Anorexia nervosa patients are often temperamentally avoidant, displaying a sensitivity to negative stimuli, which 25% of anorexic individuals meeting criteria for avoidant personality disorder, including issues with intimacy, emotional expression, and identity. Intimacy and close relationships are often avoided in anorexia nervosa patients prior to onset of the disorder but avoidance is typically worsened following onset, making avoidant traits both a risk factor and maintenance factor for AN. Experiential avoidance includes refusal to maintain contact with certain experiences/events and taking of measures to reduce their frequency/form/prerequisites. In anorexia nervosa patients, this may include repressing negative emotions and personal needs to cope with resultant stress. Patients are often shy, have few friends, avoid intimate relationships, and display psychosexual inhibition. They are also more likely to struggle to detect emotional signals from themselves and others, retrieve emotional autobiographical memories, and struggle with defensive emotions such as shame, guilty, and jealousy. Starvation worsens and is used as a mechanism for avoidance of emotions, relationships, etc.. Avoidant traits (low novelty seeking, high interpersonal distrust, anxiety disorders, avoidant-dependent personality disorder, OCPDs) are associated with poor outcomes and are common among anorexia nervosa patients, and thus treatments that focus on emotional processing rather than food and weight alone may show more success.