Dependent Personality Disorder (DPD): The Complete Guide Singapore (2022)

Updated: Jan 12



No man is an island – we are social beings that are dependent on others to help us through life. But intensified and dependency becomes a disorder.


In this article

  1. What is Dependent Personality Disorder?

  2. Dependent personality disorder in the DSM-V

  3. How is dependent personality disorder different from separation anxiety disorder?

  4. What are symptoms of dependent personality disorder?

  5. What causes dependent personality disorder?

  6. How is Dependent personality disorder diagnosed?

  7. Dependent personality disorder treatments

  8. Where to get help for DPD in Singapore

  9. How does dependent personality disorder affect daily life?

  10. Culture and Dependent Personality Disorder

  11. What happens if you don’t get help for dependent personality disorder?

  12. How is dependent personality disorder and codependency different?

  13. Dependent personality disorder tests

What is Dependent Personality Disorder?


Dependent Personality Disorder (DPD) is the least studied personality disorder. DPD belongs to the third cluster of personality disorders, which are characterized by fear and anxiety.


Less than one percent of the population has been diagnosed with dependent personality disorder. Multiple studies say that women are more susceptible to the disorder, but conflicting research suggests that the prevalence is similar across the genders


Dependent personality disorder in the DSM-V


In the review of the DSM-IV, it was suggested the Dependent Personality Disorder, along with four other personality disorders, be taken out of the next edition of the guide. These disorders had proven to have low clinical utility and validity.


In a journal article, it was found that the criteria for diagnosing DPD presented in the DSM-IV were incongruent with the empirical research. [1]


How is dependent personality disorder different from separation anxiety disorder?


The two mental conditions can feel like the same thing. Separation anxiety disorder is defined as the fear of being away from a particular person, an environment, even a pet. [2]


The condition is considered a juvenile disorder, and it is rare that adults are diagnosed with separation anxiety disorder. [3] One critical differentiator between the two is that separation anxiety does not render a person completely helpless in making decisions for themselves.


While extensive research of the correlation between the two disorders are lacking, a study showed strong comorbidity links between the two. The study concluded that it is possible separation anxiety disorder is a result of dependent personality disorder. [4]


What are symptoms of dependent personality disorder?


Like other personality disorders, there are rarely any physical symptoms of dependent personality disorder. These are some observable traits that someone potentially with DPD may have:


Lack of independence

Those with dependent personality disorder find it difficult to start new tasks. Due to their wholehearted belief in their own incapability, they avoid working independently and doing anything that requires them to be held accountable. They also need supervision and constant reassurance. [5]


Lack of confidence

One of the key characteristics of someone with DPD is their low self-esteem. They naturally have low esteems as a result of belittling their own abilities. Any criticism will further cement the individual’s belief that they are inept. [6]


Extreme submissive behavior

People with DPD may end up in toxic situations that their condition refuse to let them get out of. As a result of their heavy reliance on other people, they avoid disagreements with anyone that is in charge of their welfare for the fear of that person leaving them.


Individuals with DPD are also willing to go to lengths and endure emotional and physical abuse. They refuse to be by themselves because they believe they are so incapable of taking care of themselves. [7]


What causes dependent personality disorder?


There is no exact cause for dependent personality disorder, and the lack of research means that there are a lot of criticism around the existing research and findings. Most journals hypothesize that the development of the personality disorder is owed to a combination of these factors:


Trauma

Negative or traumatic events in one’s life might mean higher chances of developing personality disorders in adulthood. Stakes are further raised for people with high interpersonal stress but poor support systems. [8]


Family environment

Events that happen in childhood may sometimes affect one’s behavior later as a grown adult. Journal articles cite upbringing as a possible cause of developing dependent personality disorder. Parents that were overprotective and authoritarian are more likely to create dependency because the child is unable to form any autonomy, instead, teaching them that there is always someone more powerful and capable. [9]


How is Dependent personality disorder diagnosed?


Physical exams are performed to see if another condition is causing the symptoms. If the individual is cleared of any physical conditions, they will be referred to a mental health professional.


The mental health professional will try to learn about the patient – how they’re feeling, the family’s mental health history, other mental health issues the individual may have and about their relationships to understand their thought processes and behavior. The responses are compared against the DSM-5 to determine if the person has DPD.


Dependent personality disorder treatments


Generally, personality disorders are difficult to treat. However, due to the inherent traits of DPD that include being in tune to someone else’s body language and being a people pleaser, it can aid in the treatment.


There have also been reports of psychotherapy going awry because the individual’s submissiveness and desire to be looked after that can test the therapist’s patience. At the other end of the spectrum, the patient may draw out the therapy because of their fear of abandonment. [10]


Psychodynamic therapy

With psychodynamic therapy, it focuses on two correcting two main problems that make up the dysfunctional behavior in someone with DPD – reconditioning behavior and replacing dependency responses with autonomous and adaptive behaviors. [11]


In the limited case studies available, it is also highlighted that DPD patients with a more severe form of separation anxiety or very low esteem may require a supportive treatment approach. [12]


This strategy relies on a very close therapist-patient relationship to help build self-esteem and teach healthy coping mechanisms. It is referred as a supportive treatment approach because it mimics a parent supporting a child in order to override past traumas. [13]


Cognitive Behavioral therapy (CBT)

CBT is also used to increase the patient’s confidence in themselves, especially their autonomy and self-reliance.


