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Dependent Personality Disorder -DSM5

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Presentation of Dependent Personality Disorder based on DSM5 (Diagnositc and Statistical Manual Fifth Edition) published by American Psychiatric Association in 2013.

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Dependent Personality Disorder -DSM5

  1. 1. Dependent Personality Disorder DSM5 Lucia Merino, LCSW May 2015
  2. 2. Definition of Personality Disorder DSM5  A personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.  personality disorders are ways of thinking and feeling about oneself and others that drastically and negatively affects how a person functions in life.
  3. 3. Definition of Dependent Personality Disorder (Cluster C) DSM5  DPD is a pattern of submissive and clinging behavior related to an excessive need to be taken care of.  Individuals with this disorder often appear anxious or fearful.  Individuals often present with co-occurring personality disorders from different clusters.  Data from 2001-2002 suggest 15% of US adults have at least one PD. Cluster A: paranoid, schizoid, and schizotypal (odd or eccentric) 5.7% Cluster B: antisocial, borderline, histrionic and narcissistic (dramatic, emotional, or erratic) 1.5% Cluster C: avoidant, dependent, and obsessive compulsive (anxious or fearful) 6%
  4. 4. General Personality Disorder Criteria DSM5 A) An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture. Manifested in two or more of the following areas: 1. Cognition: ways of perceiving and interpreting self, people, and events. 2. Affectivity: the range, intensity, lability and appropriateness of emotional response. 3. Interpersonal functioning. 4. Impulse control. B) The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. C) The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  5. 5. General Personality Disorder Criteria DSM5 (cont.) D) The pattern is stable and of long duration, and its onset can be traced back at least to adolescence or early adulthood. E) The enduring pattern is not better explained as a manifestation or consequence of another mental disorder. F) The enduring pattern is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., head trauma).
  6. 6. Diagnostic Criteria for Dependent Personality Disorder -DSM5 A pervasive 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: 1. Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others. 2. Needs others to assume responsibility for most major areas of his life. 3. Has difficulty expressing disagreement with others because of fear of loss of support or approval. (Does not include realistic fears of retribution.) 4. Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgement or abilities rather than a lack of motivation or energy).
  7. 7. Diagnostic Criteria for Dependent Personality Disorder –DSM5 (cont.) 5. Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant. 6. Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to take care for himself/herself. 7. Urgently seeks another relationship as a source of care and support when a close relationship ends. 8. Is unrealistically preoccupied with fears of being left to take care of himself or herself. Refer to Diagnostic Features in pg. 675 DSM5.
  8. 8. Associated Features Supporting Diagnosis –DSM5 Individuals with DPD are often characterized by pessimism and self-doubt, tend to belittle their abilities and assets, and may constantly refer to themselves as “stupid.” They take criticism and disapproval as proof of their worthlessness and lose faith in themselves. They may seek overprotection and dominance from others. Occupational functioning may be impaired if independent initiative is required. They may avoid positions of responsibility and become anxious when faced with decisions. Social relations tend to be limited to those few people on whom the individual is dependent. There may be an increased risk of depressive disorders, anxiety disorders, and adjustment disorders. DPD often co-occurs with other personality disorders, especially borderline, avoidant, and histrionic personality disorders. Chronic physical illness or separation anxiety disorder in childhood or adolescence may predispose the individual to the development of this disorder.
  9. 9. Differential Diagnosis Dependent personality disorder must be distinguished from dependency arising as a consequence of: 1) other mental disorders: e.g. depressive disorders, panic disorder, agoraphobia, and as a result of other medical conditions 2) other personality disorders and personality traits. 3) personality change due to another medical condition. 4) substance use disorders. Refer to page 677 DSM5.
  10. 10. In Summary:  The essential feature of dependent personality disorder is a pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation.  The dependent and submissive behaviors are designed to elicit caregiving and arise from a self-perception of being unable to function adequately without help of others.
  11. 11. References: Diagnostic and Statistical Manual of Mental Disorders Fifth Edition DSM5 Lucia Merino May 2015

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