Avoidant personality disorder and its relationship to social phobia
Abstract
This review summarizes past and recent findings in the empiric literature and the evolution of the concepts of avoidant personality disorder (APD) and social phobia (SP). APD is an internally consistent dimensional personality pathology that causes dysfunction that appears to be dimensional rather than a sudden jump in impairment after a certain number of criteria have been met. It has state and trait personality components. Evidence indicates that symptoms are at least partially treatable with psychological or pharmacologic interventions. APD and SP have similar symptoms and treatment response and identical genetics. We can conclude from the empiric evidence that no dividing line exists between APD and SP, with APD merely being the more severe form of the disorder. The best conceptualization is that APD is a dimensional personality pathology that in its attenuated form (SP) resembles an anxiety disorder.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Shortcomings in establishing interpersonal relationships and severe feelings of inferiority are cardinal features of avoidant personality disorder.
“Shortcomings in establishing interpersonal relationships and severe feelings of inferiority are seen as cardinal features of APD [3, 6, 7].”
Cites
The prevalence of DSM-IV personality disorders in psychiatric outpatients
Zimmerman, M., Rothschild, L., & Chelminski, I. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.10.1911 · Cited by 825 · cited 1× · see citing works
“A large clinical epidemiologic study of 859 psychiatric outpatients with personality disorders found a 14.9% prevalence of APD [ 13 ].”
BackgroundInfluentialMcGlashan, T. H., Grilo, C. M., Skodol, A. E., Gunderson, J. G., Shea, M. T., Morey, L. C., Zanarini, M. C., & Stout, R. L. (2000) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2000.102004256.x · Cited by 542 · see citing works
Phenelzine vs Atenolol in Social Phobia: A Placebo-Controlled Comparison
Liebowitz, M. R., Schneier, F., Campeas, R., Hollander, E., Hatterer, J., Fyer, A., Gorman, J., Papp, L., Davies, S., Gully, R., et al. (1992) · Archives of General Psychiatry · doi:10.1001/archpsyc.49.4.290 · Cited by 444 · see citing works
McGlashan, T. H., Grilo, C. M., Sanislow, C. A., Ralevski, E., Morey, L. C., Gunderson, J. G., Skodol, A. E., Shea, M. T., Zanarini, M. C., Bender, D. S., et al. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.5.883 · Cited by 415 · see citing works
Pharmacotherapy of Social Phobia
Versiani, M., Nardi, A. E., Mundim, F. D., Alves, A. B., Liebowitz, M. R., & Amrein, R. (1992) · The British Journal of Psychiatry · doi:10.1192/bjp.161.3.353 · Cited by 333 · see citing works
Psychopathology of social phobia and comparison to avoidant personality disorder.
Turner, S. M., Beidel, D. C., Dancu, C. V., & Keys, D. J. (1986) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.95.4.389 · Cited by 302 · see citing works
Social phobia: A comparison of specific and generalized subtypes and avoidant personality disorder.
Turner, S. M., Beidel, D. C., & Stemberger, R. M. T. (1992) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.101.2.326 · Cited by 281 · see citing works
Validity of the distinction between generalized social phobia and avoidant personality disorder.
Herbert, J. D., Hope, D. A., & Bellack, A. S. (1992) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.101.2.332 · Cited by 237 · see citing works
Avoidant personality disorder and the generalized subtype of social phobia.
Holt, C. S., Heimberg, R. G., & Hope, D. A. (1992) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.101.2.318 · Cited by 236 · see citing works
Brown, E. J., Heimberg, R. G., & Juster, H. R. (1995) · Behavior Therapy · doi:10.1016/s0005-7894(05)80095-4 · Cited by 229 · see citing works
Associations in the Course of Personality Disorders and Axis I Disorders Over Time.
Shea, M. T., Stout, R. L., Yen, S., Pagano, M. E., Skodol, A. E., Morey, L. C., Gunderson, J. G., McGlashan, T. H., Grilo, C. M., Sanislow, C. A., et al. (2004) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.113.4.499 · Cited by 202 · see citing works
Alnæs, R., & Torgersen, S. O. (1988) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1988.tb06371.x · Cited by 196 · see citing works
Psychophysiological differences between subgroups of social phobia.
