Avoidant Personality Disorder

Excerpt

In the 5th century B.C., Hippocrates offered his hypothesis regarding the origin of behavior with his humoral theory, postulating temperament was derived from the heterogeneous balance of the four distinct humors in the body. The four humors consisted of black bile - melancholic, yellow bile - irritable, phlegm - apathetic, and blood - sanguine. The humors and their subsequent temperaments supposedly embodied the elements of earth, fire, water, and air, respectively. References to this nascent personality classification would be observed throughout antiquity up until the 20 century. The first nosological listing of personality types manifested with the creation of the diagnostic and statistical manual of mental disorders (DSM) I in 1952, in which seven distinct personality types were identified. This initial list was modified in subsequent editions of DSM, ultimately precipitating the ten personality disorders, evident in the current DSM (DSM V - 2013).

These ten disorders are further categorized into three clusters – clusters A, B, and C. Cluster A contains paranoid, schizoid, and schizotypal. Cluster B consists of antisocial, histrionic, narcissistic, and borderline personality disorders. And cluster C includes avoidant, dependent, and obsessive-compulsive personality disorders. Personality disorders can be described as chronic life-long maladaptive behavior patterns that are inflexible and pervasive, infiltrating all aspects of an individual’s life. Of salience for this review will be avoidant personality disorder (AVPD). AVPD was first introduced in the psychiatric nosology in DSM III in 1980. It is associated with an overly sensitive hyper-vigilant temperament, with a general longing to relate to others. Sentiments regarding the formal designation of AVPD have been mixed, as some essentially view it as a more severe variant of social anxiety disorder (SAD).