Dependent personality disorder

Dependent personality disorder
Classification and external resources
Specialty	Psychiatry
ICD-10	F60.7
ICD-9-CM	301.6
MedlinePlus	000941
MeSH	D003859

Dependent personality disorder (DPD), formerly known as asthenic personality disorder, is a personality disorder that is characterized by a pervasive psychological dependence on other people. This personality disorder is a long-term (chronic) condition in which people depend on others to meet their emotional and physical needs, with only a minority achieving normal levels of independence.

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.

A study in 2012 estimated the heritability of DPD to be between 55% and 72%.^[1]

Epidemiology

Dependent personality disorder occurs in about 0.6% of the general population. The disorder is diagnosed more often in females than males; however, research suggests that this is largely due to behavioural differences in interviews and self-reporting rather than a difference in prevalence between the sexes.^[2][3] 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. ^[4] Children and adolescents with a history of anxiety disorders and physical illnesses are more susceptible to acquiring this disorder.^[5]

American Psychiatric Association

The DSM-IV-TR contains a Dependent Personality Disorder diagnosis. It refers to a pervasive and excessive need to be taken care of which leads to submissive and clinging behavior and fears of separation. This begins by early adulthood and can be present in a variety of contexts.^[6]

World Health Organization

The World Health Organization's ICD-10 lists dependent personality disorder as F60.7 Dependent personality disorder:^[7]

It is characterized 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)

It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.

Millon's subtypes

Psychologist Theodore Millon identified five adult subtypes of dependent personality disorder.^[8][9] Any individual dependent may exhibit none or one of the following:

Subtype	Description	Personality Traits
Disquieted	Including avoidant features	Restlessly perturbed; disconcerted and fretful; feels dread and foreboding; apprehensively vulnerable to abandonment; lonely unless near supportive figures.
Selfless	Including masochistic features	Merges with and immersed into another; is engulfed, enshrouded, absorbed, incorporated, willingly giving up own identity; becomes one with or an extension of another.
Immature	Variant of “pure” pattern	Unsophisticated, half-grown, unversed, childlike; undeveloped, inexperienced, gullible, and unformed; incapable of assuming adult responsibilities.
Accommodating	Including histrionic features	Gracious, neighborly, eager, benevolent, compliant, obliging, agreeable; denies disturbing feelings; adopts submissive and inferior role well.
Ineffectual	Including schizoid features	Unproductive, gainless, incompetent, useless, meritless; seeks untroubled life; refuses to deal with difficulties; untroubled by shortcomings.

Differential diagnosis

The following conditions commonly coexist (comorbid) with dependent personality disorder:^[10]

• mood disorders
• anxiety disorders
• adjustment disorder
• borderline personality disorder
• avoidant personality disorder
• histrionic personality disorder

See also

• Codependency
• Suggestibility

General:

• DSM-IV codes (personality disorders)
• ICD-10 codes (personality disorders)

References

Notes

1. Gjerde et al. 2012.
2. http://www.mentalhealth.com/home/dx/dependentpersonality.html[]
3. Bornstein, Robert F. (1996-01-01). "Sex Differences in Dependent Personality Disorder Prevalence Rates". Clinical Psychology: Science and Practice 3 (1). doi:10.1111/j.1468-2850.1996.tb00054.x.
4. Coolidge, F.L., Thede, L., Jang, K.L. "Are personality disorders psychological manifestations of executive function deficits? Bivariate heritability evidence from a twin study. Behavior Genetics (2004), pp. 34, 75-84, cited in Nolan-Hoeksema, Abnormal Psychology (6th. ed.), pp. 273, McGraw Hill Education (2014)". ISBN 978-0-07-803538-8.
5. Nolen-Hoeksema, Susan (2014). Abnormal Psychology (6th. ed.). McGraw Hill Education. ISBN 978-0-07-803538-8.
6. "Dependent Personality Disorder".
7. Dependent personality disorder - International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)
8. Millon et al. 2004.
9. Millon 2006.
10. "Internet Mental Health - dependent personality disorder". Mentalhealth.com. Retrieved 2014-05-12.

