Tag: Personality disorders

 

The Loneliness Epidemic and Avoidant Personality Disorder 

Although loneliness has always been a friend of mine (Backstreet boys 1997), there is an epidemic of loneliness across all age groups. 

We live in a world where we are all more connected with each other through technological advances and social media, yet people feel more disconnected than ever. 

The COVID-19 pandemic did make this any better, 36% of all Americans, including 61% of young adults and 51% of mothers with young children feel loneliness is a significant problem in their lives. 

The question is are people feeling lonely because they are suffering from avoidant personality disorder?

Epidemiology: 

The prevalence of APD is 2.36% in the general population, and it appears to occur equally in males and females. 

Definitions and Criteria for diagnosis: 

Let’s start with a definition of what avoidant personality disorder is and how it can impact a person’s life. 

This is part of the cluster C personality disorders often thought of as the anxious/fearful personality disorders. These individuals experience excessive social anxiety, severe feelings of inferiority and inadequacy, and while they desire close relationships, they avoid the feared stimulus instead living in self-imposed social isolation. 

Other key criteria include: 

-patterns of social inhibition 

-hypersensitivity to rejection or criticism 

-it must be present by early adulthood 

This affects all areas of life and should be a pervasive pattern. It’s not something that is isolated or situational.  

DSM-5 Criteria: 4 out of 7 are required to make a diagnosis 

  1. Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection. 
  2. Unwilling to engage in relationships unless they are certain of being liked. (They will look for social cue or indicators of interest before committing and often attempt to read other minds) 
  3. Shows restraint in relationships for fear of being ridiculed or shamed 
  4. You are preoccupied with being criticized or rejected 
  5. The person is inhibited in new interpersonal situations because of feelings of inadequacy 
  6. The person will view themselves as socially inept, inferior to others, or unappealing to others. 
  7. The person is reluctant to take personal risks for fear of embarrassment 

It’s important to keep in mind this diagnosis is largely unchanged since DSM-III and are primarily viewed through a psychoanalytic lens. The key difference between avoidant personality disorder and social anxiety is these feelings are pervasive throughout the person’s life, where in social anxiety they are limited to social situations. Although some believe these are the same disorder with many of the criteria overlapping. Avoidant patients tend to read more into things and are constantly looking for any indication from others that supports their theory that they are defective or inadequate. 

Other personality disorders can have rejection sensitivity and sensitivity to criticism, this is often seen in narcissistic personality disorder. We are all sensitive to criticism in certain situations it’s not necessarily pathological. 

Treatment: 

This largely focuses on psychotherapy and sometimes medication if other comorbid psychiatric disorders are identified. Some of the psychotherapy techniques that are effective include social skills training, cognitive behavioral therapy, and exposure therapy. These are also good cases for psychoanalysis if the person can commit to that form of therapy. 

Conclusion :

Could Some of the Loneliness people are experiencing be due to avoidant personality disorder?

-Possibly, but it’s only going to be a small percentage considering the prevalence of avoidant personality disorder is 2.36%. 

-Loneliness has many contributing factors and encouraging people to spend less time connecting digitally and more time connecting face to face is a good place to start. 

0

Help, I think I’m a Narcissist

Introduction

It seems like everywhere I look there’s a video or article with titles such as “how to tell if you’re a narcissist” or “is your significant other a narcissist.” This got me thinking about narcissistic personality disorder (NPD), and why everyone thinks they or someone they know has this disorder. 

Brief Review of NPD Criteria from DSM-5 (5 out of 9 required) 

-Grandiose sense of self-importance 

-Preoccupied with fantasies of unlimited power, success, beauty etc. 

-Believes they are special and unique 

-Requires excessive admiration 

-Has a sense of entitlement (unreasonable expectations) 

– Interpersonally exploitative 

-Lacks empathy 

-Often envious of others or believes others are envious of them 

-Shows arrogant, haughty behaviors and attitudes 

Distinction Between a Disorder, and being a Jerk 

There is an important distinction between having NPD and having narcissistic traits. In diagnosing NPD there is a long list in DSM-5 of which the person must have 5 out 9 criteria to qualify for the diagnosis. These criteria will be present in all circumstances and relationships. Most importantly it must cause impairment in function and a subjective sense of distress. If the person meets these criteria, and it’s working for them in their life, they would not be diagnosed with NPD. You need to have the functional impairment, that is what makes it a disorder. Although these people may not have a disorder, it still does not make them a pleasure to be around. There can still be relationship difficulties both professionally and on a personal level.

Common Types of Narcissism 

The classic grandiose narcissist, this is the kind of person who cannot stop bragging about what they have, and what they have done. They tend to enjoy showing off symbols of status such as new cars or even attractive partners. They do things based on what will get them the most admiration and recognition from others rather than personal values. These types are encountered on a regular basis, you may know people like this in your personal life. 

There is a classic example of the highly successful professional who will stop at nothing to achieve their goals even if it’s at the expense of others. So naturally one place you may encounter these individuals is in the workplace. These types will exploit other people, cheat, work the system, whatever they can do to get ahead. They are usually successful and superficially charming. This pattern is less commonly encountered in daily life.

0

Powered by WordPress.com.

Up ↑

%d bloggers like this: