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Avoidant personality disorder and social phobia: distinct enough to be separate disorders?

Elizabeth Ralevski, Yale University School of Medicine
Charles A. Sanislow, Yale University School of Medicine
Carlos M. Grilo, Yale University School of Medicine
Andrew E. Skodol, Columbia University and New York State Psychiatric Institute
John G. Gunderson, Harvard Medical School and McLean Hospital
M. Tracie Shea, Brown University Medical School
Shirley Yen, Brown University Medical School
Donna S. Bender, Columbia University and New York State Psychiatric Institute
Mary C. Zanarini, Harvard Medical School and McLean Hospital
Thomas H. McGlashan, Yale University School of Medicine

Abstract

Objective: Existing evidence from anxiety disorder research indicates that social phobics (SP) with avoidant personality disorder (AVPD) experience more anxiety and show more impairment than patients with SP alone. The purpose of this study was to examine whether in patients diagnosed with AVPD, the co-occurrence of SP adds to its severity. We hypothesized that the addition of SP will not add to the severity of AVPD alone.

Method: Two groups of patients (AVPD = 224; AVPD/SP = 101) were compared at baseline and 2 years later on multiple demographic and clinical variables.

Results: Patients with AVPD and an additional diagnosis of SP differed little from patients with AVPD alone.

Conclusion: These findings suggest that AVPD and SP may be alternative conceptualizations of the same disorder.

Suggested Citation

Ralevski, E., Sanislow, C. A., Grilo, C. M., Skodol, A. E., Gunderson, J. G., Shea, M. T., Yen, S., Bender, D. S., Zanarini, M. C., & McGlashan, T. H. (2005). Avoidant personality disorder and social phobia: distinct enough to be separate disorders? Acta Psychiatrica Scandinavica, 112(3), 208-214.