Dependent Personality Disorder, Essays (university) of Medicine

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Dependent Personality Disorder

CHAPTER I

PRELIMINARY

Background Humans are social beings who need other humans to survive. In living their lives from childhood, adolescence, adulthood to old age, humans will have a habit of using a pattern that is relatively similar in addressing the problems they face. The way or method of settlement that is carried out appears as a certain pattern and can be called a feature or sign to identify the individual. This is what is known as a person's character or personality Personality is a pattern of behavior, habits, emotions and body shape of a person that is shown which is a character or characteristic of a person and is shown in his daily life in ordinary conditions and is stable. But there are several disorders that can affect a person's personality which are called personality disorders. A person's personality is disrupted if the person exceeds his capacity so that he can harm himself and his environment Everyone has been completely dependent on others during their lifetime, although for many this was only during their youth. Even as adults, many people still show some dependence on others, for example, they need support, guidance, and approval from others, especially during their stressful times. Addiction will be a form of psychopathology, if there is abnormal dependence and if the dependence causes personal and/or functional disturbances. This personality disorder is known as Dependent Personality Disorder, where this pattern involves docile behavior and spoiled behavior where a person has needs that are difficult to handle alone. Individuals with dependent personality disorder generally have a lack of self- confidence, a great feeling of discomfort when making and deciding on their own, self-doubt, and a search for approval. They can easily be taken advantage of because they are very obedient, agree easily, and trust others. Dependent personality disorder is part of Cluster C personality disorders along with obsessive compulsive personality disorder and avoidant personality disorder. Sufferers of this disorder have a mindset that if they argue or oppose the opinion of their interlocutors they will be hated, and because of this sufferers will tend to be passive in communicating with peers and have difficulty expressing opinions, sufferers of dependent personality disorder will obey whatever is said by the interlocutor. Based on a survey conducted by Akbar to 43 respondents, only 7 out of 43 people knew about this dependent personality and the rest did not answer at all, or around 16% and 84%

CHAPTER II

LITERATURE REVIEW

A. Definition of Personality and Personality Disorders Personality is the totality of behavioral and emotional characteristics which are the character or characteristics of a person in his daily life in ordinary and stable conditions. Personality is generally used as a global descriptive label for a person's behavior that can be observed objectively as well as an individual's personal experience that he can subjectively report. Personality disorders are characterized by personality traits (cognitive, affective, motivational, and behavioral) that are inflexible, maladaptive, and cause significant distress and/or impairment of functioning. This disorder develops from the interaction of genetic factors and early environmental experiences. Each personality disorder is characterized by a specific set of beliefs, assumptions and problem-solving strategies. Individuals with personality disorders display predictions about how the individual will behave under a given set of circumstances. This provides clues to the examiner regarding a person's disability and how to approach it for therapeutic purposes B. Dependent Personality Disorder Definition Dependent personality disorder is characterized by a persistent and excessive pattern of psychological dependence on others (to be cared for and to meet one's emotional and physical needs), fear of separation, and passivity, attachment to others, and submissive behavior. It begins in early adulthood, and is present in a variety of contexts and is associated with inadequate functioning.^9 People with dependent personality disorder place their own needs below those of others, ask others to take responsibility for major problems in their lives, lack self-confidence, and may experience strong discomfort if they are alone for more than a brief period. This disorder is closely related to depression, separation anxiety, fear of separation from loved ones, somatoform disorders, physical symptoms that cannot be explained by an emotional basis and social anxiety disorder, in which the individual experiences a paralyzing fear of social encounters and situations. People with dependent personality disorder develop their separation anxiety

because they feel abandoned when they are not in the presence of people they depend on. They are at risk of developing social phobia because they do not like leaving familiar people and surroundings. They use physical symptoms as a way to receive sympathy, protection, and attention from others. Every human being feels depressed when they do not receive the support they need, when they lose close relationships, or when it comes to taking on responsibilities that you are not ready to feel. But the risk of depression is much higher in people with dependent personalities, especially if they lack the social skills necessary to maintain relationships with others. C. Epidemiology Dependent personality disorder is more common in women than men. One study diagnosed 2.5% of personality disorders that fell into this category. This disorder is more common in young children than older children Data from the 2001-2002 National Epidemiological Survey on Alcohol and Associated Conditions yields an estimated prevalence of Dependent Personality Disorder of 0.49%, and Dependent Personality, based on the probability subsample from Part II of the National Comorbidity Survey Replication, to be 0.6%.11 Being one The most frequently diagnosed personality disorder, dependent personality disorder is found in approximately 14% of people with personality disorders and in approximately 2.5% of the general population. Other estimates suggest a mean prevalence rate of 20%, with a range from 2% to 55%. D. Etiology

