Anxiety Avoidant Personality Disorder Generalized Social Phobia And Shyness Putting The Personality Back Into Personality Disorders.pdf

REVIEW
Avoidant Personality Disorder, Generalized
Social Phobia, and Shyness: Putting the
Personality Back into Personality Disorders
David C. Rettew, MD
With increasing recognition of social phobia as mon and often debilitating disorder,
interest is developing in its boundaries with other disorders such as avoidant personality
disorder and temperamental constructs such as shyness. Such interest reflects the more
general debate concerning Axis I disorders, personality disorders, and what is considered
normal personality variance. This review summarizes the available paring
avoidant personality disorder (APD), generalized social phobia (GSP), and shyness. In
paring APD and GSP, comorbidity rates have varied from approximately 25%
to numbers high enough that the ability to diagnose one disorder without the other was
questioned. Comparisons of the characteristics of APD and GSP have yielded few qualita-
tive differences, although some studies have shown evidence that APD may represent a
more severe form of GSP with respect to levels of symptoms, fear of negative evaluation,
anxiety, avoidance, and depression. Personality dimensions including, but not limited to,
shyness have been found to be strongly associated with GSP and APD, and there is some
evidence that persons who suffer from social anxiety also suffer from fears and avoidance
across nonsocial domains. In conclusion, although there is evidence that shyness, GSP,
and APD exist along a continuum, the factors that constitute this continuum may need
to be revised. (HARVARD REV PSYCHIATRY 2000;8:283–297.)
Recent years have witnessed a surge of interest in anxiety (APD). Where the boundaries lie between the clinical disor-
disorders,particularly social phobia (SP),once hailed as “the ders of SP and APD and the temperamental constructs of
neglected anxiety disorder.”1 Research in shyness and other shyness and social inhibition remains in question and is the
temperamental di