Dependent personality disorder (DPD) is characterized by pervasive concerns about being separated from caretaker figures as well as difficulty with independence and autonomy. People with this disorder are anxious and insecure when they are not with a person who will support them, make decisions for them and generally take care of them. DPD is not rare-about 2.5 percent of the population has the disorder. In addition, people with DPD often have other personality disorders such as avoidant, histrionic and borderline.

Characteristics of DPD

The 1994 edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), a professional reference used for diagnosis, defines DPD as a pervasive and excessive need to be taken care of, leading to submissive and clinging behavior and fears of separation, beginning by early adulthood, as indicated by at least five of these characteristics:

* is unable to make everyday decisions without an excessive amount of advice and reassurance from others
* needs others to assume responsibility for most major areas of her life
* has difficulty expressing disagreement with others because of fear of loss of support or approval (not including realistic fears of retribution)
* has difficulty initiating projects or doing things himself (because of a lack of self-confidence in judgment or abilities, rather than a lack of motivation or energy)
* goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant
* feels uncomfortable or helpless when alone, because of exaggerated fears of being unable to care for herself
* urgently seeks another relationship as a source of care and support when a close relationship ends
* has an unrealistic preoccupation with fears of being left to take care of himself

The dimensions of dependency

Dependency is a term widely used in psychiatric literature. In terms of DPD, it’s useful to think about dependency as having three related dimensions:

* Emotional reliance on others and separation anxiety when the person does not have access to those other people. This may be so strong in some people that they are willing to remain in a relationship even though they are mistreated in order to avoid the feeling of abandonment or aloneness. They also may behave ingratiatingly to make sure their partner won’t leave them.
* A lack of self-confidence in social situations. This involves submissive behavior and a tendency to agree with others even when they are incorrect. They typically have considerable hesitancy about speaking up or being assertive.
* Avoidance of autonomy, characterized by seeking guidance and direction from others even though they may secretly wish for more independence. Some people with DPD, however, may become assertive or even aggressive if they believe a relationship with a significant caretaker figure is threatened.

Two of the pervasive core beliefs in people with the disorder are “I am helpless” and “Others should take care of me.”

What's Related

• Frequently Asked Questions about Dependent Personality Disorder
• What Causes Dependent Personality Disorder?
• An Introduction to Borderline Personality Disorder
• Frequently Asked Questions about Borderline
• What Is Antisocial Personality Disorder?
• Introduction to Antisocial Personality Disorder
• Mentalization Based Therapy (MBT)
• Intermittent Explosive Disorder
• What is Al-Anon and Alateen?
• Symptoms of Borderline Personality Disorder
• Other articles by Daniel Ploskin, MD

 

Last reviewed:
  On August 21, 2007
  By John M. Grohol, Psy.D.