Avoidant personality disorder: empirical support for DSM-IV revisions.

This article attempts to answer three questions about avoidant personality disorder (AVPD): (a) Is it a coherent unidimensional entity, (b) Is the requirement that four or more of the criteria be met in order to make the diagnosis justified, and (c) Are the changes made in DSM-IV supported? Four hundred thirty-four people presenting for treatment for anxiety were assessed with the Personality Disorder Examination. The criteria met were factor analyzed to indicate the unidimensionality of the diagnosis. Measures of internal consistency were calculated to validate the instruction to diagnose AVPD if four or more criteria were observed. Confirmatory factor analysis showed that a single factor was the best fit to the observed pattern of relationships between the seven AVPD criteria. The internal consistency of the seven criteria was moderate (Cronbach's alpha = .76) with a median intercriterion correlation of .29. The data provided good support for the hypothesis that the seven DSM-III-R AVPD criteria assess a single dimension. Three of the criteria did not reflect this factor as highly as the remaining four and these three have either been dropped in DSM-IV or substantially revised.