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The criteria for dependent personality disorder (DPD) in DSM-IV appear to fall into two categories: dependent and attachment behaviors. The relevance of this division was evaluated in a sample of 182 patients admitted to a national Norwegian psychiatric hospital. Principal Components Analysis of all items belonging to the most frequent personality diagnoses revealed six components. The items for DPD formed two components, labeled attachment/abandonment and dependency/incompetence. Two criteria for borderline personality disorder also loaded on the attachment/abandonment component, while six criteria for avoidant personality disorder loaded on the dependency/incompetence component. Early Maladaptive Schemas of abandonment and failure correlated significantly higher with the attachment/abandonment component than with the dependency/incompetence component.
The base rates of DSM dependent personality disorder (DPD) in clinical samples vary from 17% of lnpatients (Gude & Vaglum, 2001), 29% of day treatment patients (Wilberg et al., 1998), to 47% of outpatients (Alnaes & Torgersen, 1988). Despite these high rates, Cluster C disorders, and DPD as part of them, has been studied less than other personality disorders (Alnaes & Torgersen, 1997; Endler & Kocovski, 2002; Livesley, Schroeder, & Jackson, 1990).
Several theories about the development of a dependent personality have been proposed (Millon & Davis, 1996). Bornstein (1997) suggested that the criteria for DPD are inconsistent with empirical research on dependency in several aspects, offering a revision of the criteria. Hirschfeld and colleagues (1977) reported an empirical analysis of interpersonal dependency which showed components that are related to the concepts of dependency and attachment: emotional reliance on another person, lack of social self-confidence, and assertion of autonomy. Birtchnell (1996) located the dependent and the borderline personalities in the octant labeled "fear of rejection/disapproval" in his interpersonal-based circumplex model. Cognitive theory, formulated by Beck and colleagues, has linked dependency to a maladaptive schema of incompetence (Beck, Rush, Shaw, & Emery, 1976). Livesley et al. (1990) studied the relationship between dependent traits identified from the literature and refined using the opinions of samples of psychiatrists. One of the reasons for their interest in the features of dependency was that, in their opinion, there seemed to be two forms of dysfunction: attachment and dependency behaviors. The psychometric analysis of data from a general population and a clinical sample supported such a division of the dependency construct.