Table of Contents
Extreme social reticence, inadequacy, shyness, fear of rejection, and sensitivity towards criticism causes social anxiety disorder (SAD) and avoidant personality disorder (AVPD). SAD and AVPD do not differ in the general level of their symptom severity; for example, both disorders have nano assertiveness as a widespread interpersonal problem, but there is a slight difference between these two disorders.
Before getting into detail about differences, let’s briefly explain each disorder separately with its definition, symptoms, causes, and possible help.
Social Anxiety Disorder (SAD)
Social anxiety disorder explains a concept of social anxiety along with different phobias. People with social anxiety avoid social gatherings in the first place. They undergo a different kinds of triggers in social gatherings. Such emotional triggers cause them to flee or freeze at the moment, and it leads to social awkwardness (Schneier & Goldmark, 2015). People with SAD low-key want to be friends with others because they don’t find themselves inferior, but their fears get in their way of interaction. They keep their social circle small, intimate and offer their services only.
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Fig 1: Situations when SAD patients get triggered.
Symptoms of SAD
Social anxiety disorder manifests itself in a variety of physical and behavioural symptoms. Trembling, sweating, nausea, and stammering when trying to talk are some of the physical symptoms. These symptoms cause the patient to become more self-conscious because they assume others have noticed, resulting in a deep sense of humiliation, social awkwardness, and embarrassment (Schneier & Goldmark, 2015).
As a result, they may adjust their conduct in the following ways
- They strive to avoid circumstances in which they could be forced to talk.
- Withdraw from personal and professional ties.
- Avoid eye contact in social gatherings.
These symptoms can be stressful for the person, and they may struggle to cope with day-to-day tasks. If you see these signs in a friend or family member, try to talk to them about it. The fear of judgment by others causes persistent and irrational fears for social gatherings, and this fear can affect them even before the social gathering (Schneier & Goldmark, 2015). It can initiate over-thinking ahead of the gathering, even before weeks, and affect their ability to work. Not only work, it can also affect their studies, relations (including friendships), and other activities. (Leichsenring & Leweke, 2017).
Causes of SAD
Different factors can cause SAD, such as family history, childhood trauma, past experiences, and personal traits. The general concept is that anxiety disorders run in the family. But it is more related to behaviours that children adopt from their parents rather than genetics. For example, childhood traumas include bullying in school, humiliation from parents, teachers, or friends, sexual abuse, and lack of parental care and attention. Personal traits include being shy or clingy (Leichsenring & Leweke, 2017).
Treatment of SAD
SAD is treatable, and its coping process and recovery time changes from person to person. Its treatment includes medication and psychotherapy e.g. Cognitive Behavioral Therapy CBT (Leichsenring & Leweke, 2017).
Avoidant Personality Disorder (AvPD)
Avoidant personality disorder AvPD is an inflexible and pervasive set of behaviours related to extreme social reticence, inadequacy, inferiority complex, fear of rejection, and sensitivity towards criticism. It affects daily life activities of a person and causes distress in their work and relationships (Weinbrecht et al., 2016). Cluster C personality disorder that causes anxiety, fearful personality, and complexed approach is characterized as AvPD. It involves extreme sensitivity and inferiority complex that allows them to think that they deserve the hatred. Unlike SAD, patients with AvPD are not willing to make friends because they have a fear of rejection/disapproval. About 2.5% of the population (roughly equal numbers of men and women) is affected with avoidant personality disorder (Weinbrecht et al., 2016).
Fig 2: Reasons when AvPD patients get triggered
Symptoms of AvPD
Some common symptoms of AvPD patients include (Weinbrecht et al., 2016)
- Avoidance of social gathering and occupational activities.
- Unwillingness to participate or interact with people unless they are sure that they will be liked or appreciated by them.
- Avoidance of gathering of the fear of being incompetent or unappealing.
- Hesitation to do new things out of fear of embarrassment.
Causes of AvPD
The causes of AvPD can be genetic, social, psychological, and environmental. Psychological factors include criticism, emotional abuse, and lack of affection. Social and ecological factors include facing the same behaviour from elders, unjustified scolding, and rejection by them. The chances of AvPD being transferred into the children genetically are similar to SAD, but the severe condition is AvPD (Lampe & Malhi, 2018).
Treatment of AvPD
Avoidant personality disorder is relative hard to treat as compare to SAD because it includes patterns of behavior. Their patients also find it difficult to recognize that help is needed and beneficial. Talk therapy, medication, and coping processes are included in its treatment (Lampe & Malhi, 2018).
