Dependent Personality Disorder 675
order, all can be diagnosed. Both avoidant personality disorder and dependent personal-
ity disorder are characterized by  feelings of inadequacy, hypersensitivity to criticism, and
a need for reassurance. Although the primary focus of concern in avoidant personality
disorder is avoidance of humiliation and reject ion, in dependent pers onality disorder the
focus is on being taken care of. However, avoidant personality disorder and dependent
personality disorder are particularly likely to  co-occur. Like avoidant personality disor-
der, schizoid personality disorder and schizotypal personality disorder are characterized
by social isolation. However, individuals with avoidant personality disorder want to have
relationships with others and feel their loneliness deeply, whereas those with schizoid or
schizotypal personality disorder may be conten t with and even prefer  their social isola-
tion. Paranoid personality disorder and avoida nt personality disorder are both character-
ized by a reluctance to confide in others. Ho wever, in avoidant personality disorder, this
reluctance is attributable more to a fear of being embarrassed or being found inadequate
than to a fear of others’ malicious intent.
Many individuals display avoidant personality traits. Only when these traits are in-
flexible, maladaptive, and persisting and caus e significant functional impairment or sub-
jective distress do they constitu te avoidant personality disorder.
Personality change due to another medical condition. Avoidant personality disorder
must be distinguished from personality ch ange due to another medical condition, in
which the traits that emerge ar e attributable to the effects of another medical condition on
the central nervous system. 
Substance use disorders. Avoidant personality disorder must also be distinguished
from symptoms that may develop in a ssociation with persistent substance use.
Dependent Personality Disorder