and excessive need to be taken care of that leads to submissive
and clinging behavior and fears of separation, beginning by early
adulthood and present in a variety of contexts, as indicated by
five (or more) of the following:
Has difficulty making everyday decisions without an excessive amount
of advice and reassurance from others
Needs others to assume
responsibility for most major areas of his or her life.
Has difficulty expressing disagreement with others because of fear
of loss of support or approval.
Has difficulty initiating projects or doing things on his or her own
(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 himself or herself.
Urgently seeks another relationship as a source of care and support
when a close relationship ends.
Is unrealistically preoccupied with fears of being left to take care
of himself or herself.
have similar or even the same symptom. The clinician, therefore,
in his diagnostic attempt has to differentiate against the following
disorders which he needs to rule out to establish a precise diagnosis.
The cause of this
disorder is not known. The disorder usually appears in early adulthood.
This disorder is common but not well studied; however, more women
than men have been found to have dependent personality disorder.
There is no specific
treatment for this disorder. Psychotherapy may be useful in gradually
helping people to make choices that affect their own life. Medication
may also be helpful. Improvements are usually seen only with long-term
therapy or treatment.
and Psychotherapy [ See
Therapy Section ]:
As with all personality
disorders, psychotherapy is the treatment of choice. Treatment is
likely to be sought by individuals suffering from this disorder when
stress or other complications within their life have led to decreased
efficiency in life functioning. As with all other personality disorders
as well, they may present with a clear Axis I diagnosis and the personality
disorder may only become apparent after a few sessions of therapy.
The most effective
psychotherapeutic approach is one which is focuses on solutions to
specific life problems the patient is presently experiencing. Long-term
therapy, while ideal for many personality disorders, is contra-indicated
in this instance since it reinforces a dependent relationship upon
the therapist. While some form of dependency will exist no matter
the length of therapy, the shorter the better in this case. Termination
issues will likely be of extreme importance and will virtually be
a litmus test of how effective the therapy has been. If the individual
cannot end therapy successfully and move on to become more self-reliant,
it should not be seen as a therapeutic failure. Rather, the individual
was not likely seeking life-changing therapy in the first instance
but instead solution-focused therapy.
Psychopharmacology Section ] :
As with all personality
disorders, medications should only be prescribed for specific problems
suffered by the individual. Sedative drug abuse and overdose is common
in this population and should be prescribed with additional caution.
Anti-anxiety agents and antidepressants should be prescribed only
when there is a clear Axis I diagnosis in conjunction with the personality
disorder. Physicians should resist the temptation to overprescribe
to someone with this disorder, because they often present with multiple
physical complaints or anxiety. The anxiety in this instance is clearly
situationally-related and medication may actually interfere with effective
Personality Disorder Links