Definition
The Dependent Personality Disorder (DPD) occurs when an individual has an excessive or pervasive need for care from others resulting in them being clinging, submissive, and having the fear of separation. The disorder occurs equally in both men and women but is more apparent in their young adulthood or when forming adult relationships. In most instances, individuals with DPD will have low levels of self-esteem thereby making them become self-denigrating and self-critical (First & Tasman, 2013).
Etiology
Early studies conducted of dependent personality traits looked at the disorder psychoanalytically and the traits were associated with weaning and breastfeeding. Individuals, who at the oral stage of development became fixated, remained dependent on other people’s support. As such, high dependency levels in the oral stage came from frustration or over-gratification. Parenting styles also contributed to high dependency levels such as the authoritarian style of parenting. This style normally prevents children from learning through the system of trial-and-error. In such parenting style, children are known to develop autonomy and self-efficacy feelings. The other parenting style is the overprotective parents who make children believe that by themselves they cannot make it. This is with regard to the guidance, help, and support accorded by most parents to their children. Such family experiences have led to the formation of cognitive structures and have led children to develop certain beliefs and mental representations about their self-efficacy and other people’s power (Hales, Yudifsky & Gabbard, 2011).
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Submissiveness plays a critical role in the emergence of this disorder. Therefore, genetic or constitutional factors are known to be contributing factors and the social and cultural factors are known to play a role in the development of the disorder. Some biological issues also come into play. For instance, during childhood, children may develop a fearful, withdrawing, sad temperament and prolonged health issues that force parents to be overprotective and this may automatically lead to the child’s high dependency. The concern of many parents in such instances relates to their children’s body type (endomorphic and ectomorphic) that have low energy thresholds. When we talk about dependency, it is considered a normative in some cultures. Therefore, DPD represents the exaggerated and maladaptive variance of normal ratios of dependency (Hales, Yudifsky & Gabbard, 2011).
Lastly, social learning is another etiology for DPD where people learn to be dependent and social reinforcement is given importance. Such instances have seen children have conflicting experiences due to the teachings they are given with regard to obeying the law. Moreover, children are also taught to be dependent on the elderly on issues pertaining their guidance and protection. Furthermore, the same children learn the importance of being autonomous and creative in their dealings.
Signs and Symptoms
Individuals always have high levels of dependency on other people and most often feel the need for care
Towards others, people with DPD are submissive or possess clingy behaviors
If left alone, such individuals are fearful especially when providing for themselves self-care
They lack self-confidence and thus, in most instances they will require excessive advice and reassurance from others even when making trivial decisions
The lack of self-confidence makes them have difficulty when starting and even undertaking simple life projects
They have fear of being disapproved and thus have difficulty when it pertains to disagreeing with other people
Low tolerance of abusive or poor treatment
The end of a friendship means that they have an urgent need to start a new one (Mayo Clinic, n.d.).
Treatments and Interventions
Psychotherapy is one of the primary treatment accorded to patients suffering from DPD and their aim is to increase the sense of independence in an individual and thus, giving them the ability to function interdependently (Sperry, 2016). The most common type is the cognitive behavioral therapy and the focus is on self-talk. Moreover, they teach the individual the importance of being aware of one’s thoughts and actions and the associated influence. Therefore, the patient is encouraged to set goals and learn the importance of being assertive. Most therapists recommend that patients face their DPD through sources such as those of anxiety by developing systematic behavioral skills in a more graduated fashion.
Therapeutic treatment encourages the existence of a bond between the therapist and the patient. In such instances, the patient may find it easy to transfer his or her dependability on the therapist and this will defeat the whole purpose of having therapy. The newest form of therapy involves family members since they are enmeshed and therapists have found it difficult to treat their DPD patients. Through therapy, patients learn new skills of coping with the disorder and being assertive thereby enabling them to meet their emotional needs independently.
Other doctors prescribe to their patient’s medication, which is not a good approach because some patients have become overly dependent on the drugs. This has resulted in them being psychologically dependent on them instead of using the available resources. Nonetheless, patients with DPD are at risk of getting anxiety disorders, depression, and phobias plus substance abuse. This is where medication comes in reducing the occurrence of such conditions.
Diagnosis and Prognosis
The primary of diagnosing is seen from the need for others in terms of assuming responsibility for most aspects of their daily life and difficulty when it pertains to making decisions alone without the input of other people. The extreme difficulty when disagreeing with other people which lead them to go excessive lengths when seeking approval from even strangers is also an important factor to be considered (Mayo Clinic, n.d.). Often, doctors will perform a physical exam where they may ask in-depth questions about the individual’s health. Ideally, some symptoms are linked to underlying physical health problems. Secondly, psychiatric evaluation can be conducted where the doctor will discuss with the patients their feelings, thoughts, and behavior. Such diagnosis may require the use of a questionnaire. Lastly, the diagnostic criterion in the DSM-5 is the option where the doctor compares symptoms of the patient to the criteria in DSM-5 (Diagnostic and Statistical Manual of Mental Disorders).
Preventive Methods
Prevention of DPD may not be possible but through treating the disorder, patients learn about productive ways of coping with their situations. Therefore, if psychotherapy is done at an early stage them the patient’s personality may be modified.
A summary of a Related Case Study
Three years ago, a 38-year old woman called Cindy developed some panic symptoms. The panic attacks were excessive and prompted her to move back into her parents’ home. This move left her to be too dependent on her parents and was not able to live by herself. The condition left her homebound because she feared that she could be attacked for no reason. For her, both her parents were her best friends, care, and concerned which has made her more overly reliant. Her parents are her source of emotional and financial support even when it concerns making decisions. The doctor prescribed for her Valium, which has left her progressively habituated (Sperry, 2016).
References
First, M. B. & Tasman, A. (2011). Clinical guide to the diagnosis and treatment of mental disorders . New York, NY: John Wiley & Sons
Hales, R. E., Yudifsky, S. C. & Gabbard, G. O. (2011). Essential of psychiatry (3rd ed.). Washington, DC: American Psychiatry Pub
Mayo Clinic. (n.d.). Personality disorders . Retrieved from http://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/dxc-20247656
Sperry, L. (2016). Handbook of diagnosis and treatment of DSM-5 personality disorders: Assessment, case conceptualization, and treatment (3rd ed.). New York, NY: Routledge