Hofmann, S. G., Newman, M. G., Ehlers, A., & Roth, W. T. (1995) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.104.1.224 · Cited by 169 · see citing works
Prevalence of personality disorders among patients with anxiety disorders
Sanderson, W. C., Wetzler, S. E., Beck, A. T., & Betz, F. (1994) · Psychiatry Research · doi:10.1016/0165-1781(94)90036-1 · Cited by 150 · see citing works
Social phobia in the Australian National Survey of Mental Health and Well-Being (NSMHWB)
Lampe, L. A., Slade, T. N., Issakidis, C., & Andrews, G. (2003) · Psychological Medicine · doi:10.1017/s0033291703007621 · Cited by 146 · see citing works
Hope, D. A., Herbert, J. D., & White, C. S. (1995) · Cognitive Therapy and Research · doi:10.1007/bf02230408 · Cited by 133 · see citing works
The relationship of social phobia subtypes and avoidant personality disorder
Schneier, F. R., Spitzer, R. L., Gibbon, M., Fyer, A. J., & Liebowitz, M. R. (1991) · Comprehensive Psychiatry · doi:10.1016/0010-440x(91)90028-b · Cited by 132 · see citing works
Alpert, J. E., Uebelacker, L. A., McLean, N. E., Nierenberg, A. A., Pava, J. A., Worthington, J. J., Tedlow, J. R., Rosenbaum, J. F., & D, M. F. M. (1997) · Psychological Medicine · doi:10.1017/s0033291797004765 · Cited by 130 · see citing works
Avoidant personality disorder: Interpersonal problems as predictors of treatment response
Alden, L. E., & Capreol, M. J. (1993) · Behavior Therapy · doi:10.1016/s0005-7894(05)80211-4 · Cited by 128 · see citing works
Social phobia: Axis I and II correlates.
Turner, S. M., Beidel, D. C., Borden, J. W., Stanley, M. A., & al, E. (1991) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.100.1.102 · Cited by 122 · see citing works
Avoidant Personality Disorder: Current Status and Future Directions
Alden, L. E., Laposa, J. M., Taylor, C. T., & Ryder, A. G. (2002) · Journal of Personality Disorders · doi:10.1521/pedi.16.1.1.22558 · Cited by 113 · see citing works
Grilo, C. M., McGlashan, T. H., Morey, L. C., Gunderson, J. G., Skodol, A. E., Shea, M. T., Sanislow, C. A., Zanarini, M. C., Bender, D. S., Oldham, J. M., et al. (2001) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2001.00436.x · Cited by 111 · see citing works
Avoidant Personality Disorder as a Predictor for Treatment Outcome among Generalized Social Phobics
Feske, U., Perry, K. J., Chambless, D., Renneberg, B., & Goldstein, A. (1996) · Journal of Personality Disorders · doi:10.1521/pedi.1996.10.2.174 · Cited by 109 · see citing works
Is Avoidant Personality Disorder More Than Just Social Avoidance?
Taylor, C. T., Laposa, J. M., & Alden, L. E. (2004) · Journal of Personality Disorders · doi:10.1521/pedi.18.6.571.54792 · Cited by 105 · see citing works
Reichborn‐Kjennerud, T., Czajkowski, N. O., Torgersen, S. O., Neale, M. C., Ørstavik, R., Tambs, K., & Kendler, K. S. (2007) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2007.06101764 · Cited by 96 · see citing works
The relationship between avoidant personality disorder and social phobia
Hummelen, B., Wilberg, T., Pedersen, G., & Karterud, S. (2007) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2007.03.004 · Cited by 88 · see citing works
Intensive behavioral group treatment of avoidant personality disorder
Renneberg, B., Goldstein, A. J., Phillips, D., & Chambless, D. L. (1990) · Behavior Therapy · doi:10.1016/s0005-7894(05)80337-5 · Cited by 83 · see citing works
Alprazolam treatment of avoidant personality traits in social phobic patients.
Reich, J. H., Noyes, R., & Yates, W. R. (1989) · PubMed · Cited by 80 · see citing works
Self-citationGeneralized Social Phobia Versus Avoidant Personality Disorder
van Velzen, C. J. M., Emmelkamp, P. M. G., & Scholing, A. (2000) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(00)00030-x · Cited by 78 · see citing works
Reich, J. H. (2000) · European Psychiatry · doi:10.1016/s0924-9338(00)00240-6 · Cited by 73 · see citing works
Self-citationHofmann, S. G., Newman, M. G., Becker, E. S., Taylor, C. B., & Roth, W. T. (1995) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(95)00022-g · Cited by 67 · see citing works
Avoidant personality disorder and social phobia: distinct enough to be separate disorders?
Ralevski, E., Sanislow, C. A., Grilo, C. M., Skodol, A. E., Gunderson, J. G., Shea, M. T., Yen, S., Bender, D. S., Zanarini, M. C., & McGlashan, T. H. (2005) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2005.00580.x · Cited by 66 · see citing works
Psychopathology of social phobia: Effects of subtype and of avoidant personality disorder
Tran, G. Q., & Chambless, D. L. (1995) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(95)00027-l · Cited by 65 · see citing works
Stravynski, A., Belisle, M., Marcouiller, M., Lavallée, Y.-J., & Eue, R. (1994) · The Canadian Journal of Psychiatry · doi:10.1177/070674379403900805 · Cited by 57 · see citing works
Psychopharmacological treatment of avoidant personality disorder
Deltito, J. A., & Stam, M. (1989) · Comprehensive Psychiatry · doi:10.1016/0010-440x(89)90079-5 · Cited by 53 · see citing works
Personality disorders and features in social phobia and panic disorder.
