The relationship between social anxiety disorder (SAD) and avoidant personality disorder (DEP) is much debated in the literature .
According to various authors, the two disorders would be similar and differentiable solely on the basis of the symptomatological level, while for others the two psychopathological pictures would refer to different constructs (aspects of personality versus anxious reactivity), while presenting symptomatic overlaps.
When both were included in DSM III, the principle to differentiate them was based on a single empirical study in which only fear of performance was recognized in the DAS, while in the DEP the discomfort with social interaction seemed to be prevalent; in the course of the updates of the DSM this difference has disappeared contributing to confusion of the syndromes.
In a recent article, Kieran et al. (2016, DOI 10.1002 / pmh.1349) investigated these two pathologies again trying to contribute to the debate. The purpose of the study is to determine whether DEP and SAD can be differentiated based on personality traits or the severity of symptoms.
Two samples were enrolled in the present study, which ultimately resulted from 131 subjects (university sample) and 271 subjects (sample drawn from the general population).
The tests administered were: Infrequency Scale, SCID-II, Personality Diagnostic Questionnaire – 4, WHO Disability Assessment Schedule 2.0, WHO Quality of life- BF, Measuring Disordered Personality Functioning, Social Functioning Questionnaire, Social Phobia Inventory, Personality Inventory DSM 5, Multidimensional Personality Questionnaire BF.
The results highlighted, first of all, that there doesn’t seem to be a difference based on personality traits. The study, in fact, recognizes that DEP is no more personality disorder than SAD is and highlights how it is more appropriate to think in terms of personality traits than anxiety symptoms for both disorders.
Furthermore, even from a symptomatological point of view there does not seem to be a difference between the DEP and the SAD, observing how the impairment is particularly marked for both syndromes .
Finally, as usual, the authors review the possible limitations of the study, in particular due to the online recruitment of the sample drawn from the general population and the fact that the sample was not clinical.
In any case, the study represents a useful contribution to the debate on social anxiety disorders and, while not providing definitive answers, it offers a starting point for perhaps better understanding how DAS is a disorder still underestimated and little considered for the personality aspects that perhaps they represent the central element of the disorder itself.
