Thankfully, the DSM-IV¹ acknolwedges the similarity between APD and SAD:

There appears to be a great deal of overlap between Avoidant Personality Disorder and Social Phobia, Generalized Type, so much so that they may be alternative conceptualizations of the same or similar conditions.

When I read over the criteria² for APD, everything hit right on the mark and described my experiences perfectly: avoiding social situations and interpersonal contact for fear of criticism, disapproval, rejection; unless certain of being liked; restraint in intimate relationships out of fear of being shamed or ridiculed; preoccupied with criticism and rejection; inhibited in new interpersonal relationships because of feelings of inadequacy; views self as socially inept; reluctant to take personal risks/engage in new activities³. Read my intro post and you’ll notice the connections.

You might wonder how APD is any different from SAD, if it is at all. I went back to the criteria of SAD and what I noticed is that APD seems to be a more specified description of SAD. Some researchers conclude that APD is a more intense version of SAD, but I disagree, based on my own experience. I think that its entirely possible that the most intense cases of SAD will also be diagnosed with APD, but not all cases APD are intense versions of SAD. I say this because, as I mentioned in my intro post, most folks don’t know I even have SAD and would never suspect it. Also, I don’t feel like an “intense” version⁴. However, APD hits the nail on the head and is even more to the point about my struggles than is SAD.

The next question is whether these disorders should have entirely different paths of treatment. I think not. Both seem to have the same roots and patterns: cognitive behavioral⁵. I have found the techniques from the Social Anxiety Workbook to be tremendously helpful and get right to the heart of my struggles, so I see no need to have an APD Workbook. I suspect the “Social Anxiety” has taken on a more popularized quality and probably sounds a bit more appealing to the average person than “Avoidant Personality”⁶.

I’m still in the midst of exploring APD and have found a great website appropriately titled, Avoidant Personality. They list a couple of online message groups, as well as some relevant books. What is your experience? Is APD helpful in understanding your experience of SA (or if you are a mental health practioner, helpful in working with individuals)? Do you think they are of the same disorder, or distinctly separate?

1. The DSM-IV is the “Diagnostic and Statistical Manual of Mental Disorders”. The current edition is the Fourth Edition-Text Revision, or DSM-IV-TR. This is the “official” manual used by mental health practitioners and is required by many health insurance providers. [back]
2. Every mental health disorder in the DSM includes certain criteria that an individual must meet in order to be diagnosed with that disorder. This is very important because all of us meet some/a few of the criteria for some/a few of the disorders, for example Generalized Anxiety Disorder. [back]
3. Wikipedia has a nice page on APD, including full criterion. [back]
4. For example, not being able to leave the house, severe occupational interference, etc. [back]
5. Cognitive behavioral theory and therapy maintain that our emotional struggles stem from the thought patterns that we hold and are reinforced by our behavior. Treatment involves examining our thought patterns, challenging and changing them, and creating more accurate thoughts, and to engage in new behaviors supporting our new thoughts and desired outcomes [back]
6. An Amazon.com search of “Avoidant Peronality Disorder” reveals a grand total of zero books [back]