Jansen, M. A., Arntz, A. R., Merckelbach, H. L. G. J., & Mersch, P. P. A. (1994) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.103.2.391 · Cited by 50 · see citing works
Social phobia and avoidant personality disorder: One spectrum disorder?
Tillfors, M., Furmark, T., Ekselius, L., & Fredrikson, M. (2004) · Nordic Journal of Psychiatry · doi:10.1080/08039480410005530 · Cited by 44 · see citing works
Avoidant Personality Disorder: A Brief Review of Issues and Data
Millon, T. (1991) · Journal of Personality Disorders · doi:10.1521/pedi.1991.5.4.353 · Cited by 42 · see citing works
Social Phobia and Personality Disorder: Severity of Complaint and Treatment Effectiveness
Mersch, P. P. A., Jansen, M. A., & Arntz, A. R. (1995) · Journal of Personality Disorders · doi:10.1521/pedi.1995.9.2.143 · Cited by 39 · see citing works
Personality traits in social phobia, II: Changes during drug treatment.
Fahlén, T. (1995) · PubMed · Cited by 35 · see citing works
Avoidant Personality Disorder: Empirical Support for DSM-IV Revisions
Baillie, A., & Lampe, L. A. (1998) · Journal of Personality Disorders · doi:10.1521/pedi.1998.12.1.23 · Cited by 28 · see citing works
Hummelen, B., Wilberg, T., Pedersen, G., & Karterud, S. (2006) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2006.01.006 · Cited by 27 · see citing works
Avoidant Personality Traits Distinguish Social Phobic and Panic Disorder Subjects
Noyes, R., WOODMAN, C. L., Holt, C. S., et al. (1995) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199503000-00004 · Cited by 27 · see citing works
State and Trait in Personality Disorders
Reich, J. H. (2007) · Annals of Clinical Psychiatry · doi:10.1080/10401230601163584 · Cited by 27 · see citing works
Self-citationA case of social phobia with avoidant personality disorder treated with MAOI
Deltito, J. A., & Perugi, G. (1986) · Comprehensive Psychiatry · doi:10.1016/0010-440x(86)90051-9 · Cited by 26 · see citing works
Personality Disorders in Social Phobia
Johnson, M., & Lydiard, R. B. (1995) · Psychiatric Annals · doi:10.3928/0048-5713-19950901-10 · Cited by 24 · see citing works
Personality traits in social phobia, I: Comparisons with healthy controls.
Fahlén, T. (1995) · PubMed · Cited by 19 · see citing works
Personality Disorders: Current Research and Treatments
Reich, J. H. (2013) · Cited by 15 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Baldwin, D. S., Anderson, I. M., Nutt, D. J., Allgulander, C., Bandelow, B., den Boer, J. A., Christmas, D. M., Davies, S., Fineberg, N., Lidbetter, N., et al. (2014) · Journal of Psychopharmacology · doi:10.1177/0269881114525674 · Cited by 676 · see citing works
Kampmann, I. L., Emmelkamp, P. M. G., Hartanto, D., Brinkman, W.-P., Zijlstra, B. J. H., & Morina, N. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.12.016 · Cited by 226 · see citing works
Schema Therapy for Personality Disorders—A Review
Jacob, G. A., & Arntz, A. (2013) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2013.6.2.171 · Cited by 181 · see citing works
Baljé, A., Greeven, A., van Giezen, A., Korrelboom, K., Arntz, A., & Spinhoven, P. (2016) · Trials · doi:10.1186/s13063-016-1605-9 · Cited by 39 · see citing works
“Shortcomings in establishing interpersonal relationships and severe feelings of inferiority are seen as cardinal features of APD [3, 6, 7].”
- Authors
- Reich, J.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Reich, James
- ORCID
- Reich, James
- Venue
- Current Psychiatry Reports
- Published
- 2009-01-22
- Volume
- 11
- Issue
- 1
- Pages
- 89-93
- ISSN
- 1523-3812 (ISSN-L)
- 1535-1645
- OpenAlex
- W1987504426
- Cited by
- 49
- References
- 48
- Citations by year
- 2025: 1 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 3 · 2018: 1 · 2017: 2 · 2016: 3 · 2015: 8 · 2014: 4 · 2013: 6 · 2012: 6
- FWCI
- 4.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Psychiatry Reports (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Keywords
- avoidant personality disorder, social anxiety disorder, treatment response, genetic overlap, anxiety disorders
- MeSH terms
- Behavior Therapy, Combined Modality Therapy, Diagnosis, Differential, Humans, Personality Disorders, Phobic Disorders, Psychotropic Drugs, Self Concept, Social Perception, Cognitive Behavioral Therapy, Treatment Outcome, Diagnostic and Statistical Manual of Mental Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review