Which diagnosis best fits duration, episodicity, and exclusions?
A
Avoidant personality disorder
Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood; ≥4 of 7: avoids occupational activities involving interpersonal contact due to fears of criticism; unwilling to get involved unless certain of being liked; shows restraint in intimate relationships due to fear of shame; preoccupied with being criticised/rejected; inhibited in new interpersonal situations; views self as socially inept/unappealing/inferior; unusually reluctant to take risks or engage in new activities
APervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood; ≥4 of 7: avoids occupational activities involving interpersonal contact due to fears of criticism; unwilling to get involved unless certain of being liked; shows restraint in intimate relationships due to fear of shame; preoccupied with being criticised/rejected; inhibited in new interpersonal situations; views self as socially inept/unappealing/inferior; unusually reluctant to take risks or engage in new activities
BMarked fear/anxiety about ≥1 social situation with possible scrutiny by others
Additional criteria
ANo additional structured criteria supplied
BB. Fears acting in a way that will be humiliating, embarrassing, or negatively evaluated C. Social situations almost always provoke fear/anxiety D. Social situations avoided or endured with intense anxiety
Key features
AA. Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood; ≥4 of 7: avoids occupational activities involving interpersonal contact due to fears of criticism; unwilling to get involved unless certain of being liked; shows restraint in intimate relationships due to fear of shame; preoccupied with being criticised/rejected; inhibited in new interpersonal situations; views self as socially inept/unappealing/inferior; unusually reluctant to take risks or engage in new activities
BA. Marked fear/anxiety about ≥1 social situation with possible scrutiny by others B. Fears acting in a way that will be humiliating, embarrassing, or negatively evaluated C. Social situations almost always provoke fear/anxiety
Common specifiers
AMild; Moderate; Severe
BPerformance only
Differential flags
ASocial anxiety disorder (highly comorbid; AvPD more pervasive and characterological); Schizoid PD (no desire for connection; no distress about isolation); Dependent PD (seeks closeness but fears abandonment)
BAgoraphobia (fear of escape/help rather than scrutiny); Panic disorder (unexpected attacks); GAD (worry across multiple domains)