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A functionalist perspective on social anxiety and avoidant personality disorder

Published online by Cambridge University Press:  14 October 2009

Peter LaFreniere
Peter LaFreniere*
Affiliation:
University of Maine
*
Address correspondence and reprint requests to: Peter LaFreniere, Department of Psychology, University of Maine, Orono, ME 04469; E-mail: peter.lafreniere@umit.maine.edu.
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Abstract

A developmental–evolutionary perspective is used to synthesize basic research from the neurosciences, ethology, genetics, and developmental psychology into a unified framework for understanding the nature and origins of social anxiety and avoidant personality disorder. Evidence is presented that social anxiety disorder (social phobia) and avoidant personality disorder may be alternate conceptualizations of the same disorder because they have virtually the same symptoms and genetic basis, and respond to the same pharmacologic and psychotherapeutic interventions. A functionalist perspective on social anxiety is formulated to (a) explain the origins of normative states of anxiety, (b) outline developmental pathways in the transition from normative anxiety to social anxiety and avoidant personality disorders, and (c) account for the processes leading to gender-differentiated patterns of anxiety-related disorders after puberty.

Type
Regular Articles
Information
Development and Psychopathology , Volume 21 , Issue 4: Precursors and Diverse Pathways to Personality Disorder in Children and Adolescents: Part 2 , November 2009 , pp. 1065 - 1082
Copyright
Copyright © Cambridge University Press 2009

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References

Ainsworth, M. D. (1967). Infancy in Uganda: Infant care and the growth of love. Baltimore, MD: Johns Hopkins University Press.Google Scholar
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Arlington, VA: Author.Google Scholar
Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic. New York: Guilford Press.Google Scholar
Bowlby, J. (1969). Attachment and loss: Vol. I. Attachment. New York: Basic Books.Google Scholar
Bowlby, J. (1973). Attachment and loss: Vol. II. Separation, anxiety, and anger. New York: Basic Books.Google Scholar
Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.CrossRefGoogle Scholar
Cahill, L. (2006). Why sex matters for neuroscience. Nature Reviews: Neuroscience, AOP. Advance online publication. doi:10.1038/nrn1909.CrossRefGoogle ScholarPubMed
Campos, J. (1994, Spring). The new functionalism in emotion. SRCD Newsletter.Google Scholar
Campos, J., Mumme, D., Kermoian, R., & Campos, R. (1994). A functionalist perspective on the nature of emotion. Monographs of the Society for Research in Child Development, 59 (2/3, No. 240).Google Scholar
Chorpita, B. F., & Barlow, D. H. (1998). The development of anxiety: The role of control in the early environment. Psychological Bulletin, 124, 3–21.Google Scholar
Cicchetti, D. (1990). An historical perspective on the discipline of developmental psychopathology. In Rolf, J., Masten, A., Cicchetti, D., Neuchterlein, K., & Weintraub, S. (Eds.), Risk and protective factors in the development of psychopathology. New York: Cambridge University Press.Google Scholar
Cicchetti, D., & Aber, J. L. (1998). Contextualism and developmental psychopathology. Development and Psychopathology, 10, 137–141.CrossRefGoogle ScholarPubMed
Collaer, M. L., & Hines, M. (1995). Human behavioral sex differences: A role for gonadal hormones during early development? Psychological Bulletin, 118, 55–107.CrossRefGoogle ScholarPubMed
Costello, E. J., Angold, A., Burns, B. J., Stangl, D. K., Tweed, D. L., Erkanli, A., et al. (1996). The Great Smoky Mountains Study of Youth. Goals, design, methods, and the prevalence of DSM-III-R disorders. Archives of General Psychiatry, 53, 1129–1136.CrossRefGoogle ScholarPubMed
Craske, M. G. (2003). Origins of phobias and anxiety disorders: Why more women than men? London: Elsevier.Google Scholar
Crick, N. R., & Zahn-Waxler, C. (2003). The development of psychopathology in females and males: Current progress and future challenges. Development and Psychopathology, 15, 719–742.CrossRefGoogle ScholarPubMed
