Table of Contents:

  1. Introduction
  2. Features of DPD
  3. Codependency in DPD vs C-PTSD
  4. Dependent personality style vs disorder
  5. Resources & FAQs

Dependent Personality Disorder

Dependent personality disorder (DPD) prototypic description:

Dependents feel inadequate, fragile and need others to rely on. They struggle with being alone and find it nearly impossible to make their own decisions They are submissive and are more than willing to put others’ needs and views above their own. They will do whatever it takes to get others to care for them, to give them affection, and give direction to their lives.

Features of DPD

  • Triggering Event(s): The expectation that they can rely on themselves; being alone
  • Behavioral Style: Docile, passive, non-assertive, insecure, and submissive; doubts themselves & lacks self-confidence
  • Interpersonal Style: People-pleasers, self-sacrificing, clingy & needs reassurance; over-compliant & over-reliant on others; want others to be in control of their lives; avoids arguments; puts themselves down so they can receive the support of others; urgently seeks a new relationships when one ends
  • Cognitive Style: Suggestible and persuadable ; optimistic, sometimes to the point of naïveté; uncritical; minimises difficulties and are easily taken advantage of
  • Affective Style: Insecure & anxious; lack self-confidence & fear being alone; fear abandonment & rejection; often sad or somber
  • Temperament: Low energy; fearful, sad or withdrawn; melancholic
  • Attachment Style: Preoccupied
  • Parental Injunction: “You can’t do it by yourself”
  • Self-View: Pleasant but inadequate, fragile
  • World-View: Other people need to take care of them because they are unable to
  • Maladaptive Schemas: Defectiveness; self-sacrifice; approval-seeking
  • Optimal Diagnostic Criterion: Needs other people to be responsible for most major parts of their lives
  • Defining Strategy & Belief: Help-elicting; other people are needed to survive.

Subtypes: Accommodating; Disquieted; Immature; Ineffectual; Selfless (Millon)

Often comorbid with: depression, anxiety, adjustment disorders, BPD, AvPD, HPD, chronic illness, separation anxiety

Often confused with: separation anxiety disorder, dependency associated with other conditions (e.g. agoraphobia, physical disability), BPD, HPD, AvPD, C-PTSD

Dependency in DPD vs C-PTSD

Both DPD and C-PTSD come with attachment issues, fear of abandonment, and feeling inferior. How do we distinguish between them?

Firstly, let’s look at the diagnostic criteria:

Complex Post-Traumatic Stress Disorder (ICD-11)

  • Exposure to trauma
  • PTSD symptoms: re-experiencing (flashbacks, intrusive thoughts, nightmares etc); avoidance of reminders (both internal and external triggers); & hypervigilance and/or startle reaction (which may be decreased in C-PTSD, unlike PTSD).
  • Emotional dysregulation (mood swings, irritability, impulsivity, dissociation, feeling numb)
  • Negative view of self (feeling worthless, guilty, ashamed, defeated, diminished, like a failure, survivor’s guilt, etc)
  • Difficulties in relationships (ability to form new relationships and sustain old ones, feeling close to people, avoiding people, “there may be occasional intense relationships, but the person has difficulty sustaining them.”)
  • “Significant impairment in personal, family, social, educational, occupational or other important areas of functioning. If functioning is maintained, it is only through significant additional effort.”

Dependent Personality Disorder (DSM-5)

  • Meeting general personality disorder criteria, and;
  • “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:
    • 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 [their] life.
    • Has difficulty expressing disagreement with others because of fear of loss of support or approval. (Note: Do not include realistic fears of retribution.)
    • Has difficulty initiating projects or doing things on [their] 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 [of themselves].
    • 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 [themself].”

* The DSM-5 doesn’t include C-PTSD, and the ICD-11 doesn’t include DPD.

On the surface, they look fairly easy to distinguish between. But when you look at the symptoms:

  • Difficulty in sustaining normal relationships; becoming too attached
  • Feeling better when you have someone taking care of or supervising you
  • Emotional dysregulation
  • Impairment in functioning
  • Fear of expressing disagreement; overly passive; accepting abuse if it means keeping the peace
  • Feeling helpless, very low self esteem, feeling inferior, unable to take criticism
  • Hypervigilance, overly focusing on what others think of you

They’re actually pretty similar!

The difference lies in where the symptoms come from. C-PTSD is always caused by trauma, and the symptoms reflect that. A person with C-PTSD is scared of disagreeing with someone because they fear it will cause more trauma. A person with DPD is scared of disagreeing because they fear it will cause loss of support and approval. Of course, someone with DPD could have experienced trauma too, which makes it harder to distinguish where the symptoms come from. And someone could have both!

Dependent Personality Style vs Disorder
Dependent Dependent
Seek advice from others but are able to make their own decisions. Unable to make their own decisions without excessive advice from others; want others to make major life decisions for them.
Polite, agreeable, tactful, like to keep the peace. Always agrees with people even when they are wrong, because they fear being rejected.
Prefer to follow rather than lead, but can go it alone. Finds it very difficult to do things by themselves.
Thoughtful, often puts themselves before others. Willingly does unpleasant or demeaning things to get others to like them.
Prefers company instead of being alone. Feels uncomfortable or helpless when alone; avoids being alone at all costs.
Strongly committed to relationships, works hard to keep them. Feels devastated or helpless when close relationships end, and urgently finds another one; afraid of being abandoned.
Responds to criticism by correcting their mistakes. Hypersensitive to criticism or disapproval.

Resources & FAQs