The toll of avoidant personality disorder and social isolation

James Holmes from San Diego, California graduated at the top of his class from the University of California, Riverside in 2010, but was slipping behind in graduate school at the University of Colorado Denver’s Neuroscience Ph.D. graduate program. He was reported to have worked in a socially isolated environment that was considered “isolating drudgery”, where students spend hours by themselves in tiny rooms doing science experiments on rats. He had failed an important exam before buying one of the guns he allegedly used to shoot up the “Dark Knight” theater in Aurora, Colorado on July 20, 2012. Neighbors reported that the young man was constantly isolated. According to an article in Business Insider, the isolated environment where he was working on his Ph.D. program is being considered as a possible cause of how and why he decided to go on a killing spree.

Continued isolation like that which Holmes endured can factor into the development of a number of different issues including avoidant personality disorder. Avoidant personality disorder (AvPD) is a syndrome characterized by a long-standing pattern of social anxiety and withdrawal, sensitivity to social criticism and low self-esteem (DSM-5). People diagnosed with avoidant personality disorder come from all types of backgrounds.

There are many reasons why a person would intentionally prefer to be alone or isolated. Abuse during childhood or adulthood can cause people to perceive the world and those around them as being unsafe. Such circumstances can also create a ‘victim mentality’ in people’s psyche, in which they exist by walking a tight-rope of avoidance in the attempt to remain safe and secure.

Perpetual isolation can cause a person to experience emotional, physical and mental deterioration. Despite the many reasons people feel compelled to isolate themselves, such as having suffered abuse, dealing with a mental illness or struggling with drug abuse, there remains a pertinent need to remain socially active to survive. “For members of social species, life on the social perimeter is aversive and unsafe. The presence of connections among conspecifics is the defining characteristic of social species and the absence of these connections (i.e., social isolation) threatens the health, life, and genetic legacy of members of many different social species.” (Ruan; Wu 2008)

Social rejection and disapproval are normal and sometimes unavoidable in life when dealing with multiple types of personalities as it’s hard to please everyone. Unfortunately, many people will stop all attempts of branching out to build new relationships based on prior experiences of being rejected. People comprise a social species and for members of a social species, being on the perimeter of social circles is unsafe. Connections define the social species and the absence of these connections, through isolation, threatens the health, life and genetic legacy of members of a social species. (Ruan; Wu 2008)

AvPD DSM 5 diagnostic criteria

Avoidant personality disorder is characterized by pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation, beginning in early adulthood. The disorder presents in a variety of contexts, as indicated by four (or more) of the following:

  1. Avoidance of occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval or rejection
  2. Unwillingness to get involved with people unless certain of being liked
  3. Show of restraint within intimate relationships because of the fear of being shamed or ridiculed
  4. Preoccupation with being criticized or rejected in social situations
  5. Inhibition in new interpersonal situations because of feelings of inadequacy
  6. Views self as socially inept, personally unappealing or inferior to others
  7. Unusual reluctance to take personal risks or to engage in any new activities because they may prove embarrassing

Along with the aforementioned diagnostic criteria for identifying AvPD there are several other symptoms that can be exhibited by someone dealing with the disorder. These can include:

  • Mistrust of others
  • Highly self-conscious
  • Difficulties in occupational functioning
  • Extreme shyness or anxiety in social situations
  • Avoidance of physical contact
  • Self-critical about problems relating to others
  • Emotional distancing related to intimacy
  • Self-imposed social isolation

Treatment for avoidant personality disorder


Individuals who suffer from avoidant personality disorder typically have poor self-esteem issues surrounding social interactions. Various studies have been published concerning the effectiveness of behavioral treatment for interpersonal problems in various groups of psychiatric outpatients. Such research has focused on two types of behavioral regiments. The first, exposure strategies are based on the notion that exposure to fear-provoking situations is the mechanism underlying behavioral change. The second set of strategies, skill-training strategies, are based on the assumptions that people who are socially dysfunctional have failed to acquire the behaviors necessary to handle interpersonal interactions (Stravynski; Shahar 1983). Through the use of these types of treatment methods, those with AvPD may have the ability to lead an improved lifestyle.

If you or a loved one would like more information on how to obtain treatment for avoidant personality disorder, you can call the Mental Health Helpline at 855-653-8178.