CASE STUDY LINDA

Linda is a 30-year-old British American woman who has worked in a New York garment factory for 12years. She likes her work setting, and upon arriving at work, she immediately goes to her workstationwithout engaging in conversation (criterion 1). She stays to herself at break time, even when othersinvite her to join a conversation (5). Several of her coworkers are part of groups that socialize afterwork hours. She has been invited to join a card club, a sewing circle, and a service club that helpselderly persons. She says she did not join any of those groups because she was not sure the memberswould like her if they really got to know her (2). She also was concerned that with more than threepeople in a group, several members of the group would make fun of her (4). A coworker tried to set herup for a date with Sam, a popular employee who was handsome and kind. Linda said she could notmeet Sam for a date because she was afraid she would say something that might cause him toridicule her (3). She recently started seeing a psychotherapist because she would like to feel morecon?dent and make some real friends. She reports to the therapist that she sees herself asunappealing, feels inferior to others (6), and fears she will be embarrassed if she tries to beginnew activities, such as joining the service club that serves elderly persons (7). She is hopeful that shecan make some positive changes with the help of her therapist.Linda meets seven of the diagnostic criteria (1, 2, 3, 4, 5, 6, and 7) for a diagnosis of AVPD.People with AVPD may b e disposed to the disorder if they have grown up in a home with overlyanxious parents who may have been diagnosed with social phobia or AVPD. However, geneticpredisposition and the impact of environmental factors have not been clearly associated with thedevelopment of AVPD (Tillfors, Furmak, Ekselius, & Fredrikson, 2001). Cultural practices mayconsider avoidant behaviors appropriate; conversely, avoidant behavior could be the result ofacculturation following immigration to the United States. For instance, language barriers maycontribute to isolation and fear of criticism when a person attempts to communicate, which mayadd dif?culty to social situations.