Sources

• Beck, Aaron T; Freeman, Arthur (1990). Cognitive Therapy of Personality Disorders. New York: Guilford Press. ISBN 978-0-89862-434-2.
• Millon, Theodore; Davis, Roger Dale (1996). Disorders of Personality: DSM-IV and Beyond. New York: Wiley. ISBN 978-0-471-01186-6.
• Millon, Theodore (1981). Disorders of Personality: DSM-III, Axis II. New York: Wiley. ISBN 978-0-471-06403-9.
• Perry, J. C. (1996). "Dependent personality disorder". In Gabbard, Glen O.; Atkinson, Sarah D. Synopsis of Treatments of Psychiatric Disorders. American Psychiatric Press. pp. 995–8. ISBN 978-0-88048-859-4.
• Gjerde, L. C.; Czajkowski, N.; Røysamb, E.; Ørstavik, R. E.; Knudsen, G. P.; Østby, K.; Torgersen, S.; Myers, J.; Kendler, K. S.; Reichborn-Kjennerud, T. (2012). "The heritability of avoidant and dependent personality disorder assessed by personal interview and questionnaire". Acta Psychiatrica Scandinavica 126 (6): 448–57. doi:10.1111/j.1600-0447.2012.01862.x. PMC 3493848. PMID 22486635. Lay summary – Norwegian Institute of Public Health (September 24, 2012).
• Millon, Theodore; Millon, Carrie M.; Meagher, Sarah; Grossman, Seth; Ramnath, Rowena (2004). Personality Disorders in Modern Life. Wiley. ISBN 978-0-471-66850-3.
• Millon, Theodore (2006). "Personality Subtypes".
• Kantor, Martin (1992). Diagnosis and Treatment of the Personality Disorders. Ishiyaku EuroAmerica. ISBN 978-0-912791-89-0.
• Ellison, J. M.; Adler, D. A. (1990). "A strategy for the pharmacotherapy of personality disorders". In Adler, David A. Treating Personality Disorders. San Francisco: Jossey-Bass. pp. 43–63. ISBN 978-1-55542-811-2.
• Adler, David A., ed. (1990). Treating Personality Disorders. San Francisco: Jossey-Bass. ISBN 978-1-55542-811-2.
• Richards, Henry Jay (1993). Therapy of the Substance Abuse Syndromes. New York: Jason Aronson. ISBN 978-0-87668-539-6.
• Zimmerman, Mark (1994). Diagnosing DSM-IV-R Psychiatric Disorders in Primary Care Settings: An Interview Guide for the Nonpsychiatrist Physician. Psych Products. ISBN 978-0-9633821-3-9.
• Ekleberry, Sharon (2014). "Dependent Personality Disorder (DPD)". Treating Co-Occurring Disorders. p. 63–4. ISBN 978-1-317-82549-4.
• Oldham, John M.; Morris, Lois B. (1990). The Personality Self-portrait: Why You Think, Work, Love, and Act the Way You Do. Bantam. ISBN 978-0-553-05757-7.
• Sperry, Len (1995). Psychopharmacology and Psychotherapy: Strategies for Maximizing Treatment Outcomes. Psychology Press. ISBN 978-0-87630-787-8.
• Stone, Michael H. (1993). Abnormalities of Personality: Within and Beyond the Realm of Treatment. Norton. ISBN 978-0-393-70127-2.
• Benjamin, Lorna Smith (1993). Interpersonal Diagnosis and Treatment of Personality Disorders. Guilford Press. ISBN 978-0-89862-990-3.
• Benjamin, Lorna Smith (1996). "Dependent Personality Disorder". Interpersonal Diagnosis and Treatment of Personality Disorders. Guilford Press. pp. 221–39. ISBN 978-0-89862-990-3.

External links

• J. Christopher Perry, M.P.H., M.D., 2005 (Dependent Personality Disorder)
• Diagnostic Features, Complications, Prevalence, Associated Laboratory Findings
• MedlinePlus Medical Encyclopedia: Dependent personality disorder