- Describe the characteristics and diagnosis of dependent personality disorder
Dependent Personality Disorder
Dependent personality disorder (DPD) is a cluster C personality disorder characterized by a pervasive psychological dependence on other people.
|Avoidant||socially inhibited and oversensitive to negative evaluation; avoids occupations that involve interpersonal contact because of fears of criticism or rejection; avoids relationships with others unless guaranteed to be accepted unconditionally; feels inadequate and views self as socially inept and unappealing; unwilling to take risks or engage in new activities if they may prove embarrassing||C|
|Dependent||allows others to take over and run their life; is submissive, clingy, and fears separation; cannot make decisions without advice and reassurance from others; lacks self-confidence; cannot do things on their own; feels uncomfortable or helpless when alone||C|
|Obsessive-Compulsive||pervasive need for perfectionism that interferes with the ability to complete tasks; preoccupied with details, rules, order, and schedules; excessively devoted to work at the expense of leisure and friendships; rigid, inflexible, and stubborn; insists things be done a certain way; miserly with money||C|
Dependent personality disorder (DPD) is a long-term condition in which people depend on others to meet their emotional and physical needs, with only a minority achieving normal levels of independence. Dependent personality disorder (DPD) is characterized by excessive fear and anxiety. Dependent personality disorder (DPD) begins by early adulthood, is present in a variety of contexts, and is associated with inadequate functioning. Symptoms can include anything from extreme passivity, devastation, or helplessness when relationships end; avoidance of responsibilities; and severe submission.
People who have dependent personality disorder are overdependent on other people when it comes to making decisions. They cannot make a decision on their own as they need constant approval from other people. Consequently, individuals diagnosed with DPD tend to place the needs and opinions of others above their own as they do not have the confidence to trust their decisions. This kind of behavior can explain why people with DPD tend to show passive and clingy behavior. These individuals display a fear of separation and cannot stand being alone. When alone, they experience feelings of isolation and loneliness due to their overwhelming dependence on other people.
DSM-5 refers to dependent personality disorder as a pervasive and excessive need to be taken care of, which leads to submissive and clinging behavior and fears of separation. This behavior begins by early adulthood and can be present in a variety of contexts.
According to the DSM-5, the disorder is indicated by at least five of the following factors:
- has difficulty making everyday decisions without an excessive amount of advice and reassurance from others.
- needs others to assume responsibility for most major areas of their life.
- has difficulty expressing disagreement with others because of fear of loss of support or approval.
- has difficulty initiating projects or doing things on their own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy).
- goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant.
- feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for themselves.
- urgently seeks another relationship as a source of care and support when a close relationship ends.
- is unrealistically preoccupied with fears of being left to take care of themselves.
There are similarities between individuals with dependent personality disorder and individuals with borderline personality disorder in that they both have a fear of abandonment. Those with dependent personality disorder do not exhibit impulsive behavior, unstable affect, and poor self-image experienced by those with borderline personality disorder.
The following conditions are commonly comorbid with dependent personality disorder:
- mood disorders
- anxiety disorders
- adjustment disorder
- borderline personality disorder
- avoidant personality disorder
- histrionic personality disorder
Based on a survey of 43,093 Americans, 0.49% of adults meet diagnostic criteria for DPD (National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; Grant et al., 2004). Traits related to DPD, like most personality disorders, emerge in childhood or early adulthood. DPD is more common among women compared to men as 0.6% of women have DPD compared to 0.4% of men. A 2004 twin study suggests a heritability of 0.81 for developing dependent personality disorder. Because of this, there is significant evidence that this disorder runs in families. Children and adolescents with a history of anxiety disorders and physical illnesses are more susceptible to acquiring this disorder.
The exact cause of dependent personality disorder is unknown. A study in 2012 estimated that between 55% and 72% of the risk of the condition is inherited from one’s parents. The difference between a dependent personality and a dependent personality disorder is somewhat subjective, which makes diagnosis sensitive to cultural influences such as gender role expectations. There is a higher frequency of the disorder seen in women than men.
Dependent traits in children tended to increase with parenting behaviors and attitudes characterized by overprotectiveness and authoritarianism. Traumatic or adverse experiences early in an individual’s life, such as neglect and abuse or serious illness, can increase the likelihood of developing personality disorders, including dependent personality disorder, later on in life. This likelihood is especially prevalent for those individuals who also experience high interpersonal stress and poor social support.
People who have DPD are generally treated with psychotherapy. The main goal of this therapy is to make the individual more independent and help them form healthy relationships with the people around them. This is done by improving their self-esteem and confidence.
Medication can be used to treat patients who suffer from depression or anxiety because of their DPD, but this does not treat the core problems caused by DPD.
Key Takeaways: Dependent personality disorder
Case Study: DEPENDENT PERSONALITY DISORDER
This case study looks at the patient of a 27-year-old, white female named Sally. She works as an administrative assistant whose work required extensive data entry. Sally’s mother used her network to get this stable job for her daughter. Sally is consumed with pleasing her mother and even asks for her mother’s advice on what to wear to the office each day. Sally consistently worries about pleasing others and her colleagues at work, even at the expense to herself, which leads to the diagnosis of dependent personality disorder. The degree to which her self-destructive passivity and compliance at work stemmed from her early experiences within the family are unclear, but her parents’ overprotectiveness likely played some role in the etiology of her personality pathology.
This video describes the diagnostic criteria and treatment options for dependent personality disorder.
dependent personality disorder (DPD): a personality disorder characterized by a pervasive and excessive need to be taken care of, leading to a lack of independent action