Which diagnosis best fits duration, episodicity, and exclusions?
A
Avoidant personality disorder
Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood; ≥4 of 7: avoids occupational activities involving interpersonal contact due to fears of criticism; unwilling to get involved unless certain of being liked; shows restraint in intimate relationships due to fear of shame; preoccupied with being criticised/rejected; inhibited in new interpersonal situations; views self as socially inept/unappealing/inferior; unusually reluctant to take risks or engage in new activities
AA. Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood; ≥4 of 7: avoids occupational activities involving interpersonal contact due to fears of criticism; unwilling to get involved unless certain of being liked; shows restraint in intimate relationships due to fear of shame; preoccupied with being criticised/rejected; inhibited in new interpersonal situations; views self as socially inept/unappealing/inferior; unusually reluctant to take risks or engage in new activities
BA. Persistent deficits in social communication/interaction across multiple contexts (≥3 components: social-emotional reciprocity; nonverbal communicative behaviours; developing/maintaining relationships) B. Restricted, repetitive patterns of behaviour/interests/activities (≥2 of: stereotyped/repetitive motor movements; insistence on sameness/inflexible routines; highly restricted interests; hyper/hyporeactivity to sensory input) C. Symptoms present in early developmental period (may not fully manifest until social demands exceed capacity)
Common specifiers
AMild; Moderate; Severe
BWith/without accompanying intellectual impairment; With/without accompanying language impairment; Associated with a known medical or genetic condition; Associated with another neurodevelopmental, mental, or behavioural disorder
Differential flags
ASocial anxiety disorder (highly comorbid; AvPD more pervasive and characterological); Schizoid PD (no desire for connection; no distress about isolation); Dependent PD (seeks closeness but fears abandonment)
BADHD (comorbid in ~50%; social deficits not as pervasive; no RRBs - code both when criteria independently met); Social anxiety disorder (fear of negative evaluation; social motivation and desire intact); Social (pragmatic) communication disorder (social deficits without RRBs - mutually exclusive with ASD)