A child that attempts to avoid all responsibilities in which they must socialize with others may not just simply be shy. Although the diagnosis of Avoidant Personality Disorder can only be made in those over the age of 18, many symptoms present well before early adulthood. Most children go through phases where they are shy or prefer known acquaintances to meeting new people. Normal developmental trust building occurs throughout the formative years and, depending on the personality of the child and the parent, will form the ability to trust in adulthood.
Causes
Avoidant Personality Disorder can be caused by learned behavior. In an environment with a parent that has difficulty interacting with others or one where trusted and loved individuals show strict criticism under the guise of love, a child may develop a general mistrust for others and low self-esteem. Although a very small percentage of the population, around 1%, suffers from this disorder, for those that experience it life can be dysfunctional and lonely. They may not admit to their fear but the pattern of behavior will be easily noticed.
Symptoms
Symptoms of Avoidant Personality Disorder are best observed over time. A few situations in which the person avoids contact with others are not enough to make this diagnosis. There must be an almost daily occasion in which the person avoids school, work, or other social activities. It may be a clue when the child avoids situations that are usually pleasurable to others such as birthday parties or celebration of an accomplishment. The person with the disorder may verbalize feeling as though they are beneath others or that they have no friends. They may have great difficulty making connections with others unless they are positive that the person will hold them in positive regard. There is a marked fear of saying or doing the wrong thing in front of others, not looking good enough, and becoming embarrassed. While in social situations the person may sit alone and look at others trying to decide if others like or dislike them. Intimate or romantic relationships are often difficult either due to the low self esteem of the sufferer or the annoyance of the partner from having to constantly reassure them of their affection toward them. In children, this might manifest in repetitive questioning about the feelings of loved ones or friends. Play dates or time at the playground may reveal the self-isolation of a child that may develop Avoidant Personality Disorder. If behaviors are caught in childhood, there is a good chance that the disorder will not be an issue in adulthood.
Treatment
Treatment for Avoidant Personality Disorder or the early symptoms of it will include some form of counseling. Usually, a mental health professional can make a diagnosis based on family and client interviews about patterns of behavior. The type of therapy provided will be dependent on the age of the client and the underlying triggers for the behavior. If the driving force of the disorder is anxiety or phobia the counseling may be focused on increasing self confidence and lowering tension in social situations. Generally, a form of Cognitive Behavior Therapy will be employed but the techniques used can range from play therapy to exposure therapy with reframing and relaxation techniques. Therapy will likely be successful if the client is willing to participate in counseling and desires relief from symptoms. In severe cases, medication might be used to help reduce the disabling feelings that keep the client from living a fulfilling life. If the client is a child, it will likely be necessary to participate in family counseling. Avoidant Personality Disorder does not have to be a lifelong issue and can be helped with proper treatment.
