Avoidant personality disorder in individuals with generalized social anxiety disorder: what does it add?
Avoidant personality disorder (AvPD) has a high level of symptom overlap and comorbidity with generalized social anxiety disorder (GSAD). We examined whether the presence of comorbid AvPD adds significant clinically relevant information for individuals seeking treatment for GSAD. Results suggested that AvPD was significantly associated with poorer quality of life and greater disability in univariate, but not multivariate analyses. Endorsement of more AvPD symptoms was associated with increased disability, increased risk of intimacy, and lower social support, even after covariate adjustment. Specifically, AvPD item 3, hard to be "open" even with people you are close to, was most strongly correlated with quality of life and disability. A binary diagnosis of AvPD alone adds little beyond a marker of greater GSAD severity and depression among patients with GSAD, while a specific feature of AvPD not captured by the GSAD diagnosis, namely emotional guardedness, may be associated with greater impairment.
Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 6th Floor, Boston, MA 02114-2790, United States. lmarques@partners.org
Luana
L
Marques
Eliora
E
Porter
Aparna
A
Keshaviah
Mark H
MH
Pollack
Michael
M
Van Ameringen
Murray B
MB
Stein
Naomi M
NM
Simon
D000328:Adult; D000987:Antisocial Personality Disorder / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D010698:Phobic Disorders / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D012649:Self Concept; D012720:Severity of Illness Index; D012917:Social Adjustment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult