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La relación de la fobia social con el trastorno de la personalidad por evitación: una propuesta basada en hallazgos clínicos empíricos para clasificar de nuevo el trastorno de la personalidad por evitación

Published online by Cambridge University Press:  12 May 2020

J. Reich*
Affiliation:
Facultades de Medicina de Harvard y Stanford, Departamentos de Psiquiatría, 2255 North Point St., Suite 102, San Francisco, CA94123, EE.UU.
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Resumen

En el sistema del DSM, la fobia social y la personalidad por evitación se conceptuaron como entidades independientes. Cada una tenía criterios diagnóstics separados, si bien solapados. Los criterios de inclusión y exclusión específicos proporcionados por el DSM permitieron a la investigación empírica guiar revisiones futuras. Esta revisión evalúa las publicaciones empíricas y la evolución de los conceptos de estos diagnóstics del DSM-III al DSM-III-R y al DSM-IV. Los datos empíricos nos llevan a la conclusión de que no existe línea divisoria entre la fobia social y el trastorno de personalidad por evitación. Además de no existir línea diagnóstica divisoria entre los trastornos, parece no haber separación de ambos por las técnicas de tratamiento. Esto plantea preguntas interesantes sobre cómo diferenciamos los trastornos del Eje I de los del Eje II. Se comunican propuestas para revisiones de las categorías de fobia social y trastorno de la personalidad por evitación.

Type
Editorial
Copyright
Copyright © European Psychiatric Association 2000

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References

Bibliografía

Alden, LECapreol, MJ.Avoidant personality disorder, interpersonal problems as predictors of treatment response. Behav Ther 1993; 24: 357–76.CrossRefGoogle Scholar
Alnaes, STorgensen, S.The relationship between DSM-III symptom disorders (Axis I) and personality disorders (Axis II) in an outpatient population. Acta Psychiatr Scand 1988; 78: 475–92.Google Scholar
Alpert, JEUebelacker, LAMe Lean, NENierenberg, AAPava, JAWorthington, JJ, et al. Social phobia, avoidant personality disorder and atypical depression: co-occurrence and clinical implications. Psychol Med 1997; 27: 627–33.CrossRefGoogle ScholarPubMed
Brown, EJHeimberg, RGJuster, HR.Social phobia subtype and avoidant personality disorder: effect on severity of social phobia, impairment, and outeome of cognitive behavioral treatment. Behav Ther 1995; 26: 467–86.CrossRefGoogle Scholar
Deltito, JAPerugi, G.A case of social phobia with avoidant personality disorder treated with MAOI. Compr Psychyiatry 1986; 27: 255–8.CrossRefGoogle ScholarPubMed
Deltito, JAStam, M.Psychopharmacological treatment of avoidant personality disorder. Compr Psychiatry 1989; 30: 498504.CrossRefGoogle ScholarPubMed
Dilsaver, SCQamar, ABDel Medico, VJ.Secondary social phobia in patients with major depression. Psychiatry Res 1992; 44: 3340.CrossRefGoogle ScholarPubMed
Emmanuel, NBrawman-Mintzer, OJohnson, MMorton, MLydiard, ABallenger, J.Personality disorders in social phobia. Presented at the 13th Annual Meeting of the Anxiety Disorder Association of America, March 17-19. South Carolina: Charleston; 1993.Google Scholar
Fahlen, T.Personality traits in social phobia II: changes during drug treatment. J Clin Psychiatry 1995; 56: 569–73.Google ScholarPubMed
Fahlen, T.Personality traits in social phobia, I: Comparisons with healthy Controls. J Clin Psychiatry 1995; 56: 560–8.Google ScholarPubMed
Feske, UPerry, KJChambless, DLRenneberg, BGoldstein, AJ.Avoidant personality disorder as a predictor for treatment outeome among generalized social phobics. J Pers Disord 1996; 10: 174–84.CrossRefGoogle Scholar
Herbert, JDHope, DABellak, AS.Validity of the distinction between generalized social phobia andavoidant personality disorder. J Abnorm Psychol 1992; 101: 332–9.CrossRefGoogle ScholarPubMed
Hofmann, SGNewman, MGBecker, ETaylor, CBRoth, WT.Social phobia with and without avoidant personality disorder: preliminary behavior therapy outeome findings. J Anxiety Disord 1995; 9: 427–38.CrossRefGoogle Scholar
Hofmann, SGEhlers, ANewman, MGRoth, WT.Psychophysiological differences between subgroups of social phobia. J Abnorm Psychol 1995; 104: 224–31.CrossRefGoogle ScholarPubMed
Holt, CSHeimberg, GHHope, HA.Avoidant personality disorder and the generalized subtype of social phobia. J Abnorm Psychol 1992; 2: 318–25.CrossRefGoogle Scholar
Hope, AHHerbert, JDWhite, C.Diagnostic sybtype, avoidant personality disorder, and efficacy of cognitive-behavioral group therapy for social phobia. Cognit Ther Res 1995; 19: 399417.CrossRefGoogle Scholar
Jansen, MAArntz, AMerckelbach, HMersch, PPA.Personality disorders and features in social phobia and panic disorder. J Abnorm Psychol 1994; 103: 391–5.CrossRefGoogle ScholarPubMed
Johnson, MRLydiard, RB.Personality disorders in social phobia. Psychiatr Ann 1995; 25: 554–63.CrossRefGoogle Scholar
Liebowitz, MRSchneier, FCampeas, RHollander, EHatterer, JFyer, A, et al. Phenelzine vs atenolol in social phobia: a placebo-controlled comparison. Arch Gen Psychiatry 1992; 49: 290300.CrossRefGoogle ScholarPubMed
Livesley, JWSchroeder, MLJackson, DNJang, KL.Categorical distinctions in the study of personality disorder: implications for classification. J Abnorm Psychol 1994; 103: 617.CrossRefGoogle Scholar
Mersch, PPMarijke, AJansen, MAArntz, A.Social phobia and personality disorder: severity of complaint and treatment effectiveness. J Pers Disord 1995; 9: 143–59.CrossRefGoogle Scholar
Millón, T.Avoidant personality disorder: a brief review of issues and data. J Pers Disord 1991; 5: 353–62.CrossRefGoogle Scholar
Neenan, PFelkner, JReich, J.Schizoid personality traits developins secondary to panic disorder. J Nerv Men Dis 1986; 174: 483.CrossRefGoogle Scholar
Noyes, RWoodman, CLHolt, CSReich, JHZimmerman, MB.Avoidant personality traits distinguish social phobia and panic disorder subjects. J Nerv Men Dis 1995; 183: 145–53.CrossRefGoogle ScholarPubMed
Reich, J.Personality dysfunction appearing under stress. Proceedings of the 1998 American Psychiatric Association Annual Meeing, 1 June 1998. Toronto, Cañada.Google Scholar
Reich, J.Relationship between DSM-III avoidant and dependent personality disorders. Psychiatry Res 1990; 34: 281–92.CrossRefGoogle ScholarPubMed
Reich, JGoldenberg, IGoisman, RVasile, RKeller, M.A prospective follow-along study of the course of social phobia. II. Testing for predictors of course. J Nerv Men Dis 1994; 182: 297301.CrossRefGoogle Scholar
Reich, JGoldenberg, IVasile, RGoisman, GKeller, M.A prospective follow-along study of the course of social phobia. Psychiatry Res 1994; 54: 249–58.CrossRefGoogle ScholarPubMed
Reich, JHNoyes, RYates, W.Alprazolam treatment of acoidant personality traits in social phobic patients. J Clin Psychiatry 1989; 50: 91–5.Google ScholarPubMed
Reich, JPerry, JCShera, DDyck, IVasile, RGoisman, RM, et al. Comparison of personality disorders in different anxiety disorder diagnoses: panic, agoraphobia, generalized anxiety, and social phobia. Ann Clin Psychiatry 1994; 6: 125–34.CrossRefGoogle ScholarPubMed
Reich, JVasile, R.The effect of personality disorders on the treatment outcome of Axis I conditions: an update. J Nerv Men Dis 1993; 191: 475–84.CrossRefGoogle Scholar
Renneberg, BGoldstein, AJPhillips, DChambless, DL.Intensive behavioral group treatment of avoidant personality disorder. Behav Ther 1990; 21: 363–77.CrossRefGoogle Scholar
Sanderson, WWetzler, SBeck, ABetz, F.Prevalence of personality disorders among patients with anxiety disorders. Psychiatry Res 1994; 51: 391–5.CrossRefGoogle ScholarPubMed
Sanderson, WCWetzler, SBeck, ATBetz, F.Prevalence of personality disorders in patients with major depression and dysthymia. Psychiatry Res 1992; 42: 93–9.CrossRefGoogle ScholarPubMed
Schneier, FRSpitzer, RLGibbon, MFyer, ABLiebowitz, MR.The relationship of social phobia subtypes and avoidant personality disorder. Compr Psychiatry 1991; 32: 496502.CrossRefGoogle ScholarPubMed
Stravynski, ABelisle, MMarcouiller, MLavalee, YEllie, R.The treatment of avoidant personality disorder by social skill training in the clinic or in real-life setting. Can J Psychiatry 1994; 39: 377–83.CrossRefGoogle ScholarPubMed
Tran, CQChambless, DL.Psychopathology of social phobia: effect of subtype and of avoidant personality disorder. J Anxiety Disord 1995; 9: 489501.CrossRefGoogle Scholar
Turner, SMBeidel, DCTownsley, R.Social phobia: a comparison of specific and generalized subtypes and avoidant personality disorder. J Abnorm Psychol 1992; 101: 326–31.CrossRefGoogle ScholarPubMed
Turner, SMBeidel, DCBorden, JWStanley, MAJacob, RG.Social phobia: Axis I and Axis II correlates. J Abnorm Psychol 1991; 100: 102–6.CrossRefGoogle ScholarPubMed
Turner, SMBeidel, DCDancu, CVKeys, DJ.Psychopathology of social phobia and comparison to avoidant personality disorder. J Abnorm Psychol 1986; 4: 389–94.CrossRefGoogle Scholar
Versiani, MNardi, AEMundim, FDAlves, ABLiebowitz, MRAmrein, R.Pharmacotherapy of social phobia: a controlled study with moclobemide and phenelzine. Br J Psychiatry 1992; l6l: 353–60.CrossRefGoogle Scholar
Widiger, TA.Generalized social phobia versus avoidant personality disorder: A commentary on three studies. J Abnorm Psychol 1992; 101: 340–3.CrossRefGoogle ScholarPubMed