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Dependent personality disorder (DPD) refers to a psychiatric condition characterized by someones overreliance on other individuals to make their daily choices. People with DPD require help in what to wear, what job to take, what to eat, among other physical and emotional needs. This fact is evident because these people lack self-assurance to act on their own. Personality disorders are highly linked with many adverse effects in the general population, for instance, criminal behaviors, occupational dysfunction, and marital difficulties.
Distinguishing personality disorders from other normal personality traits has triggered debates recently. This research paper adequately describes dependent personality disorder and includes common symptoms, causes, co-morbidities, and prognosis.
Dependent personality disorders are invasive in the general population of the United States. Approximately, 14.8% of adult people in the country had at least one personality disorder (Grant, et al, 2004). With reference to the historic personality disorder, the DSM-IV-TR reveals that in a clinical setting, the disorder has been diagnosed more regularly on women than their male counterparts. However, the figures varied in different locations, an implication that the causes affect both men and women. Several studies have justified that a number of personality disorder counting avoidant, dependent, and paranoid were linked with significant emotional disability and impairment.
A number of researchers concur that impairment is a crucial aspect of whether severe personality traits comprise symptoms of personality disorder. For instance, based on DSM-IV-TR, personality behaviors are nonflexible and maladaptive and this brings in functional destruction and amounts to personality disorders (Trull et al, 2010). The National Epidemiological Survey on Alcohol and Related Conditions (NESARC) carried out research reviewing mental illness and reports based on the study indicated extreme occurrence rates for the personality disorder.
Analysis assessing co-morbidity rates and life satisfaction contributed to more issues. The fact that different personality disorders entail emotion regulation challenges, people with such diagnoses may become vulnerable to overdo and ultimately become reliant on substances. A high co-morbidity rate was recorded for both alcohol and nicotine reliance. Despite the fact that lower co-morbidity rates were recorded among lifetime drug dependence, further examination of the odds ratios revealed that the co morbid condition was highly connected with personality disorder diagnoses. Report from correlation assessment indicated that submissiveness, anxiousness, and separation insecurity amounted to 30% of the variability in DPD symptoms McClintock & McCarrick, 2017).
The use of samples and clinical tests has played a significant role to determine the common symptoms of the disorder. Individuals suffering from personality disorders should be served through the adoption of an integrated treatment process. Assessment for people having the above disorders should be adequately done through the use of assessment instruments which are purposely meant for the practice, and this should be done carefully like any other laboratory test (American Psychiatric Association, 2013). Assessment process is usually done to gather the relevant information about an individual while at the same time engaging in a complex process on the specific client to establish the absence or the presence disorder. The assessment also helps to identify the major strengths of the individual and the problematic areas, which might object any treatment process adopted or recovery. The appropriate assessment engages the given patient in the continued development of the very best treatment approach or relationship.
Individuals with this disorder lack the self-esteem to trust their capability to make useful decisions and they tend to count on other people. They may be overwhelmed by loss and separation and may even suffer abuse to keep a relationship. Researchers have identified several symptoms. These include; severe passivity, avoiding being alone and personal accountability, difficult making a helpful decision without outside reassurance, easily hurt by criticism, incapable to meet basic demands of life, and difficulties expressing disagreements with other individuals. The diagnosis of DPD entails several tests and evaluations. A thorough assessment of previous medical history and psychological tests are significant. Most importantly, DPD is differentiated from other disorders, for instance, borderline personality disorder because both share comparable symptoms.
Researchers hold varying opinions on what causes DPD. Therefore, the accurate cause is not known, but mostly it entails a mixture of developmental, biological, and psychological aspects. The reported cases of the disorder reveal that it emerges in early adulthood. Other causes held accountable are linked with other disorders. For instance, people who suffer chronic physical illness and those who experience separation anxiety disorder in childhood are more vulnerable and at a higher possibility of developing DPD (American Psychiatric Association, 2013). It is worth noting that the approximate incidence of DPD in the general population is at a lower percent, although women are more susceptible to the disorder compared to men. Children from overprotective families are also found to develop dependent personality behavior.
