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Dependent Personality Disorder


Dependent Personality Disorder (DPD) is a personality disorder where the sufferers tend to depend on others to meet their needs, be it physical or emotional. People with DPD tend to be clingy and portray themselves as helpless and passive, and have a fear of separation or being alone.
Dependent Personality Disorder occurs in both men and women, with its onset in early adulthood and belong to Cluster C or anxious disorders.

People with DPD tend to:

  • Let others decide for them.

  • Avoid responsibilities because they see others as being more capable.

  • Have an intense fear of separation and abandonment.

  • Move directly into another relationship when one ends.

  • Be submissive and non confrontational because they are afraid of losing support or approval.

  • Be oversensitive to criticism.

  • Tolerate being treated badly by others.

  • Dislike being alone.



In order to be diagnosed with DPD, you will have to meet certain criterion laid out by the DSM IV or the ICD-10.

For the DSM IV, the diagnostic criteria are as follows:

A pervasive and excessive need to be taken care of that leads to submissive and clinging behaviour and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others.

  2. Needs others to assume responsibility for most major areas of his or her life.

  3. Has difficulty expressing disagreement with others because of fear of loss of support or approval.
    Note: Do not include realistic fears of retribution.

  4. Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy).

  5. Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant.

  6. Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself.

  7. Urgently seeks another relationship as a source of care and support when a close relationship ends.

  8. Unrealistically preoccupied with fears of being left to take care of himself or herself.


The ICD-10 requires a person to fulfill the general personality disorder criteria first, and lists Dependent Personality Disorder as follows:

It is characterised by at least 3 of the following:

  1. Encouraging or allowing others to make most of one's important life decisions.

  2. Subordination of one's own needs to those of others on whom one is dependent, and undue compliance with their wishes.

  3. Unwillingness to make even reasonable demands on the people one depends on.

  4. Feeling uncomfortable or helpless when alone, because of exaggerated fears of inability to care for oneself.

  5. Preoccupation with fears of being abandoned by a person with whom one has a close relationship, and of being left to care for oneself.

  6. Limited capacity to make everyday decisions without an excessive amount of advice and reassurance from others.


Associated features may include perceiving oneself as helpless, incompetent, and lacking stamina. Includes:
asthenic, inadequate, passive, and self-defeating personality (disorder)

Cause of DPD
There is no known cause of DPD, although some researchers have theorised that an overprotective parent or an authoritarian style of parenting might lead to the development of this disorder in people who are genetically predisposed to it.

Diagnosing DPD

If you believe that you may have SPD, you will need to see your gp, who will make a referral to your local mental health unit. Your gp may examine you for any physical symptoms in order to rule out any medical condition.
If you are given an appointment to see a psychologist or a health care professional, you will be need to be assessed in order to be diagnosed with DPD. There will be several sessions at least before a diagnosis is confirmed, if any.
The possibility of BPD will need to be eliminated before giving a DPD diagnosis.

Treatment

Individuals with DPD very seldom seek treatment, but they might seek to alleviate symptoms associated with their condition such as depression or anxiety. In these cases, medication such as anti-depressants or anti-anxiety drugs will be useful in combating the symptoms, but care must be taken to prevent the sufferers from being over dependent on them.
Sometimes, their behaviour will result in situations they find overwhelming, for which they might seek help. Psychotherapy is a useful treatment to help them in such situations.

Millon's subtypes

Disquieted Dependent
This subtype is characterised by avoidant features, and the sufferer tends to feel very lonely unless they are near a supportive figure. They are also often worried and restless, and quite anxious of the idea or prospect of abandonment. They also usually have an impending feeling of doom.

Immature Dependent
People who belong in this subtype tend to display very child like and feel as though they are incapable of handling adult responsibilities. They also come across as very inexperienced, gullible and naive.

Accomodating Dependent
This subtype is characterised by histrionic features. Accomodating Dependents are usually genial, hospitable, sociable and refuses to acknowledge that they have negative feelings. They tend to fit into the role where they are submissive and compliant.

Selfless Dependent
This subtype features masochistic features whereby the whole self of the sufferer is completely submerged under the identity of the other.

Ineffectual Dependent
People who belong to this subtype often display schizoid features, where they are not very troubled by the fact that they are not very productive or incapable of achieving anything. They prefer a life without any troubles, and they will not deal with any hardship or difficulties.

© PDChat 2013

References:

Dependent Personality Disorder - Diagnostic and Statistical Manual of Mental Disorders Fourth edition Text Revision (DSM-IV-TR) American Psychiatric Association (2000)
Dependent Personality Disorder - International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)
Millon, Theodore (2006). "Personality Subtypes Summary”. The Official Website for Theodore Millon, Ph.D., D.Sc.. DICANDRIEN, Inc. http://millon.net/taxonomy/summary.htm

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