APD and SAD Differences and Treatments

APD shares similarities with SAD.
People with APD may resemble those with SAD. Getty / Fadhi Muhammed / EyeEm

Avoidant personality disorder (APD) is usually first noticed in early adulthood and is present in a variety of situations. People with APD have many of the same characteristics as those with social anxiety disorder (SAD); however, the severity of the symptoms is greater.

If you have been diagnosed with APD, you tend to have low self-esteem, strong feelings of inadequacy and a sensitivity to rejection.

In new social settings, you will become extremely self-conscious, shy, or inhibited and will be preoccupied with being criticized or rejected. You tend to view yourself as socially inept, personally unappealing, or inferior to others.

In interpersonal relationships, you will show restraint. You tend not to trust others and avoid relationships unless you are certain of being liked. Often, people with APD become socially isolated as a result of this avoidance.

APD often interferes with occupational functioning. People with the disorder will avoid work that requires interpersonal contact and are reluctant to take risks or engage in new activities.

Similarity to SAD

Research has found few differences between the kinds of symptoms that people with social anxiety disorder and APD have. Because of the similarities between SAD and APD, people are often diagnosed as having both disorders (estimated between 16 to 57% of the time).

Like SAD, the central fear of people with APD is rejection, ridicule and humiliation by others. However, people with APD have a broader range of symptoms, and the symptoms are more severe.

Genetic Basis

A twin study conducted in 2007 found that those with social anxiety disorder and GAD had the same underlying genetic vulnerabilities.

These findings indicated that environmental factors may play a role in determining who develops social anxiety disorder versus GAD. 

Treatment of APD

APD is treated in much the same way as social anxiety disorder. Cognitive-behavioral therapy, social skills training, group therapy, and medication have all been shown to have some impact on the disorder. However, it is sometimes difficult for people with APD to trust their therapist enough to complete treatment.

If you believe you or someone you know may be suffering with the symptoms of APD or SAD, speak to a professional as soon as possible. If left untreated, APD can lead to impairment in functioning in most areas of a person’s life.

Sources:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author; 2013.

Cox BJ, Pagura J, Stein MB, Sareen J. The relationship between generalized social phobia and avoidant personality disorder in a national mental health survey. Depress Anxiety. 2009;26:354-362.

Hales RE, Yudofsky, SC. (Eds). The American Psychiatry Publishing Textbook of Clinical Psychiatry. Washington, DC: American Psychiatric; 2003.

Hummelen B, Wilberg T, Pederson G, Karterud S. The relationship between avoidant personality disorder and social phobia. Comprehensive Psychiatry. 2007;48(4):348-356.

Reich J. Avoidant personality disorder and its relationship to social phobia. Curr Psychiatry Rep. 2009;11:89-93.

Reichborn-Kjennerud T, Czajkowski N, Torgersen S et al. The relationship between avoidant personality disorder and social phobia: a population-based twin study. Am J Psychiatry. 2007;164:1722-8.

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