Studies concerning the co-occurrence are commonly called co-morbidity. The co-morbidity of this disorder has a limited study, however, scholars have assessed the overlap existing between borderline and dependent personality. It was justified through a study that more than 50% of people with BPD also matched criteria for DPD. The pervasiveness of such co-morbidities occurs because most elements of DPD are comparable to BPD (Trull et al, 2010). For instance, individuals with BPD are known to experience rejection sympathy. Therefore, they tend to feel distressed at even the least professed rejection. Similarly, people with DPD mostly respond the same way to criticism shown by the loved ones.
Moreover, the reported cases of dependent personality disorder reveal that it is linked with one or more co-occurring psychological disorders, with anxiety leading the others. It is evident that about 50% of people with DPD have other disturbing mental disorders as well as high percentage of substance use disorder. Higher rates of co-morbidity have been recorded among lifetime drug dependence (Grant, et al, 2004). It is evident that substance use disorders crop up in people who suffer from DPD at a higher rate as compared to the general populace. It is estimated that at least 10% of people with DPD have one-lifetime eating or drinking disorder. In this case, the binge-eating disorder was recorded among many people affected by DPD more than those using anorexia nervosa.
Diverse studies have indicated that DPD may be a lasting disorder. However, with proper therapy and treatment, people can improve their health and live normal lives. Therefore, the prognosis for people with this disorder depends on the length of successful therapy (American Psychiatric Association, 2013). It is evident that people who look for lifelong therapy are known to gain a better prognosis. Medications for this disorder should be recommended for certain problems experienced by the patient. Overdose and seductive drug abuse are frequent among patients and so caution should be given priority during prescription. Anti-anxiety antidepressants are allowed when there is a proved psychiatric diagnosis alongside the personality disorder.
Clinical assessment forms the basis of professional nursing and intervention. It provides the baseline through the development and progression of the disorder detected. Constant monitoring is important towards effective nursing and provision of proper health care to the affected individual. Just like any other disorder, management and control is very significant. This should be done in accordance with the best clinical practices. Optimal treatment for this disorder generally includes a normal and conservative approach. The intervention methods used currently are intended to improve or regain self-assurance to the patient.
DPD is categorized as Cluster C, the class comprised of fearful and anxious disorders under the Diagnostic and Statistical Manual of Mental Disorders. Mental health professionals use this important manual to determined diagnostic criteria (American Psychiatric Association, 2013). There are several disorders incorporated in Cluster C such obsessive and avoidant personality disorders, all which show increased rates of anxiety. As discussed, people with dependent personalities are known to be clingy and with problems accomplishing duties or making valuable decisions without outside help. The lack of self-confidence makes them count on their partners. Psychotherapy is the basic process used for treating DPD. Through this therapy, affected people are helped to regain confidence, become energetic and independent, and know to establish healthy relationships. The nursing profession calls for early recognition of individuals and patients who are at high risk of developing the disorder. This plays a crucial role to help people to start learning how to behave and relate with others. Therefore, it is important that all clinicians and nurses be knowledgeable and informed about this disorder to offer the best intervention practice.
American Psychiatric Association (2013). Dependent Personality Disorder DSM-5. In the Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.
Grant, B. F. et al (2004). Prevalence, Correlates, and Disability of Personality Disorders in the United States. Journal of Clinical Psychiatry, 65(7). 65. 948-58. 10.4088/JCP.v65n0711
McClintock, A.S & McCarrick, S. (2017). An Examination of Dependent Personality Disorder in the Alternative DSM-5 Model for Personality Disorders. J Psychopathol Behav Assess 39:635641.
Trull TJ, Jahng S, Tomko RL, Wood PK, Sher KJ. (2010). Revised NESARC Personality Disorder Diagnoses: Gender, Prevalence, and Comorbidity with Substance Dependence Disorders. Journal of Personality Disorders, 24(4), 412426. doi:10.1521/pedi.2010.24.4.412
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