A Review of Characteristics and Treatments of the Avoidant Personality Disorder. Could the DBT be an Option?

Avoidant personality disorder (APD) is a frequent disorder whose prevalence has been reported to be as high as 10% in mental clinic outpatients. There is an open debate on whether APD is to be considered a different disorder compared to social phobia (SP), or they are different quantitative manifestations of the same pathologic process. Treatment for APD is mainly based on evidence gathered for SP or SP in co-morbidity with APD. Suggested pharmacological treatment of APD is SSRIs or SNRIs. There is no clear cut evidence in literature that one form of psychotherapy is superior to another for the treatment of APD, also because of the paucity of published evidence. It has been recently suggested that a modified form of the dialectical behavioral therapy (DBT) could be used for the treatment of APD, together with other diagnoses that share over-control as a psychological mechanism. The present contribution reviews the published evidence on APD and describes the main issues that are nowadays debated about this disorder.