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The relationship of social phobia to avoidant personality disorder: a proposal to reclassify avoidant personality disorder based on clinical empirical findings

Published online by Cambridge University Press:  16 April 2020

J. Reich*
Affiliation:
Harvard and Stanford Medical Schools, Departments of Psychiatry, 2255 North Point St., Suite 102, San Francisco, CA94123, USA

Summary

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In the DSM system social phobia and avoidant personality have been conceptualized as independent entities. Each had separate, if overlapping diagnostic criteria. The specific inclusion and exclusion criteria provided by DSM allowed empirical research to guide future revisions. This review evaluates the empirical literature and evolution of the concepts of these diagnoses from DSM-III to DSM-IIR to DSM-IV. The empirical evidence leads us to the conclusion that there is no dividing line between social phobia and avoidant personality disorder. In addition to their being no dividing line diagnostically between the disorders, there appears to be no separation of the two by treatment techniques. This raises interesting questions about how we differentiate Axis I from Axis II disorders. Suggestions for revisions of the social phobia and avoidant personality disorder categories are given.

Type
Editorial

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