Comparison between SAD and AvPD
The main difference between SAD and AVPD is that people with SAD often know that their fears are irrational and unjustifiable. In contrast, people with AVPD tend to believe that they are unappealing and inferior to others. That’s why they find rejection and criticism not only inevitable but deserved.
Both conditions cause people to feel extremely anxious in social gatherings. People with SAD desire social connections and close friendships but find it hard to be vocal about it. But people with AVPD are socially awkward and avoid gatherings as much as possible because they share a deep fear of rejection and humiliation (Eikenaes et al., 2015).
People with SAD find judgments of others invalid, unlike AVPD. For them, others’ judgments are valid and painful as they experience real consequences after them. They have low self-esteem, and they tend to believe that these judgments and rejections are due to their incompetence and inferiority. They accept that harsh criticism as valid, deserved and natural.
AvPD is comparatively hard to treat because treating AVPD involves changes in long-held beliefs about themselves and society, but SAD has easy therapy, and they quickly restore their confidence (Frandsen et al., 2020).
There are high chances that people with AvPD also suffer from SAD, but people with SAD are not necessarily affected with AvPD. Hence, AvPD is a more severe condition as compared to SAD.
Competing perspectives between SAD and AvPD
First, both diseases are independent psychopathological processes with unique qualitative characteristics, as evidenced by the disorders’ classification as an anxiety disorder and a personality disorder, respectively.
The alternative point of view is that the both illnesses are fundamentally comparable psychopathologies that should be seen as a spectrum, with only severity differences (Eikenaes et al., 2015).
A third way to think about it, is that the both disorders are different syndromes with common elements but differing severity. The question of which model is the best suitable remains unanswered, and more research is required (Frandsen et al., 2020).
Table 1: SAD vs AvPD
|Social Anxiety Disorder (SAD)||Avoidant Personality Disorder (AvPD)|
|Fear of social interactions||Extreme shyness in social gatherings|
|Comparatively high self-esteem||Low self-esteem|
|Exposure to social gatherings provokes anxiety||Hypersensitive in social gatherings/ avoid them as much as possible|
|Comparatively confident||Highly self-conscious|
|Social gatherings are avoided, can be normalized with daily life routine||Social gatherings are avoided, but it results in self-imposed social isolation|
|People with SAD do not have inferiority complex||People with AVPD have inferiority complex|
|Easily curable||Hard to treat|
|Those with SAD understand that their fear is irrational and the world doesn’t judge them or their judgment is invalid||People with AVPD lack this insight, hold deep-rooted feelings of insecurity and worthlessness|
|Less sensitive towards criticism||Highly sensitive towards criticism|
|Self-loathing is not associated with SAD||Self-loathing is highly associated with AvPD|
|Diagnosis overlaps with general social phobias e.g. depression||Diagnosis overlaps with anxiety disorders e.g. Cluster C personality disorder|
|SAD is not associated with self-reported negligence. Hence, less severe||AvPD is associated with self-reported negligence. Hence, more severe|
Both disorders are distinct syndromes with common elements. It is concluded that both social anxiety disorder and avoidant personality disorder have similar general interpersonal problems. But people with SAD have less distress as compared to the group with AvPD. Extreme sensitivity, self-negligence, and self-loathing make them highly vulnerable to negative consequences (Eikenaes et al., 2015). Treatment of SAD is easy and short while AvPD is hard to be cured. Its primary cause is that patients with AvPD find it very hard to feel a need for help. They show unwilling behaviour towards therapy and medication because it involves changes in their long-held beliefs about themselves and society. However, both disorders make life a bit difficult and should be taken care of. Treatments may take longer than you anticipate, but it is vital and helpful (Frandsen et al., 2020).
Eikenaes, I., Egeland, J., Hummelen, B., & Wilberg, T. (2015). Avoidant personality disorder versus social phobia: the significance of childhood neglect. PloS one, 10(3), e0122846.
Frandsen, F. W., Simonsen, S., Poulsen, S., Sørensen, P., & Lau, M. E. (2020). Social anxiety disorder and avoidant personality disorder from an interpersonal perspective. Psychology and Psychotherapy: Theory, Research and Practice, 93(1), 88-104.
Schneier, F., & Goldmark, J. (2015). Social anxiety disorder. Anxiety disorders and gender, 49-67.
Leichsenring, F., & Leweke, F. (2017). Social anxiety disorder. New England Journal of Medicine, 376(23), 2255-2264.
Weinbrecht, A., Schulze, L., Boettcher, J., & Renneberg, B. (2016). Avoidant personality disorder: a current review. Current psychiatry reports, 18(3), 1-8.
Lampe, L., & Malhi, G. S. (2018). Avoidant personality disorder: current insights. Psychology research and behavior management.