Dependent Personality Disorder.
Dependent personality disorder- one of a group of conditions called anxious personality disorders, marked by feelings of nervousness and fear. DPD also marked by helplessness, submissiveness, a need to be taken care of and for constant reassurance, and an inability to make decisions. This is one of the most frequently diagnosed personality disorders.
It appears to occur equally in men and women, and usually appears in early to middle adulthood. It was formerly known as asthenic personality disorder, is a personality disorder that is characterized by a pervasive psychological dependence on other people. The difference between a ‘dependent personality’ and a ‘dependent personality disorder’ is somewhat subjective, which makes a diagnosis sensitive to cultural influences such as gender role expectations.
- Chronic and pervasive pattern of dependent, submissive, and needy behavior
- Seek out excessive advice, approval, and encouragement
- Sensitivity to criticism or rejection
- Low self-confidence and self-esteem.
- An inability to make decisions without direction from others
- Feelings of helplessness when alone
- An inability to disagree with others
- Extreme devastation when close relationships end and a need to immediately begin a new relationship
- Difficulty in making everyday decisions.
Diagnostic Criteria for Dependent Personality Disorder.
A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior 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 of himself or herself.
7. Urgently seeks another relationship as a source of care and support when a close relationship ends.
8. Is unrealistically preoccupied with fears of being left to take care of himself or herself.
Causes of Dependent Personality Disorder.
It is commonly thought that the development of dependence in these individuals is a result of over-involvement and intrusive behavior by their primary caretakers. Families of those with dependent personality disorder are often do not express their emotions and are controlling; they demonstrate poorly defined relational roles within the family unit.
Individuals with dependent personality disorder often have been socially humiliated by others in their developmental years. They may carry significant doubts about their abilities to perform tasks, take on new responsibilities, and generally function independently of others. Thus this reinforces their suspicions that they are incapable of living autonomously.
Treatment for Dependent Personality Disorder.
1.Psychodynamically oriented therapies The preferred approach is a time-limited treatment plan consisting of a predetermined number of sessions. This has been proved to facilitate the exploration process of dependency issues more effectively than long-term therapy in most patients.
2.Cognitive-behavioural therapy Cognitive-behavioural approaches attempt to increase the affected person’s ability to act independently of others, improve their self-esteem, as well as enhance the quality of their interpersonal relationships.
3. Interpersonal therapy Treatment using an interpersonal approach can be useful because the individual is usually receptive to treatment and seeks help with interpersonal relationships. However the therapist would help the patient explore their long-standing patterns of interacting with others, and understand how these have contributed to dependency issues.
4. Family and marital therapy Individuals with dependent personality disorder are usually brought to therapy by their parents. They are often young adults who are struggling with neurotic or psychotic symptoms. Marital therapy can be productive in helping couples reduce the anxiety of both partners who seek and meet dependency needs that arise in the relationship.
5. Medications Individuals with dependent personality disorder can experience anxiety as well as depressive disorders. In these cases, it may occasionally prove useful to use antidepressants or anti-anxiety agents.
Obsessive Compulsive Personality Disorder.
Obsessive-compulsive personality disorder (OCPD) is a type of personality disorder. It is marked by rigidity, control, perfectionism, and an overconcern with work at the expense of close interpersonal relationships. Persons with this disorder often have trouble relaxing because they are preoccupied with details, rules, and productivity. They are often perceived by others as stubborn, stingy, self-righteous, and also uncooperative.
Diagnostic Criteria for Obsessive-Compulsive Personality Disorder.
A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
1. Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.
2. Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met).
3. Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity).
4. Is over-conscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification).
5. Is unable to discard worn-out or worthless objects even when they have no sentimental value.
6. Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.
7. Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.
8. Shows rigidity and also stubbornness.
- Preoccupation with details, rules, lists, order, organization, or schedules to the point at which they lose major goal of the activity.
- Excessive concern for perfection in small details that interferes with the completion of projects.
- Dedication to work and productivity that shuts out friendships and leisure time activities, when the long hours of work cannot be explained by financial necessity.
- Excessive moral rigidity and inflexibility in matters of ethics and values that cannot be accounted for by the standards of the person’s religion or culture.
Faulty parenting viewed as a major factor in the development of personality disorders. However current studies have tended to support the importance of early life experiences, finding that healthy emotional development largely depends on two important variables: parental warmth and appropriate responsiveness to the child’s needs. When these qualities are present, the child feels secure and appropriately valued.
Children with this type of upbringing are also likely to choke down the anger they feel toward their parents; they may be outwardly obedient and polite to authority figures, but at the same time treat younger children or those they regard as their inferiors harshly. But genetic contributions to OCPD have not been well documented. Cultural influences may, however, play a part in the development of OCPD.
Millon, Theodore and Seth, Grossman. (2002). Personality Disorders In Modern Life ,John Wiley and Sons, NY