Curry, J. F., March, J. S., & Hervey, A. S. (2004). Comorbidity of childhood and adolescent anxiety disorders. In Ollendick, T. H. & March, J. S. (Eds.), Phobic and anxiety disorders in children and adolescents: A clinician's guide to effective psychosocial and pharmacological interventions. Oxford: Oxford University Press.Google Scholar
Daniels, D., & Plomin, R. (1985). Origins of individual differences in infant shyness. Developmental Psychology, 21, 118–121.CrossRefGoogle Scholar
DuPont, R. L., Rice, D. P., Miller, L. S., Shiraki, S. S., Rowland, C. R., & Harwood, H. J. (1996). Economic costs of anxiety disorders. Anxiety, 2, 167–172.3.0.CO;2-L>CrossRefGoogle ScholarPubMed
Emde, R. N., Plomin, R., Robinson, J., Campos, J., Corley, R., DeFries, J., et al. (1992). Temperament, emotion, and cognition at 14 months: The MacArthur Longitudinal Twin Study. Child Development, 63, 1437–1455.CrossRefGoogle ScholarPubMed
Erickson, M., Egeland, B., & Sroufe, L. A. (1985). The relationship between quality of attachment and behavior problems in preschool in a high risk sample. Monographs of the Society for Research in Child Development, 50 (No. 209), 147–186.CrossRefGoogle Scholar
Ferdinand, R. F., Van Lang, N. D., Ormel, J., & Verhulst, F. C. (2006). No distinctions between different types of anxiety symptoms in pre-adolescents from the general population. Journal of Anxiety Disorders, 20, 207–221.CrossRefGoogle ScholarPubMed
Finch, A. J., Lipovsky, J. A., & Casat, C. D. (1989). Anxiety and depression in children and adolescents: Negative affectivity or separate constructs. In Kendall, P. C. & Watson, D. (Eds.), Anxiety and depression: Distinctive and overlapping features. San Diego, CA: Academic Press.Google Scholar
Foote, D., & Seibert, S. (March, 1999). The age of anxiety: Do male and female brains respond differently to severe emotional stress? In a flurry of new research, scientists are finding tantalizing clues. Newsweek.Google Scholar
Geary, D. C. (1998). Male, female: The evolution of human sex differences. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
Goldstein, D. B. (2009). Common genetic variation and human traits. New England Journal of Medicine, 360, 1696–1698.CrossRefGoogle ScholarPubMed
Gosling, S. D., & John, O. P. (1999). Personality dimensions in nonhuman animals: A cross-species review. Current Directions in Psychological Science, 8, 69–75.CrossRefGoogle Scholar
Hummelen, B., Wilberg, T., Pedersen, G., & Karterud, S. (2007). The relationship between avoidant personality disorder and social phobia. Comprehensive Psychiatry, 48, 348–356.CrossRefGoogle ScholarPubMed
Izard, C. E. (1991). The psychology of emotions. New York: Plenum Press.CrossRefGoogle Scholar
Jackson, E. D., Payne, J. D., Nadel, L., & Jacobs, W. J. (2005). Stress differentially modulates fear conditioning in healthy men and women. Biological Psychiatry, 59, 516–522.CrossRefGoogle ScholarPubMed
Jensen, P. S., & Hoagwood, K. (1997). The book of names: DSM-IV in context. Development and Psychopathology, 9, 231–249.CrossRefGoogle ScholarPubMed
Joyce, P. R., Rogers, G. R., Miller, A. L., Mulder, R. T., Luty, S. E., & Kennedy, M. A. (2003). Polymorphisms of DRD4 and DRD3 and risk of avoidant and obsessive personality traits and disorders. Psychiatry Research, 119, 1–10.CrossRefGoogle ScholarPubMed
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., et al. (2003). The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association, 289, 3095–3105.CrossRefGoogle ScholarPubMed
Kessler, R. C., Berglund, P. A., Demler, O., Jin, R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62, 593–602.CrossRefGoogle Scholar
Kessler, R. C., Chiu, W. T., Demler O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62, 617–627.CrossRefGoogle Scholar
Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., et al. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 8–19.CrossRefGoogle ScholarPubMed
Klein, R. G., & Pine, D. S. (2002). Anxiety disorders. In Rutter, M. & Taylor, E. (Eds.), Child and adolescent psychology (4th ed.). Oxford: Blackwell Science.Google Scholar
Kraft, P., & Hunter, D. J. (2009). Genetic risk prediction—Are we there yet? New England Journal of Medicine, 360, 1701–1703.CrossRefGoogle ScholarPubMed
LaFreniere, P. J. (2000). Emotional development: A biosocial perspective. Belmont, CA: Wadsworth.Google Scholar
