1. because they are afraid of criticisms and judgements


People with avoidant personality disorder (APD) display a pattern
of behaviour which begins early during their teenage years, with some traits
such as extreme anxiety, shyness, feelings of inadequacy and
fear of being rejected. (Drago, Marogna & Sogaard, 2016). Nowadays, about 1
to 2% of the world population suffer from APD (Sanislow, Bartolini &
Zoloth, 2012). Those people tend to avoid social contact because they are
afraid of criticisms and judgements from others. Moreover, the fear of
rejection makes them want to be lonely rather than have close relationships, in
the belief that they will be neglected due to their detached behaviours
(Furnham, 2017). All of this has a negative impact on patient’s life and makes
it difficult not only for them to interact with society but also for
psychologists and psychiatrists to deal with APD. This paper, with the aim of
raising people knowledge about APD, is conducted to provide information about
the symtoms, causes and treatments of this personality disorder.

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2. Discussion of findings

2.1. Background information about APD

APD is one of the mental health conditions, which was
characterized by great shyness, social inhibition, hypersensitivity to rejection
and feelings of inferiority (Ekern, 2013). This condition was classified as
Cluster C, a category for & fearful anxious disorders, and acknowledged in
the DSM (Diagnostic and Statistical Manual of Mental
Disorders) in 1980, according to Furnham
(2017) . He also stated that APD  is equally
common between two sexes and is estimated to affect from 0.5% to 1% of the
world population, althought DSM suggests that the figure was approximtely 2.4 %,
and from 10% to 20% of psychiatric outpatients.

As reported by Ekern (2013), APD has four subtypes, as almost all people with
this disorder will show a mixture of symptoms. The four main subtypes of APD
are Phobic (Being extremely affraid of certain situations or objects), Conflicted (confusion, being unable to settle worried feelings),
Hypersensitive (greatly mistrustful, nervous and fearful), and Self-deserting.

Many people confuse APD with Social Phobia (SP), due
to a number of similarities. However, they are separate two diseases, and the
differences between them are their different ways of treatment and APD is
likely to develop better results during the early period of treatment (Draco et al., 2016).

2.2. Symptoms of APD

Gluck (2014) stated that APD initial signs appear during early
years, but often seem to be normal until late adolescence. Nearly all children
express some anxiety and shyness when interact with new people or situations;
these behaviours seem to be normal, they only become a big trouble if continue
during adulthood.

As reported by Goldberg (cited in WebMD, n.d.), APD individuals
have a tendency to avoid speaking in social situations for fear of getting
embarrassed due to saying something wrong. They also avoid social activities
because of their fear of being criticized or rejected, and this leads to the
feelings of uncomfortable, socially inept and inferior to others.

Gluck (2014) also noted that some of APD symtoms can be visibly
seen in many circumstances, but there are also some symtoms happen inside their
experiences which can not be spoted by naked eyes.


2.3. Causes of APD

Researchers and scientists do not know exactly what are the
reasons of APD, althought it is theorized by a number of experts that there are
genetic, social and psychological factors contribute to the this mental
problem’s causes (Bressert, 2017).

First of all, gene is a possible reason for this illness. A study
carried out in Norway on teenagers indicated that the inheritability of APD is
between 27% and 35%. Moreover, approximately 83% of these genes also have some
connections with other personality disorders (Lucida Treatment, 2014).

Secondly, this disorder appears may be due to the impact of social
environment on people. Lucida Treatment (2014) stated that individuals who have
APD do not learn appropriate skills to deal with social challenges from their
childhood and adolescence. Consequently, they become shy and afraid of facing
new situation and have a possibility of having APD.

According to Hageman,
T. K., Francis, A. J., Field, A. M. & Carr, S. N. (2015) in their research,
there is a connection between APD patient’s childhood experiences and
development of APD. A majority of people who suffer from APD have experience of
sexual abuse and emotional neglect from their own parents. As the result, this risk factor hurts these children mentally, and
makes them become potential
patient of APD.

2.4. Treatments of APD

To deal with this issue, APD indivisuals
need to be cure accurately. Currently, there is no medicine for
treating APD (Draco et al., 2016). The typical way to treat this mental
condition is psychotherapy, according to Bressert
(2017). However,
this treatment has some challenges, such as the requirement of interaction between
therapist and patient about personal things they are unwilling to talk about, which
could hurt them a lot.
Therefore, therapist need to build a trustful and therapeutic
relationship with patient in order to prevent them from leaving unfinished

As reported by Bressert
(2017), while some APD individuals can
withstand long-term psychotherapy,
many people go to therapist only when they are stressful, which is a common
symptom of this disorder. These shorter-term psychotherapy will only concentrate
on the instant problems in patient’s life, provide them some new and
appropriate coping skills to help. APD patient will cancel the treatment as
soon as this mental health problem disappears.