Avoidant personality disorder and social functioning: A longitudinal, observational study investigating predictors of change in a clinical sample.

Abstract

Avoidant personality disorder (AvPD) is an understudied, severe disorder. This study includes a clinical sample of AvPD patients (N = 460) treated within specialist mental health services. Social functioning was repeatedly assessed by self-report: Work and Social Adjustment Scale. Personality functioning (self-report), pretreatment occupational activity, civil status/family situation (self-report), and comorbidity; personality and symptom disorders were assessed at baseline. More extensive baseline impairment of social functioning was significantly associated with poorer personality functioning, occupational inactivity, and a larger number of comorbid PD traits and symptom disorders. Poorer personality functioning and greater comorbidity did not impede improvement. More persisting impairment of functioning was associated with living alone. The study confirms major impairments of social functioning in AvPD, strongly related to personality dysfunction. A slow improvement of social functioning was demonstrated. With the exception of the civil status, living alone, improvement was not impeded by baseline severity aspects.

Improvement of personality functioning among people treated within personality disorder mental health services. A longitudinal, observational study

“…AvPD was the most frequent PD in our clinical sample and the trend of moderate WSAS improvement is in line with former comparable studies from earlier time periods ( 12 , 88 ). The deviating trends associated with AvPD in our study were mainly evident for social activity aspects and not significant for other outcomes.…”

The ICD-11 classification of personality disorders: a European perspective on challenges and opportunities

“…This might be critical as Avoidant PD is highly prevalent and associated with poor psychosocial functioning but often goes unrecognized. At the same time there are empirically supported treatment approaches available [34,35]. In clinical contexts, Narcissistic PD often poses a challenge for treatment [36].…”

Affect Integration in patients with personality disorder

“…Given the assumption that the rate of change holds relatively constant as treatment progresses beyond 6 months, somewhere between 12 and 18 months of treatment would be necessary for attaining large effects on average in four of the five outcome domains examined (Paper IV). This would be in line with previous studies on the development of social functioning in patients with APD (Kvarstein et al, 2021) and improvements in more complex characterological phenomena that involve changes in structural capacities (Bateman & Fonagy, 2009;Dimaggio et al, 2017;Giesen-Bloo et al, 2006;Gordon-King et al, 2018;Linehan, 1993;Monsen et al, 1989;K. Monsen & Monsen, 2000;Nordmo et al, 2020;Normann-Eide et al, 2015;Solbakken et al, 2012), indicating a need for long-term treatment to detect more comprehensive changes.…”