Dependent Personality Disorder: An Overview

Dependent Personality Disorder: An Overview

Dependent personality disorder involves excessive clinginess, neediness, submissive behavior, and fear of abandonment, stemming from factors like low self-esteem and negative experiences early in life. People with a dependent personality disorder often have trouble making decisions on their own. It doesn't matter whether the decision is important or insignificant; in both cases, they require help and reassurance from another person. Someone with dependent personality disorder may also be afraid to disagree or express her or his own opinions. An individual with this disorder commonly displays passive behavior, sensitivity to rejection and criticism, and an obsession with maintaining relationships.

There appear to be three main varieties of dependent personality disorder:

•   Submissive dependence --  associated with unhealthy ideas about relationships, low involvement with parents, and controlling mothers.

•   Love dependence -- associated with better attachment styles and relationships with parents

•   Exploitable dependence -- associated with a pattern of engagement in unhealthy or even abusive relationships

Both genetic and environmental factors seem to influence the development of this disorder. Further, the contribution of genetic and environmental factors has not been shown to vary based on sex. Specific environmental factors associated with dependent personality disorder include a family environment low in expressiveness and high in control, as well as early negative experiences of loss, neglect, or rejection that lead to a fear of abandonment.

Biological Treatment

Biological treatments work by affecting the structure or function of biological systems. For example, some medications inhibit the reuptake of certain neurotransmitters, and electroconvulsive therapy uses electricity to cause changes in the brain.

Unfortunately, there is little available research on treatments for dependent personality disorder. However, mental conditions that co-occur with dependent personality disorder may be improved by pharmaceutical treatment. Reduction of co-occurring conditions could, in turn, make the dependent personality disorder easier to treat.

Behavioral Treatment

Behavioral treatments focus on altering the behaviors caused by a psychological condition. Behavioral therapy, like biological therapies, draw from science and are tested using a scientific approach. One behavioral therapy technique is exposure with response prevention, wherein the patient is exposed to progressively more distressing stimuli and prevented from engaging in maladaptive behaviors. Over time, the sessions help to decrease anxiety and increase the patient's confidence in her or his ability to cope with things that previously would have been far too much to bear.

Talk therapy, which can involve behavioral treatment techniques such as shaping, is a common treatment for dependent personality disorder. While the goal is to increase confidence, self-esteem, and independence, this method can sometimes pose a problem. Patients with this personality disorder can become dependent upon the therapist, which is, of course, counterproductive.

Cognitive Treatment

Cognitive treatments aim to alter the thought process involved in the disorder. The idea is that, because emotions and behaviors are what drives the patient's thoughts, changing the way the person thinks can reduce undesirable feelings and actions. For example, concentrating more on positive thoughts about himself or herself can raise self-esteem and minimize the negative emotions and behaviors that result from low self-esteem.

Cognitive treatments for dependent personality disorder are often a component of talk therapy. The therapist might encourage a patient to confront her or his fear of being alone, for example, by thinking it through logically and coming up with evidence that there is no reason to be fearful and that the patient is perfectly capable of functioning without assistance.

Societal and Cultural Implications

Dependent personality disorder is unique among personality disorders because it is much more common in females than in males. It is possible that a societal bias against women can cause people to view stereotypical feminine behaviors, such as submission, as pathological. It is also worth noting that the DSM includes no personality comprised of stereo typically masculine traits.

Some cultures, such as East Asian and Confucianist, value and even encourage dependence and submission. Therefore, both an individual's cultural background and the cultural climate of the society can influence the likelihood that traits resembling those of dependent personality disorder will be labeled pathological.

Dependent Personality Disorder and the Developmental Life-Span

Dependent personality disorder often begins in early adulthood. In the general population, the prevalence is 0.9% to 1.0%; in the clinical community, it is 13.0% to 15.0%. In a study of patients with personality disorders, over half of those with dependent personality disorder were over the age of 40, compared with only about a quarter of those with a different personality disorder. It is also worth noting that patients with a dependent personality disorder were also found to be more likely to have major depression or bipolar disorder than those with other personality disorders.

In short, unnecessarily needy individuals who feel incapable of acting alone usually are diagnosed with dependent personality disorder. A variety of social, cultural, and developmental factors can contribute to the condition, but treatments like talk therapy can reduce or even eliminate symptoms.

Jocelyn Aleiadih, LCSW

www.yourlifepathcenter.com