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Dependent personality disorder is essentially again one of those disorders that some people would argue is simply a trait. But people with dependent personality disorder structure their lives so that other people will take responsibility for their welfare. So they will try not to function on their own but to seek out bosses, lovers, and friends who will tell them what to do and allow them to be passive. They avoid making decisions, including intimacy, socially, what job to take, even what to wear. The dependent person will put up with a great deal in relationships in order to avoid having to function autonomously. For example, the wife who puts up with verbal and physical abuse by her husband, or vice-versa, because that person feels incapable of functioning without the spouse. Obviously there are many other reasons for remaining in abusive relationships and so most people do not have dependent personality disorders necessarily who are in abusive relationships. But that is one mechanism by which abuse is sustained and dependent personality disorder, dependant personality disorder, depend personality disorder
Predominant defenses are projection, for example, projection of responsibility, of capability, of avoidance and turning against the self. The diagnostic criteria emphasizes a pervasive pattern of dependent and submissive behavior. In terms of the etiology, most theorists write about the roots of this kind of extreme dependency as coming from childhood experiences. One hypothesis is that parents can foster this kind of dependence by giving the children the implicit or explicit message that any independent behavior is bad and will lead to abandonment. Also by essentially giving the child the sense that his or her judgment is not valid and that the only person who knows what’s right for the child is the parent. Dominant and submissive personality traits may be genetically inherited so there is some research going on that suggests that submissiveness and dependence may have some genetic temperamental bases, but research on these traits is a long way from research on DSM IV personality disorder. The diagnosis is made more often in women than in men. Again, there is some question about whether that is due to cultural bias, whether that’s due to cultural bias by the diagnostician and also cultural bias in terms of traits that are inculcated, that are gender-specific. Substance abuse, depression and somatic symptoms are common complications of dependent personality disorder.
The course and prognosis of dependent personality disorder really depends a great deal on the network of the dependent person’s relationships. As long as the dependent person can rely on the selected individuals, things go well. The person may function quite well, and then there may be catastrophic decompensation when, for example, a much needed spouse dies, when a
In terms of differential diagnosis, dependent traits are quite common in a variety of the other personality disorders; borderline, histrionic, avoidance, passive-aggressive and schizoid. It is not difficult to distinguish self-defeating personality disorder from dependent personality disorder because self-defeating doesn’t exist anymore, but passive-aggressive traits can sometimes be confused with dependent traits. The goal of the passive-aggressive behavior is quite different. It’s often to express hostility that’s unacknowledged whereas in dependent behaviors the goal is to abdicate responsibility and ask someone to take responsibility. Agoraphobia may be mistaken for dependent personality disorder, but the agoraphobic is much more active in demanding that
The agoraphobic says, "I can’t drive to work, you have to drive me to work because I can’t be alone. I can’t go shopping in the super market alone." The dependent person can’t do things because of a perceived sense of inadequacy. The agoraphobic can’t do things because of an overwhelming fear of anxiety and panic. In some areas therapy can be quite helpful to dependent people, in terms of helping them examine the effects of their dependency and passivity on others as well as on themselves. It’s important that the therapist respect the patient’s need for dependent relationships early on and not try to disrupt them, because this can lead to a abrupt decompensation. Group therapy, assertiveness training, cognitive therapy can all help address these problems of abrogation of responsibility, of self assertion and
Individuals with obsessive-compulsive personality disorder are characterized by limited ability to express warm and tender feelings, focusing on facts instead of feelings, because feelings provoke anxiety. They are often preoccupied with the right way of doing things and they insist on having things their own way. They are quite moralistic, often to the point of absurd rigidity and extreme insensitivity. Lists and routines dominate their lives. Decision-making is often very difficult for the obsessive-compulsive, as you know. They will try to reduce it to a science and then be unable to. Then often be paralyzed by indecision and fear of making a mistake. Other obsessive-compulsive traits may include extreme cleanliness and orderliness. At the healthier end of the spectrum people with this personality disorder can hold down stable jobs and have stable family lives, but many people are quite isolated due to their rigidity and fear of affect. In the interview, obsessive-compulsive individuals will usually be stiff and formal and express little emotion. They will often be detailed and quite circumstantial in their answers to questions. They will be slow to warm up