I. See Also

II. Definition

  1. Anxious or fearful personalities

III. Findings: General features of all Cluster C personalities

  1. Isolation
    1. Orderly
    2. Controlled
    3. Anxious
    4. Compulsive or Obsessive-Compulsive
  2. Passive-Aggression
    1. Self-chosen failure
    2. Masochistic
    3. Dysthymic

IV. Type: Avoidant Personality (common)

  1. Characteristics
    1. Socially inhibited, shy and lonely
    2. Sense of being inadequate with low self esteem
    3. Hypersensitive to criticism
    4. Reluctant to take risks or try new activities as they might be embarrassing
    5. Desperate for relationships
      1. But avoid social contact for fear of disapproval, criticism or rejection
      2. Impacts work, social situations, intimacy
  2. Altered interpretation of illness and physician
    1. Not forthcoming with information
    2. Will not question or disagree with doctor
  3. Recommended physician approach
    1. Reassure and validate concerns
    2. Encourage talking about concerns in future

V. Type: Obsessive Compulsive Personality

  1. Characteristics (often successful men)
    1. Inhibited, stubborn, rigid and a perfectionist - interferes with task completion
    2. Preoccupied with orderliness or perfection, rules, lists, order, organization or schedules (obscures the major point of activity)
    3. Excessively devoted to work and productivity and excludes recreation and friendships
    4. Reluctant to delegate tasks to others unless they will perform those tasks exactly as he or she directs
    5. Miserly spending habit; hoards money in case of future catastrophe
    6. Unable to throw away worthless items (without sentimental value)
    7. Mental and interpersonal control
    8. Worry about loss of emotional control
  2. Altered interpretation of illness and physician
    1. Prolongs illness behavior to obtain attention
    2. Demands urgent attention
  3. Recommended physician approach
    1. Reassure
    2. See in clinic regularly (set limits on availability)
    3. Identify support network to assist patient
    4. Avoid rejecting patient

VI. Type: Dependent Personality

  1. Characteristics (more common in women)
    1. Difficulty making everyday decisions without significant advice and reassurance from others
    2. Need to be taken care of, passive, unsure - others need to assume responsibilities for most areas of their life
    3. Submissive behavior as they fear disagreement and the loss of support or approval
    4. Difficulty initiating independent projects
    5. Volunteers to perform unpleasant tasks to obtain the nurture and support of others
    6. Urgently needs to replace one relationship when another one ends
    7. Fear of separation
    8. Sensation of helplessness
    9. May appear passive-aggressive
  2. Altered interpretation of illness and physician
    1. Exhaustive questioning
    2. Attention to minute detail
    3. Angry when routines are disrupted
  3. Recommended physician approach
    1. Careful history and examination
    2. Thorough explanations
    3. Do not emphasize uncertainty
    4. Involve patient in treatment program
  4. Evaluate for comorbid conditions
    1. Anxiety Disorder
    2. Major Depression

VII. Management

  1. Target symptoms
    1. Anxiety
    2. Behavior
    3. Obsessions
  2. Medications
    1. SSRIs
    2. Consider Benzodiazepine for short-term use

VIII. References

  1. Tomb (1992) Psychiatry, p. 147-52
  2. (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th ed, Washington D.C., APA
  3. Angstman (2011) Am Fam Physician 84(11): 1253-60 [PubMed] (or open in [QxMD Read])
  4. Ward (2004) Am Fam Physician 70(8):1505-12 [PubMed] (or open in [QxMD Read])

Images: Related links to external sites (from Google)

Ontology: Avoidant Personality Disorder (C0004444)

Definition (NCI) A disorder characterized by an enduring pattern of avoidance of social situations and interpersonal contact due to overwhelming feelings of social inadequacy and a hypersensitivity to negative evaluation or rejection.
Definition (PSY) Personality disorder characterized by excessive social discomfort, extreme sensitivity to negative perceptions of oneself, pervasive preoccupation with being criticized or rejected in social situations, and low self esteem.
Concepts Mental or Behavioral Dysfunction (T048)
MSH D010554
ICD9 301.82
ICD10 F60.6
SnomedCT 191771004, 37746008
DSM4 301.82
English Avoidant personality disorder, Avoidant personality, Avoidant Personality Disorders, Personality Disorder, Avoidant, Personality Disorders, Avoidant, AVOIDANT PERSONALITY DIS, avoidant personality disorder, avoidant personality disorder (diagnosis), Avoidant personality dis, avoidant personality disorders, avoidant disorder personality, avoidant personality, personality avoidant disorder, avoidant disorders personality, Avoidant personality disorder (disorder), avoidant; personality disorder, personality disorder; avoidant, Avoidant Personality Disorder
Italian Disturbo di personalità evitante, Personalità evitante
Dutch commando automatisme, ontwijkend; persoonlijkheidsstoornis, persoonlijkheidsstoornis; ontwijkend, ontwijkende persoonlijkheidsstoornis, Ontwijkende persoonlijkheidsstoornis
German selbstunsichere Persoenlichkeit, Vermeidungsverhalten, selbstunsichere Persoenlichkeitsstoerung
Portuguese Personalidade evitante, Transtorno da Personalidade Ansiosa, Perturbação evitante da personalidade
Spanish Personalidad evitativa, Avoidant personality disorder, Trastorno de Personalidad Evitativa, trastorno de la personalidad por evitación (trastorno), trastorno de la personalidad por evitación, Trastorno de la personalidad por evitación
Japanese 回避性人格, 回避的人格障害, カイヒテキジンカクショウガイ, カイヒセイジンカク
French Personnalité évitante, Trouble de la personnalité avec évitement, Trouble de la personnalité évitante
Czech Vyhýbavá porucha osobnosti, Vyhýbavá osobnost, vyhýbavá porucha osobnosti
Hungarian Elkerülő személyiségzavar, Elkerülő személyiség

Ontology: Anxious personality disorder (C0494415)

Concepts Mental or Behavioral Dysfunction (T048)
ICD10 F60.6
SnomedCT 192491005, 231528008
English Anxious [avoidant] personality disorder, Anxious personality disorder, Anxious personality disorder (disorder), personality disorder; anxious, anxious; personality disorder
Spanish Anxious personality disorder, trastorno ansioso de la personalidad (trastorno), trastorno ansioso de la personalidad, trastorno de personalidad ansiosa (trastorno), trastorno de personalidad ansiosa
German Aengstliche (vermeidende) Persoenlichkeitsstoerung
Korean 회피성 인격장애
Dutch angstig; persoonlijkheidsstoornis, persoonlijkheidsstoornis; angstig, Angstige [ontwijkende] persoonlijkheidsstoornis