Anxious Personality Disorders

Avoidant, Dependent, Obsessive-Compulsive

Individuals with these disorders often appear anxious or fearful, and like the other personality disorders, the generalized patterns described typically begin in early adulthood, and are present in various contexts.

Avoidant Personality Disorder

An individual with Avoidant Personality Disorder typically is socially inhibited, feels inadequate, and is over sensitive to criticism, as indicated by four (or more) of the following (from DSM IV, American Psychiatric Association, 1994):

  • Avoids work-related activities that involve much social contact, because of criticism, disapproval, or rejection
  • Is unwilling to get involved with people unless certain of being liked
  • Fears of shame or ridicule lead to excessive shyness within intimate relationships
  • Is overly concerned with criticism and rejection in social situations
  • Is inhibited in new social situations because of feelings of inadequacy
  • Views self as socially incompetent, personally unappealing, or inferior to others
  • Unusually reluctant to take personal risks or do new activities because of fear of embarrassment.

Dependent Personality Disorder

A person with Dependent Personality Disorder shows an extreme need to be taken care of that leads to fears of separation, and passive and clinging behaviour. The disorder is indicated by five (or more) of the following:

  • Difficulty making daily decisions without an excessive amount of advice and reassurance from others
  • Needs others to assume responsibility for most major areas of his or her life
  • Difficulty voicing disagreement with others because of fear of loss of support or approval (excluding realistic fears of punishment)
  • Difficulty starting projects or doing things on his or her own (because of little self-confidence in judgment or abilities, rather than a lack of motivation or energy)
  • Excessively attempts to obtain support from others such that he or she volunteers to do unpleasant tasks
  • Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself
  • Urgently seeks another relationship as a source of support when a close relationship ends
  • Overly worried about being left to take care of himself or herself

Obsessive Compulsive Personality Disorder

An individual with Obsessive Compulsive Personality Disorder is preoccupied with orderliness, perfectionism and control at the expense of flexibility, openness, and efficiency. This pattern is indicated by four (or more) of the following:

  • Is overly concerned with details, rules, lists, order, organisation, or schedules such that the major point of the activity is lost
  • Is unable to complete a project because of his or her own overly strict standards are not met
  • Excessive emphasis on work and productivity such that leisure activities and friendships are devalued (not accounted for by obvious economic need)
  • Is overly conscientious and inflexible about issues involving morality, ethics, or values (not accounted for by cultural or religious identification)
  • Is unable to throw out worn-out or worthless objects despite lack of emotional value
  • Is reluctant to delegate tasks or work with others unless they agree to exactly his or her way of doing things
  • Adopts a stingy spending style toward both self and others; money is seen as something to be gathered for future catastrophes
  • Rigidity and stubbornness

This personality disorder differs from obsessive compulsive disorder (OCD), a related mental health condition, in several important ways:

  • People with OCD are aware their behaviour is abnormal and are anxious about it. Most people with obsessive compulsive personality disorder think their behaviour is perfectly acceptable and have no desire to change it.
  • Some people with OCD are compelled to carry out rituals, such as having to touch every second lamppost as they walk down the street. This is not usually the case with people with obsessive compulsive personality disorder.
  • People with OCD may feel compelled to make lists or organise items in their house but feel anxious about doing so. People with obsessive compulsive personality disorder find relief from anxiety when doing such tasks and may become irritated when prevented from doing so.” (Taken from NHS Choices).

There also is a diagnosis known as “Personality Disorders Not Otherwise Specified”, which is separate from the previous three groups of disorders. This diagnosis would be given for disturbed personality functioning that does not the criteria for any specific Personality Disorder, but which leads to distress or harm in one or more important areas of functioning (e.g., social or work-related). The clinician may also give this diagnosis if a specific personality disorder that is not included in the DSM IV Classification seems to apply to an individual (e.g., depressive personality disorder, or passive-aggressive personality disorder; DSM IV, American Psychiatric Association 1994).