The importance of avoidant personality in social anxiety disorder with and without attention-deficit/hyperactivity disorder
In the present study, our primary aim was to compare the generalized social anxiety (GSAD) patients with and without attention-deficit/hyperactivity disorder (ADHD) in terms of avoidant personality disorder (AVPD), and some clinical variables. We also investigated the relationship of AVPD and depression with ADHD and GSAD. We hypothesized that ADHD may be associated with AVPD in patients with GSAD. Seventy-six patients with GSAD were evaluated for depression, AVPD, and childhood and adulthood diagnoses of ADHD. The GSAD patients with (n = 34) and without adulthood ADHD (n = 30) were compared with respect to some sociodemographic and clinical variables. GSAD patients with adulthood ADHD had significantly higher comorbid diagnosis of AVPD, more avoidant personality and depression symptoms than those without ADHD. Pearson’s correlation coefficient in total sample (n = 76) showed that the mean number of AVPD criteria was significantly associated with the severity of Beck Depression Inventory, Wender Utah Rating Scale (WURS), and inattention symptoms of ADHD. There were no correlations between the total and subscale scores of Liebowitz Social Anxiety Scale and the mean number of AVPD criteria. The scores of WURS significantly predicted the mean number of AVPD criteria (β = 0.305, p= 0.007). The severity of current depression (β = 0.143, p = 0.30) and inattention symptoms of adulthood ADHD (β = 0.112, p = 0.46) were not associated with the severity of AVPD symptoms. These results might demonstrate that comorbid AVPD in adult SAD patients was related to a childhood ADHD independent from depression, and inattention symptoms of ADHD in adulthood.
KeywordsSocial anxiety disorder Avoidant personality disorder Attention-deficit/hyperactivity disorder Depression
The authors received no financial support for the research, authorship, and publication of this article.
Compliance with ethical standards
The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
- Corapcigil A, Aydemir O, Yildiz M et al (1999) Adaptation into Turkish and reliability of structured clinical interview for DSM-IV (SCID). J Drug Treat 12:233–236Google Scholar
- Evren C, Dalbudak E, Ozen S et al (2017) The relationship of social anxiety disorder symptoms with probable attention deficit hyperactivity disorder in Turkish university students; impact of negative affect and personality traits of neuroticism and extraversion. Psychiatry Res 254:158–163CrossRefGoogle Scholar
- First M, Spitzer R, Gibbon M, Williams JB (1997) Structured clinical interview for DSM-IV clinical version (SCID-I/CV). American Psychiatric Press, Washington DCGoogle Scholar
- Gökler B, Ünal F, Pehlivantürk B et al (2004) Reliability and validity of schedule for affective disorders and schizophrenia for school age children-present and lifetime version-Turkish version (K-SADS-PL T). Turk J Child Adolesc Ment Health 11:109–116Google Scholar
- Gunay S, Savran C, Aksoy UM (2005) The reliability and validity study of adult attention disorder hyperactivity scale (adult ADD/ADHD DSM IV-based diagnostic secreening and rating scale. The J Educ Sci Ataturk Educ Faculty 21:133–150Google Scholar
- Hunt C, Issakidis C, Andrews G (2002) DSM-IV generalized anxiety disorder in the Australian National Survey of Mental Health and well-being. Psychol Med 106:27–34Google Scholar
- Kose S, Solmaz M, Celikel FC et al (2009) Comorbidity of Avoidant personality disorder in generalized social phobia and its impact on psychopathology. Bull Clinical Psychopharmacol 19:1340–1346Google Scholar
- Koyuncu A, Çelebi F, Ertekin E et al (2015b) Clinical effects of ADHD subtypes in patients with social anxiety disorder. J Atten Disord 2015:4Google Scholar
- Oncu B, Olmez S, Sentürk V (2005) Validity and reliability of the Turkish version of the Wender Utah rating scale for attention-deficit/hyperactivity disorder in adults. Turk Psikiyatri Derg 16:252–259Google Scholar
- Pliszka SR (1998) Comorbidity of attention-deficit/hyperactivity disorder with psychiatric disorders: an overview. J Clin Psychiatry 59(suppl 7):50–58Google Scholar
- Rappe RM, Heimberg R (1997) A cognitive-behavioral model of anxiety in social phobia. Behav Res Therapy 35:72–75Google Scholar
- Storch EA, Masia-Warner C, Brassard MR (2003) The relationship of peer victimization to social anxiety and loneliness in adolescence. Child Study J 33:1–18Google Scholar
- Turgay A (1995) Adult hyperactivity assessment scale based on DSM IV (unpublished scale). Integrative Therapy Institute Toronto, CanadaGoogle Scholar
- Turgay A, Ansari R (2006) Major depression with ADHD in children adolescents. Psychiatry (Edgmont) 3:20–32Google Scholar