Hello. This is Dr Grande. Today's question is:
Do individuals with Avoidant Personality Disorder
respond differently to fear in others?
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Now, when we talk about Avoidant Personality Disorder, we're talking about a contruct that's
that's fairly similar
to Social Anxiety Disorder.
And we know from the research that Social Anxiety Disorder
has this relationship with fear
in other individuals.
Meaning individuals with Social Anxiety Disorder tend to
avoid fearful expressions in other people.
So this question is really asking,
'Is that the same for Avoidant Personality Disorder?'
Now, there's not a lot of research published
on Avoidant Personality Disorder, but there was a study published in
2011, by Rosenthal and colleagues
that looked at Avoidant Personality Disorder
and all of the facial expressions to see if there were any differences between individuals who have
Avoidant Personality Disorder and those that didn't.
So first, let's take a look at Avoidant Personality Disorder:
What are the symptoms that we would see associated with this disorder?
Well, we know from the Diagnostic and Statistical Manual, the DSM,
that there are seven symptoms in the symptom criteria.
We see avoiding occupational activities where there is significant interpersonal contact
because of a fear of criticism, disapproval or rejection.
We see an unwillingness to form friendships unless there's a certainty of being liked.
Trouble with intimate relationships and this is because of fear of shame.
A preoccupation with criticism or rejection in social situations.
Being inhibited with new relationships and this is because of a fear of inadequacy.
Feelings of being inept, or inferior and also a reluctancy to take risks
because of a fear of being embarrassed.
So we see a lot of themes, here, with Avoidant Personality Disorder.
Fear of rejection, disapproval, criticism, feelng inadequate, inept, inferior
and being ashamed or embarrassed.
So we can see how Avoidant Personality Disorder can really cause difficulties in a lot of different areas of somebody's life
Now, there's a theory as far as some of the interpersonal problems we see
with mental disorders, including personality disorders,
that there's this impaired ability to recognise facial expressions.
And that's what we're really talking about, here, with Avoidant Personality Disorder and fearful expressions.
We see research on Social Anxiety Disorder, which is similar to Avoidant Personality Disorder
and I mention those findings,
before there is an avoidance of fearful faces, there.
But we also see difficulties recognising facial expressions , in general, with Antisocial Personality Disorder
And the research is mixed around Borderline Personality Disorder
but generally, we do see some differences in facial recognition, abilities and tendencies
in Borderline Personality Disorder.
So to understand how this study and other studies like it, function, it's first, important to understand
the prototypical facial expressions.
We know there are six and these have been found to be facial expressions that are recognised across cultures.
So we have: Sadness, happiness, anger, fear, surprise and disgust.
Those are the six facial expressions.
So, oftentimes when researchers hypothesise,
that there's going to be some sort of impairment with facial recognition,
they use these six facial expressions, even if they really think that only one might be statistically. significantly different.
So, it's fairly common for the tests of facial recognition to include all six of the facial expressions.
Now, in this particular study, a specific instrument was used to evaluate how accurately
somebody recognised facial expressions
and it's called the Multi- Morph Facial Affect Recognition Task
and really, it's a fairly clever type of instrument. Here we see an individual is given the list of those six
facial expressions and they're shown an image of a neutral face
and that neutral face gradually moves through stages, to what's called a 100% expression.
So, one of those six facial expressions at 100%.
So, it should be easily recognisable for most people.
So, it moves from neutral, which is 0% to that full expression, 100%, in 39 stages.
So, it's quite gradual.
It really looks at two different factors: Sensitivity, we can also think of this as speed and
and this is the average number of stages it takes to correctly identify that facial expression
and accuracy: Accuracy is only measured at that 100% expression,
at that full expression. So at the end, the participant is given the opportunity to choose their final answer.
in terms of what emotion they're seeing, on the screen.
So, the finding in this study was that individuals with Avoidant Personality Disorder were less accurate
in identifying fear at that 100% expression level.
But there was no difference between individuals with Avoidant Personality Disorder and those that do not
and those that do not have a personality disorder with any of the other five facial expressions.
Also, even with fear included, there was no difference with speed, that sensitivty measure.
So, really, there weren't many differences found, at all. It was just this one difference, with this full expression
of fear, with Avoidant Personality Disorder.
These results are consistent with other results we've seen, from other studies with Social Anxiety Disorder
but it's inconsistent with some other studies on Social Anxiety Disorder.
There are other studies, that show that there's no difference across any of the facial expressions.
So, we don't really have agreement in terms of Social Anxiety Disorder and Avoidant Personality Disorder
and facial expressions, including the facial expression of fear.
So, what can we learn from this study about Avoidant Personality Disorder?
Well there's different theories as to why this finding, occurred.
But, one theory would be that individuals with Avoidant Personality Disorder regulate emotional arousal
by directing attention away from faces that have a fearful expression.
So, they attempt to avoid looking at fearful espressions and because they do this, their abilty to recognise
fearful expressions is impaired.
Another key take away from this study, in my opinion, is the relationship between Social Anxiety Disorder and
Avoidant Personality Disorder, in the research. We see quite a bit of research on Social Anxiety Disorder,
we dont see much, at all, on Avoidant Personality Disorder.
And, I think the reason for this is because a lot of researchers conceptualise these two disorders as being similar,
if not, the same thing.
So, maybe slightly different expressions of the same, underlying disorder.
Therefore, with research done on Social Anxiety Disorder, inferences can be drawn to Avoidant
Personality Disorder
So, I think one thing that needs to happen in the research is to really try to figure out if Avoidant Personality
Disorder truly is a separate, distinct construct from Social Anxiety Disorder.
And, if it is, to conduct more research on Avoidant Personality Disorder, specifically.
Of course, one of the difficulties is, it's very hard to find a sample size, large enough
using individuals who have Avoidant Personality Disorder.
So, studying Avoidant Personality Disorder is difficult and with these small sample sizes and there was a
small sample size in this study, as well. We have to be careful about interpreting the results.
I hope you find this description of Avoidant Personality Disorder and fearful facial expressions to be interesting.
Thanks for watching.