Anxiety personality disorder how to treat. How to Diagnose Anxiety Personality Disorder

anxiety disorder personality disorder is a personality disorder in which the patient has high degree the desire to avoid any social interactions, the patient experiences a feeling of inferiority, has an extreme sensitivity to the value judgments of others, especially negative ones.

Causes

Causes, causing development Anxiety personality disorder is not fully understood. A combination of social, genetic, and psychological factors can lead to an anxiety disorder.

A large number of patients with a history of anxiety disorder have a painful experience of long-term rejection and criticism from relatives or other people.

Symptoms of an Anxious Personality Disorder

Typical symptoms of anxiety disorder:

Increased sensitivity to criticism;

Maximum self-isolation from society;

Feelings of inferiority or inferiority;

Self-loathing;

Feeling distrustful of other people;

Extreme degree of shyness and modesty;

Avoidance of intimate relationships;

Tendency to addictions (psychological, chemical);

Problems with professional implementation;

All avoidance of physical contact;

High self-criticism.

Diagnostics

The diagnosis is made exclusively by a psychiatrist. Most often, the diagnosis is not difficult, since one can speak of an anxiety disorder of the personality if the patient has unreasonable anxiety for several weeks in a row.

To diagnose this condition, the method of psychological tests is widely used: the hospital anxiety and depression scale, the personal anxiety scale, the Spielberger-Khanin test, etc.

Types of disease

Anxiety personality disorders are classified into:

obsessive-compulsive disorders;

2. Anxiety - phobic disorders:

panic disorder;

Obsessive-compulsive personality disorder.

Patient's actions

The patient needs qualified medical attention.

Treatment for Anxious Personality Disorder

The main methods of treatment of anxiety disorder of the personality belongs to - psychotherapeutic treatment and drug treatment.

Methods of psychotherapy are aimed at determining the causes of the development of an anxiety disorder in a patient, as well as teaching the patient how to get out of a state of anxiety. Relaxation and meditation techniques can also help.

The patient should avoid alcohol, caffeine, and cigarette smoking, as this further stimulates nervous system and increases the feeling of anxiety, if any. The effectiveness of psychotherapy largely depends on the patient's desire to get out of the state of anxiety, the use of special techniques can reduce the patient's sensitivity to provoking factors and stabilize the situation.

Medical treatment Anxiety personality disorder includes the use of antidepressants, tranquilizers, and adrenoblockers.

The action of antidepressants is aimed at reducing the patient's feelings of anxiety, removing autonomic disorders, the drugs are prescribed for a long course.

Tranquilizer drugs relieve muscle tension, reduce the severity anxiety state, level the feeling of fear, normalize sleep.

Beta-blockers are used to relieve autonomic symptoms of the disease (palpitations, high blood pressure).

Complications

In the absence of treatment given state can be aggravated and lead to a significant decrease in the quality of life of the patient, and the patient may develop depression.

Prevention of Anxious Personality Disorder

A general system for the prevention of anxiety personality disorder has not yet been developed. For prevention purposes, you should adhere to the following recommendations: refuse to use caffeinated foods and energy drinks, consult a doctor about taking medicines if they affect the nervous system.

Trudy Griffin is a licensed psychotherapist from Wisconsin. She received her master's degree in clinical psychotherapy from Marquette University in 2011.

Number of sources used in this article: . You will find a list of them at the bottom of the page.

Anxious Personality Disorder (ADD) is a fairly common personality disorder in which people act extremely shy and fear rejection or embarrassment. Such a disorder often leads to isolation, prevents you from enjoying and living a fulfilling life. Determining the symptoms of anxiety disorder is easy enough, but to make a diagnosis, you need to see a qualified specialist in mental health.

Steps

Part 1

Strong shyness. One of the most recognizable symptoms of an anxiety disorder is strong feeling discomfort in social situations, far exceeding the usual "normal" shyness. People with this disorder find themselves frightened or very tense in situations where they have to interact with other people.

Social relationships. People with anxiety disorder often do not have close friends or romantic partners. This situation may be caused by the fact that they consider themselves socially incompetent.

What activities does the person try to avoid? People with TPD try to have as little contact with other people as possible. This may be related to study, work or recreation and entertainment.

Reaction to criticism. Typically, people with an anxious personality disorder are extremely receptive to criticism, or they themselves see criticism in everything. It constantly seems to them that everyone condemns them, even if a person is convinced of the opposite.

• Some individuals with TPD tend to avoid tasks they are not sure they will succeed in order to avoid criticism or judgment for poor performance.
• They are afraid of criticism even in situations that other people do not take seriously (for example, during a game).