LaFreniere, P. J. (2005). Human emotions as multipurpose adaptations: An evolutionary perspective on the development of fear. In Burgess, R. & MacDonald, K. (Eds.), Evolutionary perspectives on human development. Thousand Oaks, CA: Sage.Google Scholar
LaFreniere, P. J., & Dumas, J. E. (1992). A transactional analysis of early childhood anxiety and social withdrawal. Developmental and Psychopathology, 4, 385–402.CrossRefGoogle Scholar
LaFreniere, P. J., Masataka, N., Butovskaya, M., Chen, Q., Dessen, M. A., Atwanger, K., et al. (2002). Cross-cultural analysis of social competence and behavior problems in preschoolers. Early Education and Development, 13, 201–219.CrossRefGoogle Scholar
LaFreniere, P. J., & Sroufe, L. A. (1985). Profiles of peer competence: Interrelations among measures, influence of social ecology, and relation to attachment history. Developmental Psychology, 21, 56–69.CrossRefGoogle Scholar
Lampe, L., Slade, T., Issakidis, C., & Andrews, G. (2003). Social phobia in the Australian National Survey of Mental Health and Well-Being (NSMHWB). Psychological Medicine, 33, 637–646.CrossRefGoogle ScholarPubMed
Lazarus, R. S. (1991). Emotion and adaptation. Oxford: Oxford University Press.CrossRefGoogle Scholar
Lewis, M., Feiring, C., McGuffog, C., & Jaskir, J. (1984). Predicting psychopathology in six-year-olds from early social relations. Child Development, 55, 123–136.CrossRefGoogle ScholarPubMed
Loeber, R. (1991). Questions and advances in the study of developmental pathways. In Cicchetti, D. & Toth, S. (Eds.), Rochester Symposium on Developmental Psychopathology: III. Rochester, NY: Rochester University Press.Google Scholar
MacDonald, K. B. (1995). Evolution, the Five-Factor Model, and levels of personality. Journal of Personality 63, 525–567.CrossRefGoogle Scholar
McGaugh, J. L. (2004). The amygdala modulates the consolidation of memories of emotionally arousing experiences. Annual Review of Neuroscience, 27, 1–28.CrossRefGoogle ScholarPubMed
McGuire, M., & Troisi, A. (1998). Evolutionary psychiatry. Cambridge, MA: Oxford University Press.Google Scholar
Nesse, R. M. (2000). Is depression an adaptation? Archives of General Psychiatry, 57, 14–20.CrossRefGoogle ScholarPubMed
Nesse, R. M. (2005). Natural selection and the regulation of defenses: A signal detection analysis of the smoke detector principle. Evolution and Human Behavior, 26, 88–105.CrossRefGoogle Scholar
NIMH. (2009). Social phobia (social anxiety disorder). Retrieved fromhttp://www.nimh.nih.gov/health/publications/anxiety-disorders/social-phobia-social-anxiety-disorder.shtmlGoogle Scholar
Nishizawa, S., Benkelfat, C., Young, S. N., Leyton, M., Mzengeza, S., de Montigny, C., et al. (1997). Differences between males and females in rates of serotonin synthesis in the human brain. Proceedings of the National Academy of Sciences of the United States of America, 94, 5308–5313.CrossRefGoogle Scholar
Nolen-Hoeksema, S. (1998). The other end of the continuum: The costs of rumination. Psychological Inquiry, 9, 216–219.CrossRefGoogle Scholar
Nolen-Hoeksema, S., & Girgus, J. (1994). The emergence of gender differences in depression during adolescence. Psychological Bulletin, 115, 424–443.CrossRefGoogle ScholarPubMed
Panksepp, J. (1998). Affective Neuroscience: The foundations of human and animal emotions. New York: Oxford University Press.CrossRefGoogle Scholar
Ralevski, E., Sanislow, C. A., & Grilo, C. M. (2005). Avoidant personality disorder and social phobia: Distinct enough to be separate disorders? Acta Psychiatrica Scandinavica, 112, 208–214.CrossRefGoogle ScholarPubMed
Reich, J. (2000). The relationship of social phobia to avoidant personality disorder: A proposal to reclassify avoidant personality disorder based on clinical empirical findings. European Psychiatry, 15, 151–159.CrossRefGoogle ScholarPubMed
Reich, J. (2009). Avoidant personality disorder and its relationship to social phobia. Current Psychiatry Reports, 11, 89–93.CrossRefGoogle ScholarPubMed
Reichborn-Kjennerud, T., Czajkowski, N., Torgersen, S., Neale, M. C., Ørstavik, R. E., Tambs, K., et al. (2007). The relationship between avoidant personality disorder and social phobia: a population based twin study. American Journal of Psychiatry, 164, 1722–1728.CrossRefGoogle ScholarPubMed
Rice, D. P., & Miller, L. S. (1993). The economic burden of affective disorders. In Scheffler, R. M., Rossiter, L. F., & Hu, T. W. (Eds.), Advances in health economics and health services research (Vol. 14, pp. 37–53). Greenwich, CT: JAI Press.Google Scholar
