Hostname: page-component-848d4c4894-cjp7w Total loading time: 0 Render date: 2024-06-20T06:06:59.888Z Has data issue: false hasContentIssue false
  • English
  • Français

The relationship of social phobia to avoidant personality disorder: a proposal to reclassify avoidant personality disorder based on clinical empirical findings

Published online by Cambridge University Press:  16 April 2020

J. Reich
J. Reich*
Affiliation:
Harvard and Stanford Medical Schools, Departments of Psychiatry, 2255 North Point St., Suite 102, San Francisco, CA94123, USA

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

In the DSM system social phobia and avoidant personality have been conceptualized as independent entities. Each had separate, if overlapping diagnostic criteria. The specific inclusion and exclusion criteria provided by DSM allowed empirical research to guide future revisions. This review evaluates the empirical literature and evolution of the concepts of these diagnoses from DSM-III to DSM-IIR to DSM-IV. The empirical evidence leads us to the conclusion that there is no dividing line between social phobia and avoidant personality disorder. In addition to their being no dividing line diagnostically between the disorders, there appears to be no separation of the two by treatment techniques. This raises interesting questions about how we differentiate Axis I from Axis II disorders. Suggestions for revisions of the social phobia and avoidant personality disorder categories are given.

Keywords

avoidant personality disordersocial phobia
Type
Editorial
Information
European Psychiatry , Volume 15 , Issue 3 , May 2000 , pp. 151 - 159

