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The effect of comorbid avoidant personality disorder (APD) on response to exposure-based treatment for social phobia was examined in a sample of 48 outpatients with generalized social phobia. Diagnoses were based on the Structured Clinical Interview for DSM-III-R. At pretest, clients with APD were more severely impaired on all self-report measures and had a higher frequency of comorbid diagnoses than those without the disorder. Although clients with APD improved significantly with treatment, they continued to report more severe impairment on all outcome measures at posttest and 3-month follow-up as compared to those without APD. Depression may in part explain the poorer rate of improvement during treatment of those with APD.
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