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