lundi 13 janvier 2014

Avoidant Personality Disorder

The work group is recommending that this disorder be reformulated as the Avoidant Type.
Individuals who match this personality disorder type have a negative sense of self, associated with a profound sense of inadequacy, and inhibition in establishing intimate interpersonal relationships.  More specifically, they feel anxious, inadequate, inferior, socially inept, and personally unappealing; are easily ashamed or embarrassed; and are self-critical, often setting unrealistically high standards for themselves.  At the same time, they may have a desire to be recognized by others as special and unique.  Avoidant individuals are shy or reserved in social situations, avoid social and occupational situations because of fear of embarrassment or humiliation, and seek out situations that do not include other people.  They are preoccupied with and very sensitive to being criticized or rejected by others and are reluctant to disclose personal information for fear of disapproval or rejection. They appear to lack basic interpersonal skills, resulting in few close friendships.  Intimate relationships are avoided because of a general fear of attachments and intimacy, including sexual intimacy.
Individuals resembling this type tend to blame themselves or feel responsible for bad things that happen, and to find little or no pleasure, satisfaction, or enjoyment in life’s activities.  They also tend to be emotionally inhibited or constricted and have difficulty allowing themselves to acknowledge or express their wishes, emotions – both positive and negative – and impulses. Despite high standards, affected individuals may be passive and unassertive about pursuing personal goals or achieving successes, sometimes leading to aspirations or achievements below their potential.  They are often risk averse in new situations.
Instructions
A.  Type rating.  Rate the patient’s personality using the 5-point rating scale shown below.  Circle the number that best describes the patient’s personality. 
5 = Very Good Match: patient exemplifies this type
4 = Good Match: patient significantly resembles this type
3 = Moderate Match: patient has prominent features of this type
2 = Slight Match: patient has minor features of this type
1 = No Match: description does not apply 

B.  Trait ratings.  Rate extent to which the following traits associated with the Avoidant Type are descriptive of the patient using this four-point scale:   
0 = Very little or not at all descriptive
1 = Mildly descriptive
2 = Moderately descriptive
3 = Extremely descriptive

1. Negative Emotionality:  Anxiousness             
Having frequent, persistent, and intense feelings of nervousness/tenseness/ being on edge; worry and nervousness about the negative effects of past unpleasant experiences and future negative possibilities; feeling fearful and threatened by uncertainty
2. Negative Emotionality:  Separation insecurity  
Having fears of rejection by, and/or separation from, significant others; feeling distress when significant others are not present or readily available; active avoidance of separation from significant others, even at a cost to other areas of life
3. Negative Emotionality:  Pessimism                
Having a negative outlook on life; focusing on and accentuating the worst aspects of current and past experiences or circumstances; expecting the worst outcome
4. Negative Emotionality:  Low self-esteem       
Having a poor opinion of one’s self and abilities; believing that one is worthless or useless; disliking or being dissatisfied with one’s self; believing that one cannot do things or do them well
5. Negative Emotionality:  Guilt/ shame             
Having frequent and persistent feelings of guilt/ shame/ blameworthiness, even over minor matters; believing one deserves punishment for wrongdoing
6. Introversion:  Intimacy avoidance     
Disinterest in and avoidance of close relationships, interpersonal attachments, and intimate sexual relationships
7. Introversion: Social withdrawal
Preference for being alone to being with others; reticence in social situations; avoidance of social contacts and activity; lack of initiation of social contact
8. Introversion:  Restricted affectivity  
Lack of emotional experience and display; emotional reactions, when evident, are shallow and transitory; unemotional, even in normally emotionally arousing situations
9. Introversion:  Anhedonia                
Lack of enjoyment from, engagement in, or energy for life’s experiences; deficit in the capacity to feel pleasure or take interest in things
10. Introversion: Social detachment   
Indifference to or disinterest in local and worldly affairs; disinterest in social contacts and activity; interpersonal distance; having only impersonal relations and being taciturn with others (e.g., solely goal- or task-oriented interactions)
11. Compulsivity: Risk aversion           
Complete lack of risk-taking; unwillingness even to consider taking even minimal risks; avoidance of activities that have even a small  potential to cause injury or harm to oneself; strict adherence to behaviors to minimize health and other risks


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