1. Negative attitude. People with anxiety disorder tend to overestimate the negative aspects of situations. They obsess over potential problems and make a big deal out of molehills.

   Part 2

   How to distinguish TPD from similar disorders

   1. Schizoid personality disorder. In both anxiety disorder and schizoid personality disorder, people try to avoid social interactions, but there is an important difference between the two disorders. People with an anxious personality disorder are usually extremely concerned about their isolation and want to connect with others, while people with schizoid personality disorder are usually not bothered by this problem.

   2. Social anxiety disorder. Social Anxiety Disorder and Personality Anxiety Disorder are very similar, so often only specialists can tell them apart. Typically, a person with an anxious personality disorder has more symptoms than a person with social anxiety disorder, and the symptoms are more depressing.

      • It is possible that a person with several symptoms of an anxiety disorder may actually have social anxiety disorder, but only an experienced professional can make a diagnosis.
      • Some people are diagnosed with both disorders, making it even more difficult to try to distinguish between the problems.

   3. Learn about other disorders that lead to a lack of confidence. Anxious personality disorder is not the only mental disorder that can cause lack of confidence and feelings of inadequacy. Always consider the possibility of other, similar personality disorders.

      • As with anxious personality disorder, a person with histrionic personality disorder has low self-esteem. The main difference is that people with histrionic personality disorder do everything they can to gain the approval and acceptance of others, often in an unhealthy or detrimental way, while people with anxiety disorder try to avoid contact with other people.
      • Dependent personality disorder is also characterized by low self-esteem and fear of rejection. At the same time, people with dependent personality disorder usually fixate on one person, and do not shy away from any interactions. People with dependent personality disorder also find it difficult to make their own decisions, which is not common in TPD.

   Part 3

   How to get a professional diagnosis

   1. Get a comprehensive examination. If you think that you or someone you know may have an anxiety disorder, the first step is to get tested. Your doctor's job is to rule out any physical problems that may be causing your symptoms.

      • During the appointment, the doctor will conduct an examination and review in detail information about your personal and family illnesses.

   2. Contact a mental health professional. In the absence of physical problems, the doctor will refer the patient to a psychologist or psychiatrist. It is mental health professionals who diagnose personality disorders, including anxiety disorder.

      • During the appointment, the doctor will conduct a detailed survey. The psychologist or psychiatrist will ask the patient about all the symptoms, when they first appeared and how they have changed over time.
      • There are no medical tests or tests that can diagnose this disorder. Diagnosis is based on observations of the patient's behavior and confirmed symptoms.
      • After the diagnosis is made, the patient is offered to undergo a course of psychotherapy in order to get rid of the symptoms of an anxious personality disorder.

Anxious (avoidant, avoidant) personality disorder- a personality disorder characterized by a constant desire for social isolation, feelings of inferiority, extreme sensitivity to negative assessments of others and avoidance of social interaction. People with an anxious personality disorder often believe that they are unable to communicate or that their personality is not attractive, and avoid social interaction for fear of being ridiculed, humiliated, rejected, or only disliked. Often they present themselves as individualists and talk about feeling alienated from society.

Description

Many people, including patients with various clinical syndromes, sometimes use avoidance to alleviate anxiety or avoid difficult situations. Avoidant personality disorder (IDD) is characterized by total avoidance in behavior, emotions and cognition. This avoidance is supported by cognitive themes such as self-judgment, the expectation of rejection in interpersonal relationships, and the belief that unpleasant emotions and thoughts are unbearable.

During psychotherapy, patients with IPD report their desire for love, acceptance, and friendship, but in reality they usually have few friends and do not enter into close relationships with anyone. It is difficult for them to communicate even with a psychotherapist. Their frequent loneliness and sadness are fueled by a fear of rejection that prevents them from starting or deepening friendships.

The typical IPD patient will have the beliefs "I am socially inept and undesirable" and "Other people are superior to me and will reject or criticize me upon getting to know me."

Anxiety personality disorder is most often first noticed between the ages of 18 and 24, associated with perceived or real rejection from parents or peers during childhood. To date, it remains controversial whether the feeling of rejection is a consequence of the increased attention to interpersonal interaction inherent in people with the disorder.

In the Soviet tradition, the closest diagnosis is psychasthenia.

Diagnostic indicators

ICD-10

The international classifier of diseases "ICD-10" officially used in Russia for the diagnosis of anxiety disorder of personality requires the presence of general diagnostic criteria for personality disorder, and plus to them the presence of three or more of the following personality characteristics:

• a) a constant general feeling of tension and severe forebodings;
• b) ideas about their social incapacity, personal unattractiveness and humiliation in relation to others;
• c) increased preoccupation with criticism or rejection in social situations;
• d) unwillingness to enter into relationships without guarantees to please;
• e) limited lifestyle due to the need for physical security;
• f) avoidance of social or professional activities associated with significant interpersonal contacts due to fear of criticism, disapproval or rejection.

