The Connection Between PTSD and Avoidant Personality Disorder

Avoidant Personality Disorder is More Common in PTSD

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People with post-traumatic stress disorder (PTSD) have been found to be more likely to develop other disorders, such as anxiety and mood disorders, as well as show signs of personality disorders, including borderline personality disorder, antisocial personality disorder, and avoidant personality disorder.

With regard to the latter, not much research has been conducted on the relationship between PTSD and avoidant personality disorder.

However, what has been done suggests that many people with PTSD may also be struggling with symptoms of avoidant personality disorder.

Understanding Avoidant Personality Disorder

Avoidant personality disorder is considered a personality disorder, or an enduring pattern of thoughts, emotions, and behaviors that are quite different from what you might expect given the culture in which the individual lives.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), a person with avoidant personality disorder may experience the following symptoms:

  • The avoidance of job activities that require contact with people due to fears of being criticized, disapproved of or rejected.
  • An unwillingness to become involved with people unless there is complete certainty that you will be liked and approved.
  • Being inhibited or closed off in close relationships due to fears of being shamed or ridiculed.
  • Frequent concerns about being criticized or rejected in social situations.
  • Difficulty opening up in new social situations due to feeling inadequate.
  • Feeling that you don't have social skills, are unappealing, or inferior.
  • A reluctance to take personal risks or to engage in new activities due to a fear of failure or embarrassment.

    Avoidant personality disorder is thought to be pretty rare, with only about 0.5 percent to 1 percent of people in the general population having this particular personality disorder. However, when you look at people with PTSD, studies show that the rates may be much higher.

    Rates of Avoidant Personality Disorder in PTSD

    Several studies have looked at the rates of avoidant personality disorder among people with PTSD, though most are fairly old. One of the most recent studies regarding PTSD and avoidant personality disorder was a study of military veterans with PTSD in treatment. It found that about 47 percent also had avoidant personality disorder. Another study showed that in patients with PTSD and avoidant personality disorder, the likelihood of deliberate self-harm is greater than other coexisting personality disorders.

    The rates of avoidant personality disorder found within past studies are high. It's important to keep in mind that these studies were all conducted with patients in intensive outpatient or inpatient treatment. It's likely that these patients had more severe symptoms and histories of traumatic exposure. As a result, we might expect their rates of mental health disorders to be higher than what would be found among people with PTSD in the general population.

    Getting Help for Avoidant Personality Disorder and PTSD

    If you think that you may have avoidant personality disorder, it's very important to seek help. People with avoidant personality disorder can experience a lot of difficulty managing their emotions and avoidant personality disorder has been linked with some unhealthy coping strategies, like deliberate self-harm.

    There aren't currently any well-developed treatments for avoidant personality disorder, but psychotherapy has been shown to be helpful. If your doctor finds that you have another co-occurring illness, such as depression, you may be prescribed medication as well.

     In addition, learning healthy ways of managing anxiety, avoidance, and unpleasant emotions may also be of use if you have avoidant personality disorder and PTSD.

    If you're interested in seeking out help for your PTSD and avoidant personality disorder but don't know where to look, there are a number of places on the internet that can help you find therapists in your area who may treat these disorders.

    Sources:

    Bollinger AR, Riggs DS, Blake DD, Ruzek JI. Prevalence of Personality Disorders Among Combat Veterans With Posttraumatic Stress DisorderJournal of Traumatic Stress. April  2000;13(2):255-270.

    Gratz KL, Tull MT. Exploring the Relationship Between Posttraumatic Stress Disorder and Deliberate Self-Harm: the Moderating Roles of Borderline and Avoidant Personality Disorders.  Psychiatry Research. 2012;199(1):19-23. doi:10.1016/j.psychres.2012.03.025.

    Markowitz JC, Petkova E, Biyanova T, Ding K, Suh EJ, Neria Y. Exploring Personality Diagnosis Stability Following Acute Psychotherapy for Chronic Posttraumatic Stress Disorder. Depression and Anxiety. October 6, 2015;32:919-926. doi:10.1002/da.22436.

    Medline Plus. Avoidant Personality Disorder. U.S. National Library of Medicine. Updated November 18, 2016.