Table 2: Psychotherapeutic interventions in APD.

Article	Kind of study	Sample	Result
Alden [53]	Randomized controlled study	76 APD unmarried subjects (34 F) randomized to (10 weeks treatment): 1. waiting list 2. skill training 3. graduated exposure 4. a regimen targeting intimate issues	Patients in the waiting list control group ameliorated significantly less than patients in the other groups. No dramatic differences were found in the 3 active arms of the study, regimen #4 was associated with a slight increase in the frequency of the social activities.
Emmelkamp et al. [54]	Randomized controlled study	62 APD patients randomized to (20 weeks treatment): 1. brief dynamic therapy-based 2. cognitive - behavioral therapy 3. waiting list	Cognitive behavioral treatment was associated with better results in a number of measures including the avoidant scale and the SPAI social phobia test. CBT was the only treatment to be effective against PDBQ dependent and PDBQ obsessive symptoms.
Leichsenring et al. [56]	Multicenter randomized controlled trial	495 patients with SP (25% had also APD) were randomized to: 1. CBT 2. psychodynamic therapy 3. waiting list	Remission rates for the 3 groups were: 36%, 26% and 9%. Response rates for the 3 groups were: 60%, 52% and 15%. Both CBT and psychodynamic intervention were significantly more efficacious than the control group. CBT was significantly more efficacious for remission rates, but not for response rates.
Beretta et al. [57]	Open label study	70 patients (27 with cluster C diagnosis) were treated with an ultra-brief psychodynamic intervention (4 times session, Gilleron 1989)	33% of patients ameliorated at the end of the treatment. Results were maintained after 3 and 6 months.
Wintson et al. [58]	Randomized controlled study	81 patients with personality disorders (36 with APD) were randomized to (40 weeks treatment on average): 1. brief adaptive psychotherapy 2. short-term dynamic psychotherapy 3. waiting list	Patients in the two active arms ameliorated significantly more than the patients in the control group.
Svartberg et al. [59]	Randomized study	50 patients with cluster C diagnosis (16 with APD) randomly assigned to (40 weeks treatment): 1. short-term psychodynamic treatment 2. CBT	There were no significant differences between groups at termination and follow-up
Karterud et al. [60]	Open label study	1244 patients consecutively admitted to eight different treatments programs. 1010 diagnosed with PD, 481 had APD. The treatment programs are based on group therapy and typically consist of a mixture of psychodynamic and CBT groups.	The completion rate was 76%, having a diagnosis of PD was associated with a higher risk of early termination. 59% of patients were taking medications at admittance. This number increased to 68% in the course of the treatment. Patients were discharged with a better performance in a number of tests including: GAF, CGI, CIP and QoL.

PD: personality disorder; MDD: major depressive disorder; APD: avoidant personality disorder; SPAI: social phobia anxiety inventory; PDBQ: personality disorder belief questionnaire; CBT: cognitive-behavioral therapy;

GAF: global assessment of functioning; CGI: global severity indenx; CIP: circumplex of interpersonal problems; QoL: quality of life