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Anthony Ruocco

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2012-11-22 PERSONALITY DISORDERS – LEC 11 Avoidant Personality Disorder Diagnostic Criteria: • Apervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following: o Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection. o Is unwilling to get involved with people unless certain of being liked. o Shows restraint within intimate relationships because of the fear of being shamed or ridiculed. o Is preoccupied with being criticized or rejected in social situations. o Is inhibited in new interpersonal situations because of feelings of inadequacy. o Views self as socially inept, personally unappealing, or inferior to others. o Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing. Avoidant vs. Social Phobia: • Why is there a high diagnostic co-occurent of these two disorders. • Asocial phobia is marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual thinks they are going to be humiliated. Might result in panic attacks. • Patients with avoidant personality disorder, that have more SEVERE symptoms that those with social phobia; they do not differ qualitatively on other important variables that would support them as distinct disorders. • In psychotherapy trials, avoidant personality disorder patients benefit as much as do social phobia patients, although they begin and end treatment with more severe symptoms. Aproposal for DSM-V: • Avoidant personality disorder and social phobia (generalized) reflect the same spectrum of psychopathology rather than distinct disorders. • Is it an axis I or axis II disorder? • Three key features of personality disorders: o Early onset o Chronic course o Ego-syntonic (symptoms viewed as consisten with one’s identity) o Anxiety disorders have lower remissionr ates (cured) than personality and mood disorders. o Aavoidant personality disorder and social phobia show a high degree of association across time in their naturalistic course. • Opinion by auther: combning avoidant personality disorder and social phobia will not resovle boundary isseus between normalcy and pathology but it could resolve the dilemma in distinguishing between two supposedly distinct disorders that appear to have the same underlying dimensions. Dependent Personality Disorder • High levels of trait dependency and DPD are associated with elevated risk for the following (Bornstein, 2012). • Is dependency all that bad though? In Western countries it is seen as something bad, but in different cultures depen
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