1. Genetic Factors Studies suggest that approximately 30% of dependent personality disorder risk variability is attributable to genetic factors, but it is less clear which specific physiological factors underlying dependent personality disorder cognition and behavior are observable..Little has been determined regarding this relationship between temperament and dependency. Temperamental traits of negative attitudes, low adaptability, and tendencies to withdraw may contribute to dependent personality traits later in life both directly and indirectly and may encourage over-parenting. No empirical

inconsistent, or abusive, children may develop fearful or insecure forms of attachment. which they internalize as a model and adopt in their subsequent relationships. They also have more problems calming themselves when they feel frustrated, angry, or anxious.5,9, E. Signs and Symptoms of Dependent Personality Disorder Dependent personality disorder is characterized by a pervasive pattern of dependency and submissive behavior. People with this disorder are unable to make decisions without undue advice and reassurance from others. Individuals with this personality disorder avoid responsibility and become anxious when asked to assume leadership roles. They will prefer to download or obey. If they are alone, they will find it difficult to pursue their own tasks, but find it easy to do those tasks for others. People with this disorder do not like to be alone, they seek other people to rely on, and their relationships are thus compromised by their need to attach to them. In folie α deux (shared psychotic disorder), one partner usually suffers from dependent personality disorder, and the submissive partner accepts the delusional system of the more aggressive and assertive partner on whom he is dependent. Pessimism, self-doubt, passivity and fear of expressing sexual and aggressive feelings all characterize the behavior of patients with dependent personality disorder. F. Diagnosis An important feature of dependent personality disorder is a pervasive and excessive need to be taken care of leading to submissive and clinging behavior and fear of separation. This pattern begins in early adulthood and can be present in a variety of contexts. DSM-5 diagnosis of dependent personality disorder as indicated by five (or more) of the following: 5

1. Has difficulty making everyday decisions without a lot of advice and reassurance from others.
2. Needs others to assume responsibility for most major areas of his life.
3. Difficulty expressing disagreement with others for fear of losing support or approval.

4. Has difficulty starting projects or doing things on their own (due to a lack of confidence in judgment or abilities rather than a lack of motivation or energy).
5. Makes excessive effort to gain nurturing and support from others, to the point of volunteering to do things that are distasteful.
6. Feeling uncomfortable or helpless when alone because of an overwhelming fear of not being able to take care of themselves.
7. Immediately seek other relationships as a source of care and support when a close relationship ends.
8. Unrealistically preoccupied with fear of being left to fend for itself. G. Differential Diagnosis Addiction features are present in many psychiatric disorders, making the differential diagnosis difficult. a. Mental disorders and other medical conditions Dependent personality disorder must be distinguished from addictions that occur as a result of other mental disorders (eg, depressive disorder, panic disorder, agoraphobia) and as a result of other medical conditions. b. Personality disorders and other personality traits 5  Borderline Personality Disorder Individuals with borderline personality disorder react to abandonment with feelings of emotional emptiness, anger, and demands, whereas individuals with dependent personality disorder react with increased appeasement and compliance and immediately seek alternative relationships to provide nurturing and support.  Borderline Personality Disorder Borderline personality disorder can be differentiated from dependent personality disorder by the characteristic pattern of unstable and intense relationships.  Histrionic Personality Disorder People with histrionic personality disorder, like people with dependent personality disorder, have a strong need to be

who have high separation anxiety may not benefit from short or long- term psychodynamic therapy as much as they do from other therapies, such as supportive treatment approaches.  Group Psychotherapy Group psychotherapy has also proven successful in treating dependent personality disorder. In addition, it must be determined whether the client should be placed in a group that targets only addiction problems, or a group with mixed personality disorders. Caution must be used so that the client does not get lost in mixed groups. Furthermore, it should be noted that dependent personality disorder with homogeneous groups can form close relationships more quickly, can offer support quickly, and can relieve symptoms at a faster rate. The group setting will allow the patient to try out adaptive behaviors. There are no studies that examine dependent personality disorder using only family therapy. When the addiction involves a family member or members, it is very useful to include them to facilitate patient progress beyond counseling with a physician. Doing so can reduce the amount of time needed to help patients and also provide support to members  Cognitive Behavior Therapy (CBT) This therapy aims to increase a person's self-reliance. The doctor should record what triggers the patient. For example, situations where patients face problems alone can trigger maladaptive patterns, which then cause anxiety. Knowing these triggers will allow the patient to learn more adaptive ways to deal with difficult situations. The behavioral techniques used involve techniques such as assertiveness training or dating skills, homework, relaxation training, and role playing.  Pharmacotherapy Pharmacotherapy has been used to treat specific symptoms such as anxiety and depression, which are often coexistent features of dependent personality disorder. Patients who are having panic attacks or have high levels of separation anxiety may be helped by imipramine (Tofranil). Benzodiazepines and serotonergic drugs are also useful. If the patient's

depression or withdrawal symptoms respond to psychostimulants, these drugs may be used During treatment there may be some major obstacles to overcome, which may affect the amount of time required for therapy. One of these barriers involves the patient experiencing a significant loss or separation of personal support. With the need to depend on others, this sudden absence of others can overwhelm the patient and result in a retreat in therapy for skills already learned. It is important for the doctor in this situation to be supportive, offering some advice and direction, while at the same time accepting any disturbance or delay in the patient's growth. I. Prognosis There is a tendency for work functioning to be disrupted because individuals with this disorder do not have the ability to act independently and without close supervision. Social relationships are limited to those on whom they depend, and can suffer physical and mental abuse because they are unable to assert themselves. They are at risk for major depressive disorder if they lose someone they depend on. But with treatment and therapy, the prognosis will be good

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