Additional features may include hypersensitivity to rejection and criticism.

Excluded:

DSM-IV-TR and DSM-5

The American Psychiatric Association's DSM-IV-TR, officially used in the United States for the diagnosis of mental disorders, defines avoidant personality disorder as a persistent desire for social withdrawal, feelings of inferiority, hypersensitivity to negative evaluations, and begins between the ages of 18-24, appearing in a variety of forms, and manifesting, except common criteria personality disorders, four (or more) of the following:

1. Avoidance of professional activities that require meaningful interpersonal contact due to fear of criticism, condemnation or rejection.
2. The unwillingness of a person to deal with people without the certainty that they will like him.
3. Restraining oneself from engaging in close relationships for fear of being shamed, ridiculed, or rejected due to low self-esteem.
4. Preoccupation with possible criticism or rejection in social situations.
5. Stiffness in new social situations due to feelings of inadequacy.
6. Perception of oneself as a person socially inept, unpleasant as a person, or "second-class" in relation to others.
7. Increased reluctance to take risks or engage in new activities, as this can reinforce feelings of shame.

The new edition of DSM-5 lists the same diagnostic criteria.

Differential Diagnosis

Anxious personality disorder is often confused with antisocial personality disorder (sociopathy) because of the name; clinically, the term "antisocial" means disrespect for the norms and rules of society, not social isolation.

Avoidance of social activities is characteristic of both persons with anxiety personality disorder and schizoid. The schizoid is distinguished by a "mat" affect and a desire to be left alone, while the anxious type wants to communicate, but feels fear and self-doubt. People with an anxious personality disorder are afraid that their identity will be rejected and devalued, so they avoid communication.

In dependent personality disorder, similar clinical picture, the difference is that the dependent type of personality feels the fear of parting, and the anxious one feels the fear of establishing contact.

Etiology and pathogenesis

The causes of anxiety disorder are not fully understood. A combination of social, genetic and psychological factors can influence the onset of the disorder. The disorder may occur due to temperamental factors that are hereditary. In particular, various anxiety diseases during childhood and adolescence may be associated with melancholic temperament, characterized by hereditary behavior, including traits such as shyness, fearfulness and isolation in new situations.

Many people with an anxious personality disorder have painful experiences of constant rejection and criticism from parents and/or people around them. The desire not to sever the connection with the rejecting parents makes such a person thirsty for a relationship, but her desire gradually develops into a protective shell against constant criticism.

Symptoms

Symptoms that are not diagnostic criteria include:

• excessive fear of rejection or disapproval by others;
• avoidance of interpersonal relationships;
• feeling of own inadequacy;
• reduced self-esteem;
• distrust of others;
• self-isolation from society;
• extreme degree of modesty/timidity;
• emotional distancing in intimate relationships;
• excessive shyness;
• self-criticism about problems in relationships with others;
• hypersensitivity to criticism;
• extreme anxiety and embarrassment in social situations;
• problems in professional activity;
• feeling of loneliness;
• a feeling of "second-class" compared to others;
• chronic abuse or dependence on certain substances.

People with an anxious personality disorder are overly concerned with their own shortcomings and only form relationships with others if they are sure they will not be rejected. Loss and rejection are so painful that these people choose to be alone rather than take risks and connect with people in some way.

Story

The term "avoidant personality" was first used by Millon (Millon, 1969). He described this personality as consisting of a pattern of "active detachment" manifesting itself in "fear and distrust of other people."

“These people are constantly making sure that their urges and desire for love do not lead to a repetition of the pain and suffering they experienced earlier in relationships with other people. They can only protect themselves by actively avoiding contact. Despite the desire to communicate with people, they have learned that it is better to ignore these feelings and maintain a distance in interpersonal relationships” (Millon, 1981, p. 61).

Millon's definition of HDI is largely based on social learning theory. The object relations theorists Burnham, Gladstone, & Gibson (1969) presented a concept that emphasizes the role of motivation and derives HD symptoms from the need-fear dilemma.

“He has a pronounced need for structuring the outside world and for control... His existence depends on maintaining contact with objects...

The sheer intensity of his need for objects also makes them extremely dangerous and fearsome, as they can destroy him through refusing contact. Consequently, he fears and distrusts them.

One way to prevent or alleviate the pain caused by the need-fear dilemma is to avoid the object...