References

Alden, L.E.Capreol, M.J.Avoidant personality disorder, interpersonal problems as predictors of treatment response Behav Ther 24 1993 357–376CrossRefGoogle Scholar
Alnaes, S.Torgersen, S.The relationship between DSM-III symptom disorders (Axis I) and personality disorders (Axis II) in an outpatient population Acta Psychiatr Scand 78 1988 485–492CrossRefGoogle Scholar
Alpert, J.E.Uebelacker, L.A.Mc Lean, N.E.Nierenberg, A.A.Pava, J.A.Worthington, J.J. et al. Social phobia, avoidant personality disorder and atypical depression: co-occurrence and clinical implications Psychol M 27 1997 627–633CrossRefGoogle ScholarPubMed
Brown, E.J.Heimberg, R.G.Juster, H.R.Social phobia subtype and avoidant personality disorder: effect on severity of social phobia, impairment, and outcome of cognitive behavioral treatment Behav Ther 26 1995 467–486CrossRefGoogle Scholar
Deltito, J.A.Perugi, G.A case of social phobia with avoidant personality disorder treated with MAOI Compr Psychiatry 27 1986 255–258CrossRefGoogle ScholarPubMed
Deltito, J.A.Stam, M.Psychopharmacological treatment of avoidant personality disorder Compr Psychiatry 30 1989 498–504CrossRefGoogle ScholarPubMed
Dilsaver, S.C.Qamar, A.B.Del Medico, V.J.Secondary social phobia in patients with major depression Psychiatry Res 44 1992 33–40CrossRefGoogle ScholarPubMed
Emmanuel, N.Brawman-Mintzer, O.Johnson, M.Morton, M.Lydiard, A.Ballenger, J.Personality disorders in social phobia. Presented at the 13th Annual Meeting of the Anxiety Disorder Association of America, March 17-19 South CarolinaCharleston 1993Google Scholar
Fahlen, T.Personality traits in social phobia II: changes during drug treatment J Clin Psychiatry 56 1995 569–573Google ScholarPubMed
Fahlen, T.Personality traits in social phobia, I: Comparisons with healthy controls J Clin Psychiatry 56 1995 560–568Google ScholarPubMed
Feske, U.Perry, K.J.Chambless, D.L.Renneberg, B.Goldstein, A.J.Avoidant personality disorder as a predictor for treatment outcome among generalized social phobics J Pers Disord 10 1996 174–184CrossRefGoogle Scholar
Herbert, J.D.Hope, D.A.Bellak, A.S.Validity of the distinction between generalized social phobia and avoidant personality disorder J Abnorm Psychol 101 1992 332–339CrossRefGoogle ScholarPubMed
Hofmann, S.G.Newman, M.G.Becker, E.Taylor, C.B.Roth, W.T.Social phobia with and without avoidant personality disorder: preliminary behavior therapy outcome findings J Anxiety Disord 9 1995 427–438CrossRefGoogle Scholar
Hofmann, S.G.Ehlers, A.Newman, M.G.Roth, W.T.Psychophysiological differences between subgroups of social phobia J Abnorm Psychol 104 1995 224–231CrossRefGoogle ScholarPubMed
Holt, C.S.Heimberg, G.H.Hope, H.A.Avoidant personality disorder and the generalized subtype of social phobia J Abnorm Psychol 2 1992 318–325CrossRefGoogle Scholar
Hope, A.H.Herbert, J.D.White, C.Diagnostic subtype, avoidant personality disorder, and efficacy of cognitive-behavioral group therapy for social phobia Cognit Ther Res 19 1995 399–417CrossRefGoogle Scholar
Jansen, M.A.Arntz, A.Merckelbach, H.Mersch, P.P.A.Personality disorders and features in social phobia and panic disorder J Abnorm Psychol 103 1994 391–395CrossRefGoogle ScholarPubMed
Johnson, M.R.Lydiard, R.B.Personality disorders in social phobia Psychiatr Ann 25 1995 554–563CrossRefGoogle Scholar
Liebowitz, M.R.Schneier, F.Campeas, R.Hollander, E.Hatterer, J.Fyer, A. et al. Phenelzine vs atenolol in social phobia: a placebo-controlled comparison Arch Gen Psychiatry 49 1992 290–300CrossRefGoogle ScholarPubMed
Livesley, J.W.Schroeder, M.L.Jackson, D.N.Jang, K.L.Categorical distinctions in the study of personality disorder: implications for classification J Abnorm Psychol 103 1994 6–17CrossRefGoogle Scholar
Mersch, P.P.Marijke, A.Jansen, M.A.Arntz, A.Social phobia and personality disorder: severity of complaint and treatment effectiveness J Pers Disord 9 1995 143–159CrossRefGoogle Scholar
Millon, T.Avoidant personality disorder: a brief review of issues and data J Pers Disord 5 1991 353–362CrossRefGoogle Scholar
Neenan, P.Felkner, J.Reich, J.Schizoid personality traits developing secondary to panic disorder J Nerv Men Dis 174 1986 483CrossRefGoogle ScholarPubMed
Noyes, R.Woodman, C.L.Holt, C.S.Reich, J.H.Zimmerman, M.B.Avoidant personality traits distinguish social phobia and panic disorder subjects J Nerv Men Dis 183 1995 145–153CrossRefGoogle ScholarPubMed
Reich, J.Personality dysfunction appearing under stressProceedings of the 1998 American Psychiatric Association Annual Meeting 1 June 1998 Toronto, CanadaGoogle Scholar
Reich, J.Relationship between DSM-III avoidant and dependent personality disorders Psychiatry Res 34 1990 281–292CrossRefGoogle ScholarPubMed
Reich, J.Goldenberg, I.Goisman, R.Vasile, R.Keller, M.A prospective follow-along study of the course of social phobia. II. Testing for predictors of course J Nerv Men Dis 182 1994 297–301CrossRefGoogle Scholar
Reich, J.Goldenberg, I.Vasile, R.Goisman, G.Keller, M.A prospective follow-along study of the course of social phobia Psychiatry Res 54 1994 249–258CrossRefGoogle ScholarPubMed
Reich, J.H.Noyes, R.Yates, W.Alprazolam treatment of avoidant personality traits in social phobic patients J Clin Psychiatry 50 1989 91–95Google ScholarPubMed
Reich, J.Perry, J.C.Shera, D.Dyck, I.Vasile, R.Goisman, R.M. et al. Comparison of personality disorders in different anxiety disorder diagnoses: panic, agoraphobia, generalized anxiety, and social phobia Ann Clin Psychiatry 6 1994 125–134CrossRefGoogle ScholarPubMed
Reich, J.Vasile, R.The effect of personality disorders on the treatment outcome of Axis I conditions: an update J Nerv Men Dis 181 1993 475–484CrossRefGoogle ScholarPubMed
Renneberg, B.Goldstein, A.J.Phillips, D.Chambless, D.L.Intensive behavioral group treatment of avoidant personality disorder Behav Ther 21 1990 363–377CrossRefGoogle Scholar
Sanderson, W.Wetzler, S.Beck, A.Betz, F.Prevalence of personality disorders among patients with anxiety disorders Psychiatry Res 51 1994 391–395CrossRefGoogle ScholarPubMed
Sanderson, W.C.Wetzler, S.Beck, A.T.Betz, F.Prevalence of personality disorders in patients with major depression and dysthymia Psychiatry Res 42 1992 93–99CrossRefGoogle ScholarPubMed
Schneier, F.R.Spitzer, R.L.Gibbon, M.Fyer, A.B.Liebowitz, M.R.The relationship of social phobia subtypes and avoidant personality disorder Compr Psychiatry 32 1991 496–502CrossRefGoogle ScholarPubMed
Stravynski, A.Belisle, M.Marcouiller, M.Lavalee, Y.Ellie, R.The treatment of avoidant personality disorder by social skill training in the clinic or in real-life settings Can J Psychiatry 39 1994 377–383CrossRefGoogle ScholarPubMed
Tran, G.Q.Chambless, D.L.Psychopathology of social phobia: effects of subtype and of avoidant personality disorder J Anxiety Disord 9 1995 489–501CrossRefGoogle Scholar
Turner, S.M.Beidel, D.C.Townsley, R.Social phobia: a comparison of specific and generalized subtypes and avoidant personality disorder J Abnorm Psychol 101 1992 326–331CrossRefGoogle ScholarPubMed
Turner, S.M.Beidel, D.C.Borden, J.W.Stanley, M.A.Jacob, R.G.Social phobia: Axis I and Axis II correlates J Abnorm Psychol 100 1991 102–106CrossRefGoogle ScholarPubMed
Turner, S.M.Beidel, D.C.Dancu, C.V.Keys, D.J.Psychopathology of social phobia and comparison to avoidant personality disorder J Abnorm Psychol 4 1986 389–394CrossRefGoogle Scholar
Versiani, M.Nardi, A.E.Mundim, F.D.Alves, A.B.Liebowitz, M.R.Amrein, R.Pharmacotherapy of social phobia: a controlled study with moclobemide and phenelzine Br J Psychiatry 161 1992 353–360CrossRefGoogle ScholarPubMed
Widiger, T.A.Generalized social phobia versus avoidant personality disorder: A commentary on three studies J Abnorm Psychol 101 1992 340–343CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.