Avoidant Personality in Social Phobia and Panic-agoraphobic Disorder: a Comparison

Background: Avoidant personality disorder (APD) is generally believed to be related to social phobia (SP), especially to generalized subtype. However, it has also been reported to be prevalent in panic disorder-agoraphobia (PDA). In the present investigation, we wished to explore whether APD in each of these disorders has discriminatory features.

Method: We studied 71 SP and 119 PDA patients with state-of-the-art clinical instruments based on DSM-III-R.

Results: The pattern of social avoidance in SP was more pervasive: it was characterized by a higher level of interpersonal sensitivity and greater severity, associated with psychopathology as well as a higher rate of Axis I comorbidity. By contrast, avoidance of non-routine situations characterized APD occurring in the setting of PDA.

Limitations: Differences in inclusion criteria and comorbidity rates, as well as overlap between different operational disorders, may have influenced our findings.

Conclusion: ADP is operationally broad, and 'avoidant' as a specifier of a personality type is insufficiently precise. ADP captures avoidant traits --which appear secondary to a core dimension such as interpersonal sensitivity--but is basically a heterogeneous condition influenced by the nature of comorbid Axis I disorders.