Attempts by other people to involve him in the interaction are regarded as intrusions that threaten disorganization.

A view closer to the cognitive approach can be found in the writings of Karen Horney (Horney, 1945), who described the "interpersonal avoidant" person more than 40 years before he was defined in the DSM-III-R: communication with people, and loneliness becomes the main way to prevent it .... There is a general tendency to suppress all feelings, even to deny their existence ”(p. 73-82). In a later work (Horney, 1950), Horney gives a description of the avoidant person that is consistent with cognitive formulations:

“With little or no provocation, he feels that others despise him, do not take him seriously, do not want to be in his company, and in fact neglect him. His self-contempt... makes him... very doubtful of how others treat him. Without accepting himself for who he is, he cannot believe that others, knowing all his shortcomings, can show him a friendly attitude or think well of him.

Treatment and therapy

Therapy may include a variety of techniques, such as social skills training, cognitive psychotherapy, gradual social building, group therapy to practice social skills, and sometimes pharmacotherapy.

Winning and maintaining the patient's trust is key in therapy, as people with anxiety disorder often avoid therapy sessions if they do not trust the therapist. The primary goal for both individual therapy and group social skills training is to get the patient to question their exaggerated negative beliefs about themselves.

Research and statistics

Researchers suggest that people with an anxious personality disorder may also suffer from social anxiety, excessively monitoring their own internal feeling during social interactions. However, unlike social phobes, they are also overly attentive to the reactions of the people they interact with. The extreme tension caused by this observation can cause slurred speech and taciturnity in many people with an anxious personality disorder. They are so busy watching themselves and others that fluent speech becomes difficult.

Anxious personality disorder is most common among people with anxiety disorders, although the likelihood of a combination of disorders varies due to differences in diagnostic tools. Researchers estimate that approximately 10-50% of people with panic disorder and agoraphobia have an anxiety disorder, as do 20-40% of people with social anxiety disorder. Some studies indicate that up to 45% of people with an anxiety disorder and up to 56% of people with obsessive-compulsive disorder have an anxiety disorder. Although not mentioned in the DSM-IV, earlier theorists identified "mixed avoidant-borderline personality" (APD/BPD), which was a combination of features of borderline personality disorder and anxiety personality disorder.

Literature

• Comer, R. J. Avoidant personality disorder // Fundamentals of abnormal psychology. - 4th ed. - New York: Worth Publishers, 2004. - 497 p. - ISBN 978-0716786252.
• Eckleberry, Sharon C. Dual Diagnosis and the Avoidant Personality Disorder. Retrieved February 6, 2007. Archived from the original on March 16, 2012. // The Dual Diagnosis Pages: From Our Des. - March 25, 2000
• Kantor, M. Avoidant personality disorder // Distancing: A guide to avoidance and avoidant personality disorder. Revised and additional ed. - Westport, CT: Praeger Publishers, 2003. - 296 p. - ISBN 978-0275978297.
• Rettew, D.C. Avoidant Personality Disorder: Boundaries of a Diagnosis // Psychiatric Times Magazine. - July 1, 2006
• Van Velzen, C. J. M. Social phobia and personality disorders: Comorbidity and treatment issues. - Groningen: University Library Groningen, 2002.

anxiety disorder is an neurotic state. It is characterized by constant anxiety of patients about life circumstances, their appearance or relationships with other people.

Due to internal discomfort and unpleasant thoughts, patients often withdraw into themselves, limit their social circle and do not develop their abilities.

Description of this pathological condition found in the writings of famous psychiatrists since the beginning of the 20th century, scientists have noted that increased anxiety is often combined with other mental disorders and long-term somatic illnesses.

Nowadays, empirical and practical knowledge about the disease has been accumulated, methods are known and tested on how to treat the disorder (drug and psychotherapeutic techniques).

The specialists in whose competence is the diagnosis and treatment of neurosis include psychiatrists and medical psychologists.

The line between the norm and pathology feelings of anxiety are very subtle, since such anxiety is natural mechanism protection arising in response to external circumstances. Therefore, self-discovery in oneself or treatment of the disease is unacceptable, this can lead to aggravation and complication of the neurotic state.

If you suspect an anxiety disorder, it is important to seek professional help from a healthcare provider.

ICD-10 code

In scientific circles, this neurosis has its own definition, classification and medical code. (F41) .

Anxiety personality disorder is included in the category of neurotic disorders, along with fears and phobias, suspiciousness and post-traumatic states.

One of the defining signs of pathological anxiety for scientists is the disproportionality of the defensive reaction to the provoking factor, i.e. even an ordinary event in life can cause a violent negative reaction in sick people, an emotional breakdown and somatic complaints.

