Dependent personality disorder

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at June 26, 2016
StartDiseasesDependent personality disorder

Dependent personality disorder, or DPD for short, is a personality disorder that affects both women and men. While the disorder's symptoms tend to first appear in young adulthood, statistics estimate approximately 0.6 percent of the population is suffering from DPD. The former diagnostic name for dependent personality disorder is asthenic personality disorder. "Asthenic" is a medical term denoting debilitation or weakness. 

Contents

Definition & Facts

DPD as a disorder is recognized by the World Health Organization (WHO), the American Psychiatric Association (ASA) and the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is the governing diagnostic reference tool for mental health professionals. In the DSM, dependent personality disorder is classified under the umbrella of Cluster C "anxious personality disorders" and then further defined and subdivided from there.

There are a range of issues that characterize the onset of DPD, and an individual does not have to have all of the symptoms or issues in order to be positively diagnosed with the condition. A noted psychologist named Theodore Millon further classified DPD into five distinct subtypes as follows:

  • Disquieted dependent.
  • Accommodating dependent.
  • Immature dependent.
  • Ineffectual dependent.
  • Selfless dependent.

While in childhood, dependence on caregivers is seen to be healthy, individuals with dependent personality disorder will not move out of that healthy dependence successfully when they begin to mature. Rather, their clingy and dependent behaviors may become worse and in time develop into symptoms of DPD.

Symptoms & Complaints

The chief symptoms and complaints associated with dependent personality disorder are all variations on one common theme: dependency on others. It is the reasons and behaviors surrounding the fear of assuming independence for one's self that can vary tremendously. Here are the overarching symptoms diagnosing professionals look for when identifying DPD in an individual:

  • Dependence on others for decision-making.
  • Intense fear of abandonment.
  • Extreme sensitivity to criticism.
  • Low or no personal self-confidence.
  • Intolerance of being by themselves.
  • Chronic efforts to avoid taking on adult responsibilities.
  • Willingness to set aside personal beliefs and morals, overlook mistreatment, and forgo having personal needs met for the sake of the company of others.
  • Naivete, lack of sophistication, and immaturity in dealing with life and relationships.

Causes

Researchers do not yet know exactly what brings about the onset of dependent personality disorder. What is suspected is that DPD arises from a combination of factors. This is called the "biopsychosocial model of causation." The model as applied to DPD essentially states that an intricate combination of biology (genetics), an individual's psychological makeup, and social factors lays the foundation for DPD to develop. Early life experiences, especially social and familial relationships, can shape a tendency to develop DPD.

Diagnosis & Tests

Achieving a firm diagnosis of dependent personality disorder fundamentally relies on observing consistent symptoms for at least one full year's time. Diagnosis must be done by a trained and licensed mental health professional.

Usually the individual will first see a physician to rule out physical causes such as underlying diseases. Here, the process will begin by taking a medical history, both individual and family. This will be followed by a thorough physical examination, often including blood tests.

At this point, if no underlying medical causes are identified, the individual is often referred to a trained and licensed mental health professional such as a psychiatrist or a psychologist for further evaluation. At this point, the patient may be asked to undergo a series of psychological evaluations to identify the main symptoms being experienced. 

Treatment & Therapy

Treating dependent personality disorder is less simple than prescribing psychiatric medications. Due to its complex and interdependent origins, successful DPD treatment often requires a combination of approaches.

Often people who are suffering with symptoms of DPD do not realize that DPD is a diagnosable condition much less that they may have it. So they may seek treatment or therapy for an issue such as anxiety or depression after a relationship breakup, and that is the beginning of obtaining a full and accurate diagnosis of the underlying condition.

Talk therapy (psychotherapy) is one of the main staples of successful treatment, and psychiatric medications may be prescribed to mitigate symptoms such as anxiety or depression. A highly positive attribute of DPD individuals is that they tend to be eager to participate in treatment. They are reported to miss fewer sessions and be more compliant with suggestions and assignments. They are also more likely to finish their recommended treatment cycle in full.

However, even with this factored in, treatment is generally a longer term need for people with DPD. Just as it took time for the disorder to present in full, it will take time to replace DPD behaviors with the independent behaviors required for a healthy life as an adult.

Prevention & Prophylaxis

Because researchers suspect there may be a hereditary component to dependent personality disorder, prevention is not currently possible. But the risks can be greatly reduced if parents are aware of a possible genetic predisposition that may be passed to their children.

With this awareness, parenting styles can be adjusted to foster greater self-confidence and independence from an earlier age. Combined with early treatment intervention if/when DPD symptoms begin to appear, this can help to minimize the effects of DPD in young adulthood and adulthood.

Additionally, even for patients undergoing long-term treatment for dependent personality disorder, many of the major symptoms are seen to begin resolving themselves once the person reaches their 40's or 50's. It is not yet fully understood why this occurs, but it can be helpful for both the individual and the treatment team to be aware of this trend.