Just like in psychodynamic therapy, there has to be a close relationship between the therapist and patient in order for the patient to feel comfortable to interact. Once that bond is established, the therapist can then question beliefs, and help them form more adaptive behavior to face situations that may trigger dependency. [14] [15]


Pharmacotherapy

There are no medications that directly treats personality disorders. However, medical professionals may prescribe medication to manage other comorbidities, like depression, that come with dependent personality disorder.


Where do I get help for Dependent Personality Disorder in Singapore?

Clinic/Hospital

Address

Contact

Cost (subsidised)

Cost (unsubsidised)

Institute of Mental Health


Buangkok Green Medical Park 10 Buangkok View

Singapore 539747


6389 2000 (24hr line)


imh_appt@imh.com.sg

$42

$39 (subsequent visit)

$105-$155

$72 - $103 (subsequent visit)

National University Hospital

5 Lower Kent Ridge Road

Singapore 119074


+65 6779 5555


For appointments:

65 6772 2002

appointment@nuhs.edu.sg


​$38-$58

$36 - $51 (subsequent visit)

$109.14 - $145.52

$89.88 - $108.07 (subsequent visit)

Psychology Blossom

Please contact clinic for costs and financial advisory

Please contact clinic for costs and financial advisory


How does dependent personality disorder affect daily life?


Dependent Personality Disorder may affect interpersonal relationships. People around an individual with DPD may be uncomfortable with the burden of having someone so heavily reliant on them.


People suffering from DPD are very prone to comorbidities, one of which is substance abuse. Those who cannot access help may turn to alcohol and drugs as coping mechanisms.


Culture and Dependent Personality Disorder


Several social psychology studies have observed the correlation between collectivist communities and dependent traits.


In the Journal of Nervous and Mental Disease, an article asked for the professional community of mental health to relook its criteria for dependent personality disorder in the DSM.


They argued the need to take into context the context of environment and culture that an individual is brought up, especially in East Asian philosophies like Confucianism prize submission and dependency over the unreserved expression of one’s individualism. [16]


Another study comparing students from Boston and Istanbul found this to be more applicable to people on either extreme of the individualist-collectivist spectrum. [17]


What happens if you don’t get help for dependent personality disorder?


Left alone, the mental wellbeing of someone with DPD can significantly deteriorate.


DPD is known for its high comorbidity rate. Someone with dependent personality disorder may develop a myriad of anxiety disorders, mood disorders, other personality disorders as well as alcoholism and substance addiction. Depression is also a known comorbidity of DPD patients but its likelihood is lower. [18]


Without help, persons with DPD are also likely to stay in abusive and dangerous relationships. They may also be coerced into performing dangerous acts to appease someone they rely on.


How is dependent personality disorder and codependency different?


Codependency is derived from the term “co-alcoholic” that was used to refer to the relatives or spouses of alcoholics. Codependency suggests that both parties are dependent on each other. [19]


The main difference between codependency and dependent personality disorder is the range of people it affects. A codependent person focuses their attention on one person while someone with DPD tend to feel the need to be taken care of regardless of the person in contact.


Dependent personality disorder tests


Different psychology centers do offer online tests that people can take to get a sense of whether or not they have DPD. Here are a couple tests to see if you have symptoms of dependent personality disorder:

  • 3-minute Dependent Personality Disorder test by Individual Differences Research Labs

https://www.idrlabs.com/3-minute-dependence/test.php

  • The Depedent Personality Disorder test by Barends Psychology Practice

https://barendspsychology.com/dependent-personality-disorder-test/


If you have symptoms of DPD, please consult a medical professional. These tests are in no way proper diagnoses.


Conclusion


Dependent Personality Disorder is a potentially life-threatening disorder. Not only does it affect the individual, but a lot of other people around them can also feel burdened and uncomfortable.


Though the research for DPD is lacking and what we currently know can be conflicting, consult a medical professional if you or anyone around you present these symptoms. The disorder may not be present but everyone deserves a better quality of life.

 

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About Our Writer

Rachel is an anxious INFJ with a slightly concerning obsession with coffee and true crime. She loves feeling smart and dislikes playing games she knows she will lose. Learning about mental health is her way of helping people around her. IF the world was perfect, she wishes she could bring her friends flowers in a little red wagon.

 

This editorial section solely expresses the opinion of frankie and is not endorsed nor commissioned by any external party. The list is non-exhaustive. At frankie, we believe that your best provider of medical advice is your doctor. Please consult a doctor before undergoing any treatment or procedure.