Richters, J. E., & Cicchetti, D. (1993). Mark Twain meets DSM-III-R: Conduct disorder, development, and the concept of harmful dysfunction. Development and Psychopathology, 5, 5–29.CrossRefGoogle Scholar
Rutter, M. (2006). Genes and behavior: Nature–nurture interplay explained. Oxford: Blackwell.Google Scholar
Samuels, J., Eaton, W., & Bienvenu, J. (2002). Prevalence and correlates of personality disorders in a community sample. British Journal of Psychiatry 180, 536–542.CrossRefGoogle Scholar
Shamir-Essakow, G., Ungerer, J. A., & Rapee, R. M. (2005). Attachment, behavioral inhibition, and anxiety in preschool children. Journal of Abnormal Child psychology, 33, 131–143.CrossRefGoogle ScholarPubMed
Shors, T. (2002). Opposite effects of stressful experience on memory formation in males versus females. Dialogues Clinical Neuroscience, 4, 139–147.CrossRefGoogle ScholarPubMed
Sroufe, L. A. (1996). Emotional development: The organization of emotional life in the early years. New York: Cambridge University Press.CrossRefGoogle Scholar
Sroufe, L. A. (1997). Psychopathology as an outcome of development. Developmental and Psychopathology, 9, 251–268.CrossRefGoogle ScholarPubMed
Sroufe, L. A. (2007). The place of development in developmental psychopathology. In Masten, A. (Ed.), Multilevel dynamics in developmental psychopathology: Pathways to the future. The Minnesota Symposia on Child Psychology (Vol. 34, pp. 285–300). Mahwah, NJ: Erlbaum.Google Scholar
Sroufe, L. A., Egeland, B., Carlson, E. A., & Collins, W. A. (2005). The development of the person: The Minnesota study of risk and adaptation from birth to adulthood. New York: Guilford Press.Google Scholar
Sroufe, L. A., Fox, N. E., & Pancake, V. R. (1983). Attachment and dependency in developmental perspective. Child Development, 54, 1615–1627.CrossRefGoogle Scholar
Suomi, S. J. (2000). A biobehavioral perspective on developmental psychopathology: excessive aggression and serotonergic dysfunction in monkeys. In Sameroff, A. J., Lewis, M., & Miller, S. (Eds.), Handbook of developmental psychopathology. New York: Springer.Google Scholar
Suomi, S. J. (2005). Mother–infant attachment, peer relationships, and the development of social networks in rhesus monkeys. Human Development, 48, 67–79.CrossRefGoogle Scholar
Taylor, S. E. (2006). Tend and befriend: Biobehavioral bases of affiliation under stress. Current Directions in Psychological Science, 15, 273–277.CrossRefGoogle Scholar
Tillfors, M., Furmark, T., Ekselius, L., & Fredrikson, M. (2004). Social phobia and avoidant personality disorder: One spectrum disorder? Nordic Journal of Psychiatry, 58, 147–152.CrossRefGoogle ScholarPubMed
Trivers, R. L. (1972). Parental investment and sexual selection. In Campbell, B. (Ed.), Sexual selection and the descent of man 1871–1971. Chicago: Aldine.Google Scholar
Troisi, A. (2008). Psychopathology and mental illness. In Crawford, C. B. & Krebs, D. (Eds.), Foundations of evolutionary psychology. New York: Taylor & Francis.Google Scholar
US Census Bureau. (2005). U.S. Census Bureau population estimates by demographic characteristics. Table 2 (NC-EST2004-02). Washington, DC: Author.Google Scholar
Wakefield, J. C. (1997). When is development disordered? Developmental psychopathology and the harmful dysfunction analysis of mental disorder. Development and Psychopathology, 9, 269–290.CrossRefGoogle ScholarPubMed
Wakefield, J. C. (2005). Biological function and dysfunction. In Buss, D. M. (Ed.), The handbook of evolutionary psychology. Hoboken, NJ: Wiley.Google Scholar
Warren, S., Huston, L., Egeland, B., & Sroufe, L. A. (1997). Child and adolescent anxiety disorders and early attachment. Journal of American Academy of Child & Adolescent Psychiatry. 36, 637–644.CrossRefGoogle ScholarPubMed
Weisfeld, G., & LaFreniere, P. J. (2009). Hormones and behavior. In LaFreniere, P. J. (Ed.), Adaptive origins: Evolution and human development. New York: Psychology Press/Taylor & Francis.Google Scholar
Wright, R. (1994). The moral animal: The new science of evolutionary psychology. New York: Pantheon Books.Google Scholar
Ziabreva, I., Poeggel, G., Schnabel, R., & Braun, K. (2003). Separation-induced receptor changes in the hippocampus and amygdala of Octodon degus: Influence of maternal vocalizations. Journal of Neuroscience, 23, 5329–5336.CrossRefGoogle ScholarPubMed