Quick reference
- When to use
- Use F60.6 when the client demonstrates a pervasive, inflexible, and enduring pattern consistent with Avoidant Personality Disorder that deviates from cultural expectations, causes distress or impairment, and is stable over time. Do not assign based on a single clinical encounter.
- Duration
- Personality disorders are enduring patterns — symptoms should be traceable to adolescence or early adulthood. Minimum of several sessions recommended before diagnosing. Reassess periodically as treatment may modify traits.
- Session codes
- Pair with CPT 90834/90837 for individual therapy. DBT programs: 90853 (group), 90834 (individual), plus phone coaching. 90791 for comprehensive evaluation. Long-term treatment is typical.
- Key indicators
- Enduring pattern of inner experience and behavior • Deviates from cultural expectations • Pervasive across situations • Onset in adolescence/early adulthood • Stable and long-standing • Distress or impairment
What F60.6 represents
AvPD involves a pervasive pattern of social inhibition, feelings of inadequacy, and extreme sensitivity to negative evaluation. It overlaps significantly with social anxiety disorder but is more pervasive and characterological.
Key diagnostic criteria
4+ of 7 criteria:
- Avoids occupational activities involving interpersonal contact
- Unwilling to get involved unless certain of being liked
- Restrained in intimate relationships
- Preoccupied with being criticized/rejected
- Inhibited in new interpersonal situations
- Views self as socially inept or inferior
- Reluctant to take personal risks or engage in new activities
Documentation essentials
Document pervasive pattern across settings. Distinguish from social anxiety disorder.
Differential diagnosis
Key distinction from social anxiety disorder: AvPD is more pervasive, stable, and involves broader self-concept issues.
Treatment planning
CBT with gradual exposure, schema therapy, psychodynamic approaches. Build therapeutic alliance carefully.
Insurance & billing
Accepted code. Document pervasive pattern and functional impairment.
Updates & changes
Retained in alternative DSM-5 model.
Documentation pitfalls
Don't diagnose based on social anxiety alone. Must demonstrate pervasive personality pattern.
References
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).