 

References:

1. Bornstein, R. F. (1997). Dependent personality disorder in the DSM-IV and beyond. Clinical Psychology: Science and Practice, 4(2), 175–187. https://doi.org/10.1111/j.1468-2850.1997.tb00108.x


2. Karlovec, K., Yazdi, K., Rier, U., Marksteiner, J., & Aichhorn, W. (2008). Separation anxiety disorder and school refusal in childhood: potential risk factors for developing distinct psychiatric disorders?. Primary care companion to the Journal of clinical psychiatry, 10(1), 72–73. https://doi.org/10.4088/pcc.v10n0113c


3. Bögels, S. M., Knappe, S., & Clark, L. A. (2013). Adult separation anxiety disorder in DSM-5. Clinical Psychology Review, 33(5), 663–674. https://doi.org/10.1016/j.cpr.2013.03.006


4. Mroczkowski, M. M., Goes, F. S., Riddle, M. A., Grados, M. A., Bienvenu, O. J., Greenberg, B. D., Fyer, A. J., McCracken, J. T., Rauch, S. L., Murphy, D. L., Knowles, J. A., Piacentini, J., Cullen, B., Rasmussen, S. A., Pauls, D. L., Nestadt, G., & Samuels, J. (2016). Dependent personality, separation anxiety disorder and other anxiety disorders in OCD. Personality and mental health, 10(1), 22–28. https://doi.org/10.1002/pmh.1321


5. Disney, K. L. (2013). Dependent personality disorder: A critical review. Clinical Psychology Review, 33(8), 1184–1196. https://doi.org/10.1016/j.cpr.2013.10.001


6. Beitz, K., & Bornstein, R. F. (2006). Dependent Personality Disorder. Practitioner’s Guide to Evidence-Based Psychotherapy, 230–237. https://doi.org/10.1007/978-0-387-28370-8_22


7. MSD Manuals. (2021b, May). Dependent Personality Disorder (DPD). MSD Manual Professional Edition. https://www.msdmanuals.com/en-sg/professional/psychiatric-disorders/personality-disorders/dependent-personality-disorder-dpd?query=dpd


8. Simonelli, A., & Parolin, M. (2017). Dependent Personality Disorder. Encyclopedia of Personality and Individual Differences, 1–11. https://doi.org/10.1007/978-3-319-28099-8_578-1


9. Simonelli, A., & Parolin, M. (2017). Dependent Personality Disorder. Encyclopedia of Personality and Individual Differences, 1–11. https://doi.org/10.1007/978-3-319-28099-8_578-1


10. Simonelli, A., & Parolin, M. (2017). Dependent Personality Disorder. Encyclopedia of Personality and Individual Differences, 1–11. https://doi.org/10.1007/978-3-319-28099-8_578-1


11. Simonelli, A., & Parolin, M. (2017). Dependent Personality Disorder. Encyclopedia of Personality and Individual Differences, 1–11. https://doi.org/10.1007/978-3-319-28099-8_578-1


12. Faith, Chasidy (2009) "Dependent Personality Disorder: A Review of Etiology and Treatment," Graduate Journal of Counseling Psychology: Vol. 1 : Iss. 2 , Article 7. Available at: https://epublications.marquette.edu/gjcp/vol1/iss2/7


13. Misch D. A. (2000). Basic strategies of dynamic supportive therapy. The Journal of psychotherapy practice and research, 9(4), 173–189.


14. Faith, Chasidy (2009) "Dependent Personality Disorder: A Review of Etiology and Treatment," Graduate Journal of Counseling Psychology: Vol. 1 : Iss. 2 , Article 7.


15. Gul, Seema. (2012). 4. Schema focused CBT intervention of dependent personality disorder: A case Study. Pakistan Journal of Clinical Psychology Vol.11, 2012.


16. Chen, YuJu Psy.D*; Nettles, Margaret E. PhD†; Chen, Shun-Wen PhD‡ Rethinking Dependent Personality Disorder, The Journal of Nervous and Mental Disease: November 2009 - Volume 197 - Issue 11 - p 793-800 doi: 10.1097/NMD.0b013e3181be76ae


17. Caldwell-Harris, C. L., & Ayçiçegi, A. (2006). When Personality and Culture Clash: The Psychological Distress of Allocentrics in an Individualist Culture and Idiocentrics in a Collectivist Culture. Transcultural Psychiatry, 43(3), 331–361. https://doi.org/10.1177/1363461506066982


18. Bornstein, R. F. (1995). Comorbidity of Dependent Personality Disorder and other Psychological Disorders: An Integrative Review. Journal of Personality Disorders, 9(4), 286–303. https://doi.org/10.1521/pedi.1995.9.4.286


19. Caccamise, L. (1996). Codependency: A new personality disorder?(Order No. EP12479). Available from ProQuest One Academic. (304353548). Retrieved from http://ezproxy.lib.rmit.edu.au/login?url=https://www.proquest.com/dissertations-theses/codependency-new-personality-disorder/docview/304353548/se-2?accountid=13552