Pathology is quite common in the world, according to statistics, its signs are found in one out of four examined people, and according to the World Health Organization, the disease has been detected more than 2% the population of the earth.

Causes

The etiology (origin) of the disease is not fully understood, experts suggest that it is provoked by the following factors:

• chronic heart or hormonal diseases, persistent circulatory disorders;
• taking psychoactive substances or their abrupt withdrawal, chronic alcoholism or drug addiction;
• head injuries and their consequences;
• prolonged stressful situations;
• melancholic temperament or anxious character accentuation;
• mental trauma in early childhood or adulthood extreme situations(war, being on the verge of life and death, leaving loved ones or depriving them of support);
• high susceptibility to dangers, their exaggeration;
• neurotic states (neurasthenia, depression, hysteria) or mental illness(schizophrenia, paranoia, mania).

In various psychological schools, the appearance of increased anxiety is considered from the point of view of the main approach to human mental activity:

1. Psychoanalysis . In this theory, the occurrence of an anxiety disorder occurs due to the displacement and distortion of unrealized human needs. Due to social and internal prohibitions, people constantly turn on the mechanism of suppressing their desires, to which the psyche reacts with inadequate neurotic reactions and anxiety disorders.

2. Behaviorism . In this scientific direction, high anxiety is considered as the result of a break in the connection between an external stimulus and the reaction of the psyche to it, i.e. anxiety arises out of nowhere.

3. cognitive concept defines an anxiety disorder as a reaction to mental images distorted in the mind, safe stimuli are transformed by patients into threatening ones.

Diagnostics

To identify the disease are used:

• survey during an individual consultation (collection of information about the emotional reactions of patients, their lifestyle, motivation and interests);
• psychodiagnostic examination, specialized questionnaires are usually used (Spielberg-Khanin Scale, etc.) and a projective test (Market drawing, Rorschach spots, etc.), revealing signs increased anxiety and its accompanying disorders;
• monitoring the lives of patients social contacts and relationships with others.

Kinds

1. Anxiety-depressive the disorder is characterized by feelings constant anxiety without real sources of danger. It manifests itself pathological changes in the personality of patients and their physical health.

2. anxiety-phobic the condition is caused by a constant sense of danger arising from dwelling on past traumatic events in a person's life or fictional fears of the future.

3. social the disorder is manifested by diligent avoidance of any contact with others, even their simple observation of the actions of patients causes them emotional discomfort, criticism is extremely painful for such patients.

4. Adaptive phobia proceeds with the fear of getting into new conditions of life.

5. organic anxiety is a consequence of a somatic disease, therefore, in addition to anxiety, patients have other signs of damage to the body (persistent headaches with loss of orientation in space, memory loss or severe malfunctions of the heart, pancreas, liver, etc.).

6. mixed the disorder is characterized by signs of anxiety and a lowered background of mood at the same time.

Symptoms

The signs of mental and autonomic disorders common to all forms of anxiety disorder are:

Each type of disease may have its own distinctive features. So generalized anxiety disorder, the symptoms of which are caused by total anxiety in almost any life circumstances, manifests itself in difficulty concentrating on any activity at home or at work, inability to relax and constant motor tension, pain in the stomach and digestive disorders, heart disorders.

BUT anxiety-depressive Panic attack disorder occurs with anxiety attacks on the background of depression and is characterized by:

• lack of interest in life and loved ones;
• lack of positive emotions;
• a sudden feeling of fear;
• vegetative pathology: increased heart rate, a feeling of pressure in the sternum and proximity to fainting, lack of air, excessive sweating.

Treatment

Therapeutic assistance in the treatment of the disease is:

• in the normalization of the regime of work and rest of patients (rational nutrition, prevention of physical and emotional stress, management healthy lifestyle life);
• in taking medications as prescribed by a doctor: tranquilizers and antidepressants (Xanax, Eglonil);
• psychotherapy courses (cognitive, behavioral, rational, psychoanalytic, etc.).

Most often, the treatment of increased anxiety is complex, but if the doctor confirms it psychogenic origin help in case of illness is recommended to be provided in the course of individual and group sessions with patients.

Carrying out the treatment without based on psychotherapy sessions, specialists use:

• gradual confrontation of patients with provocative stimuli by the type of addiction to them;
• changing their attitude to frightening factors through logical persuasion;
• detection and awareness of psychotraumatic situations, strengthening thoughts about prescription and the loss of their significance in real life;
• learning relaxation techniques for emotional and muscle relaxation.

A positive result of therapy is a stable change in the behavior of patients, their adequate reactions to stressful events, memories or planning their future.

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