Autism and AvPD
[PT: Autism and AvPD /End PT]
AvPD and autism have many similarities. Most notably, both disorders create social discomfort within the person with them.
Below is a Venn diagram of overlapping and separate features of the two disorders:
On the AvPD side:
Shame-Based Social Self Early rejection + sensitive temperament -> feeling socially inept, fearful, and unworthy
Self-Isolation from Fear of Judgment Wants connection but isolates due to fear of judgment and embarrassment
Social Motivation - High but Guarded Desires connection, but fear and shame block getting close
Approval-Driven Stress Social stress from [a] strong need to be liked; fragile self-esteem
On the autism side:
Neurotype-Based Social Self Autistic communication, difficulty intuitively reading allistic [non-autistic] cues
Sensory Isolation Isolates to manage sensory overload and recover energy
Interest-Led Social Drive Often prefers special-interest time and structured, deep social spaces over casual or unstructured one[s]
Mismatch-Driven Stress Stress from miscommunication, unexpected social changes, cross-neurotype dynamics, and small-talk demands
In the middle - the overlap:
Social comparison
Diffuse sense of social self
Difficulty with social initiation
Sensitivity to rejection/criticism
Difficulty with unknown situations
Elevated substance abuse, self-harm, and eating disorders
Studying, scripting, and rehearsing social interactions
High co-occurring anxiety (agoraphobia, panic, OCD, PTSD)
Social difficulties & withdrawal
Discomfort with eye contact
Rigidity & routines
The key difference between the two disorders is their origin. Autism is a hereditary condition present from birth (even though symptoms may not be noticed until later in life), while AvPD has genetic components that lead to a higher risk of developing, but is also trauma-based.
One theorises that perhaps AvPD could be a result of particularly undiagnosed/late diagnosed autism - "I think autistic people are actually at high risk for developing AVPD due to constantly being criticized and rejected over their lifespan."* This could, as the comment above says, be due to the autistic person being consistently rejected by their peers and criticised for not understanding unwritten social rules, and due to being undiagnosed/diagnosed later in life, the autistic person does not have the words to describe what they are feeling and experiencing in the moment, thus allowing AvPD to form.
It should be noted that this comorbidity - or, it seems, a misdiagnosis of one when it is really the other - is usually found amongst high-masking autistic individuals rather than low-masking autistic individuals. This is due to a high-masking autistic person's ability to often hide their discomfort with being social, usually making them seem simply "awkward".
Those with autism and those with AvPD have a similar brain structure - most notably, the connection between the amygdala and anterior cingulate gyrus is weaker in both.** Below is an image of the two areas of the brain highlighted:
These two areas of the brain are meant to work together to process emotion, regulate behaviour, and respond to stress. They do this by taking emotional input and translating it into cognitive and physical output; for example, anger is translated into yelling, if that is what the two parts deem adequate for the situation.
Now, in autism and AvPD, the connection between those two areas of the brain is impaired. This means that it may be difficult for the person with autism and/or AvPD to figure out what reaction is appropriate to certain stimuli, thus impacting their ability to be socially comfortable. However, in autism, this may be due to a simple dysfunction in the connection between the amygdala and anterior cingulate gyrus since birth, while in AvPD, the poor connection may have been "learned" from early social rejections and faux pas. <- I could not find anything that backs this up; it is simply a personal thought on the matter, but if anyone has any info on it, let me know!
The main difference between the two conditions is the motivation for avoiding social interaction. A person with autism may avoid social interaction because they don't understand unwritten social rules and wish to avoid the unnecessary stress of trying to figure them out, while a person with AvPD may avoid social interaction because of a fear of being judged or rejected.
In summation, AvPD and autism have many similarities when it comes to the discomfort with social interaction, and there is some evidence to suggest (although there were no papers that I could find on the matter) that AvPD may form due to undiagnosed/late-diagnosed autism; rejection early in life due to not being able to understand non-verbal social cues can lead to a fear of being judged and rejected later on, which in turn can cause AvPD.
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