Social phobia and avoidant personality disorder: one spectrum disorder?

General population data was used to examine if empirically derived subtypes of social phobia with and without avoidant personality disorder (APD) could be differentiated on self-report measures of anxiety severity, level of global functioning and the number of fulfilled diagnostic criteria for other personality disorders. DSM-IV diagnoses of social phobia, APD and indices of other personality disorders were determined by means of a postal survey. The presence of APD was associated with compromised functional status and a higher frequency of fulfilled diagnostic criteria for additional personality disorders. However, APD did not modify the effect of social phobia subtypes on anxiety severity, level of global functioning or number of personality disorder indices. The presence of comorbid APD in social phobics seems to predict a global functioning decrement independent of anxiety severity. The results imply that social phobia and APD may represent different points on a severity continuum rather than easily defined discreet categories suggesting that social phobia and APD may represent a spectrum of anxiety symptoms related to social anxiety.