225-238, 1976
  • Mersch PPA, Emmelkamp PMG, Lips C: Social phobia: individual response patterns and the long-term effects of behavioral and cognitive interventions: a follow-up study. Behav Res Ther 29:357-362, 1991
  • Millon T (ed): Modern Psychopathology: A Biosocial Approach to Maladaptive Learning and Functioning. Philadelphia, PA, WB Saunders, 1969, pp 231-233
  • Millon T: Disorders of Personality: DSM-III, Axis II. New York, Wiley, 1981
  • Millon T: Avoidant personality disorder: a brief review of issues and data. J Personal Disord 6:353-362, 1991
  • Millon T: Disorders of Personality: DSM-IV and Beyond. New York, Wiley, 1996
  • Numberg HG, Martin GA, Pollack S: An empirical method to define personality disorder classification using stepwise logistic regression modeling to develop diagnostic criteria and thresholds. Compr Psychiatry 35:409-419, 1994
  • Pande AC, Davidson JR, Jefferson JE, et al: Treatment of social phobia with gabapentin: a placebo-controlled study. J Clin Psychopharmacol 19:341-345, 1999
  • Perugi G, Nassini S, Socci C, et al: Avoidant personality in social phobia and panic-agoraphobia disorder: a comparison. J Affect Disord 54:277-282, 1999
  • Reich J, Noyes R, Yates W: Alprazolam treatment of avoidant personality traits in social phobic patients. J Clin Psychiatry 50:91-95, 1989
  • Rickels K, Schweizer E, Weiss S, et al: Maintenance drug treatment for panic disorder: short and long-term outcome after drug taper. Arch Gen Psychiatry 50:61-68, 1993
  • Schneier FR, Chin SJ, Hollander E, et al: Fluoxetine in social phobia (letter). J Clin Psychopharmacol 12:62-63, 1992
  • Scholing A, Emmelkamp PMG: Prediction of treatment outcomes in social phobia: a cross-validation. Behav Res Ther 377:659-670, 1999
  • Stein MB, Liebowitz MR, Lydiard RB, et al: Paroxetine treatment of generalized social phobia. JAMA 250:708-713, 1998
  • Stein MB, Fyer AJ, Davidson JRT: Fluvoxamine in the treatment of social phobia: a double-blind placebo-controlled study. Am J Psychiatry 156:756-760, 1999
  • Sternbach H: Fluoxetine treatment of social phobia (letter). J Clin Psychopharmacol 10:230, 1990
  • Stravynski A, Marks I, Yule W: Social skills problems in neurotic outpatients: social skills training with and without cognitive modification. Arch Gen Psychiatry 39:1378-1385, 1982
  • Taylor S: Meta-analysis of cognitive-behavioral treatment for social phobia. J Behav Ther Exp Psychiatry 27:1-9, 1996
  • Tran GQ, Chambless DL: Psychopathology of social phobia: effects of subtype and of avoidant personality disorder. J Affect Disord 9:489-501, 1995
  • Turner SM, Biedel DC, Dancu CV, et al: Psychopathology of social phobia and comparison to avoidant personality disorder. J Abnorm Psychol 95:389-394, 1986
  • Turner SM, Beidel DC, Townsley RM: Social phobia: a comparison of specific and generalized subtypes and avoidant personality disorder. J Abnorm Psychol 101:326-331, 1992
  • Turner SM, Beidel DC, Wolff PL, et al: Clinical features affecting treatment outcome in social phobia. Behav Res Ther 34:795-804, 1996
  • Van Ameringen M, Swinson R, Walker JR, et al: A placebo-controlled study of sertraline in generalized social phobia. Paper presented at the 19th National Conference of the Anxiety Disorders Association of America, San Diego, CA, March 25-28, 1999
  • Van Vliet IM, Den Boer J, Westenberg HGM: Psychopharmacological treatment of social phobia: a double-blind placebo controlled study with fluvoxamine. Psychopharmacology (Berl) 115:128-134, 1994
  • Van Vliet IM, Westenberg HGM, van Megan HTGM: Clinical effects of venlafaxine in social phobia. Paper presented at the 11th Congress of the European College of Neuropsychopharmacology (ECNP), Paris, France, October 31-November 4, 1998
  • Versiani M, Nardi AE, Mundim FD, et al: Pharmacotherapy of social phobia: a controlled study with moclobemide and phenelzine. Br J Psychiatry 161:353-360, 1992
  • Widiger TA: Generalized social phobia versus avoidant personality disorder: a commentary on three studies. J Abnorm Psychol 101:340-343, 1992
  • Winston A, Laikin M, Pollack J, et al: Short-term psychotherapy of personality disorders. Am J Psychiatry 151:190-194, 1994
  • World Health Organization: International Classification of Diseases, 10th Revision. Geneva, Switzerland, World Health Organization, 1991
  • Zimmerman M, Coryell WH: Diagnosing personality disorder in the community. Arch Gen Psychiatry 47:527-531, 1990
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