Avoidant Personality Disorder

People with avoidant personality disorder are preoccupied with their own shortcomings and form relationships with others only if they believe they will not be rejected. Loss and rejection are so painful that these individuals will choose to be lonely rather than risk trying to connect with others.

• Hypersensitivity to rejection/criticism
• Self-imposed social isolation
• Extreme shyness or anxiety in social situations, though the person feels a strong desire for close relationships[10]
• Avoids physical contact because it has been associated with an unpleasant or painful stimulus
• Feelings of inadequacy
• Severe low self-esteem
• Self-loathing
• Mistrust of others
• Emotional distancing related to intimacy
• Highly self-conscious
• Self-critical about their problems relating to others
• Problems in occupational functioning
• Lonely self-perception, although others may find the relationship with them meaningful
• Feeling inferior to others
• Utilizes fantasy as a form of escapism and to interrupt painful thoughts[11][12]

The World Health Organization's ICD-10 lists avoidant personality disorder as (F60.6) anxious (avoidant) personality disorder.[1] It is characterized by at least four of the following:[24]
persistent and pervasive feelings of tension and apprehension;
belief that one is socially inept, personally unappealing, or inferior to others;
excessive preoccupation with being criticized or rejected in social situations;
unwillingness to become involved with people unless certain of being liked;
restrictions in lifestyle because of need to have physical security;
avoidance of social or occupational activities that involve significant interpersonal contact because of fear of criticism, disapproval, or rejection.
Associated features may include hypersensitivity to rejection and criticism.

Research suggests that people with avoidant personality disorder, in common with sufferers of chronic social anxiety disorder (also called social phobia), excessively monitor their own internal reactions when they are involved in social interaction. However, unlike social phobics they also excessively monitor the reactions of the people with whom they are interacting. The extreme tension created by this monitoring may account for the hesitant speech and taciturnity of many people with avoidant personality disorder; they are so preoccupied with monitoring themselves and others that producing fluent speech is difficult.
Treatment of avoidant personality disorder can employ various techniques, such as social skills training, cognitive therapy, exposure treatment to gradually increase social contacts, group therapyfor practicing social skills, and sometimes drug therapy.[30] A key issue in treatment is gaining and keeping the patient's trust, since people with avoidant personality disorder will often start to avoid treatment sessions if they distrust the therapist or fear rejection. The primary purpose of both individual therapy and social skills group training is for individuals with avoidant personality disorder to begin challenging their exaggerated negative beliefs about themselves.[31]
People with AvPD can improve social awareness and skills, but with deep-seated feelings of inferiority and significant social fear, these patterns usually do not change dramatically.  Childhood peer group rejection are associated with an increased risk for the development of AvPD.