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Avoidant personality disorder
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Dependent personality disorder
Major depressive disorder
Persistent depressive disorder
Schizoid personality disorder
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This patient has a longstanding pattern of significant social inhibition (no social circle), fear of rejection (keeps an animal companion who ‘always accepts [her]’), feelings of inadequacy (social awkwardness), and desire of intimacy (wants friends and partner). These characteristics are consistent with avoidant personality disorder. Avoidant personality disorder is distinguished by extreme shyness, fear of social judgment, and feelings of inferiority. As with all personality disorders, the associated behaviors often start by adolescence and lead to disruptions of normal function. Along with dependent and obsessive-compulsive personality disorders, avoidant personality disorder falls under the cluster C category, which is characterized by anxiety and nervousness. Given the idiosyncrasies of avoidant personality disorder, patients usually only form social connections when they are certain about their acceptance. Psychotherapy is the treatment of choice. Wilberg et al. examined the psychosocial impact of a variety of personality disorders. They discovered that avoidant personality disorder is associated with low levels of social support/quality of life/education and increased levels of interpersonal problems, and can be as detrimental as borderline personality disorder. Incorrect Answers: Answer 2: Dependent personality disorder is characterized by clingy and submissive behavior towards other individuals. Patients often lack self-confidence and feel like they are unable to fend for themselves. They believe they must rely on others. While the patient in the question also lacks self-confidence, she does not have any social contacts at all and thus is not clearly dependent. Answer 3: Major depressive disorder is a mood disorder characterized by having a depressed mood or decreased interest (anhedonia) and at least 4 other key symptoms (e.g., weight change, sleep disturbance, psychomotor changes, guilt, energy change, inability to concentrate, thoughts of suicide) for at least 2 weeks. While describing some depressed mood and sleep changes, the patient does not have the other symptoms. Answer 4: Persistent depressive disorder is a mood disorder characterized by feelings of depression with at least other 2 key depressive symptoms (e.g., changes in appetite, sleep disturbance, fatigue, low self-esteem, decreased concentration, and loss of hope) for at least 2 years. While describing some depressed mood and sleep changes, the patient does not have the other symptoms. Answer 5: Schizoid personality disorder is characterized by indifference towards social relationships and a preference for solitary activates. While social isolation is seen in both avoidant and schizoid personality disorders, patients with schizoid personality disorders do not desire relationships. In contrast, this patient desires relationships. Bullet Summary: Avoidant personality disorder is distinguished by extreme shyness, fear of social judgement, and feelings of inferiority.
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