Research showed that dependent personality traits have a significant role in the development of depression. The existence of dependent behaviors and cognitions causes social rejection or interpersonal loss to produce more intense feelings of depression than they would normally do. There can be a reactive as well as an evocative element to this relationship. Individuals with dependent personalities would respond to social rejection and interpersonal loss with strong feelings of unhappiness, anguish, and hopelessness. Dependent personality traits such as extreme reassurance-seeking, fixation with worries of loss, clinging, and neediness can induce disengagement and rejection by other people which thus leads to the depressive emotions mentioned earlier.

The Effect of Dependent Personality Disorder on Depression

Characterized by a dependency on others and anxiety experienced when alone. Individuals with this disorder have an excessive need to be cared for, often seen as clingy and needy, and cannot function without others. An anxious disorder, some of the symptoms include submissive behavior, fearing rejection and abandonment, desiring constant reassurance and contact from others, and having a strong sensitivity to criticism and rejection. 

University of Rochester

- paranoid personality disorder
- schizoid personality disorder
- schizotypal personality disorder
- antisocial personality disorder
- borderline personality disorder
- histrionic personality disorder
- narcissistic personality disorder
- avoidant personality disorder
- dependent personality disorder
- obsessive–compulsive personality disorder
-dissociative identity disorder

Specific Personality Disorders

Obsessive-Compulsive Personality Disorder (OCPD) is characterized by an obsessive desire and preoccupation with things being neat and orderly to the point of inflexibility. It is an ego-syntonic disorder.

Some symptoms include: 
- rigid adherence to rules
- perfectionistic attitude
- failure to relinquish responsibility to others
- constant desire for control
- frugality
- hoarding

A disorder is proclaimed when these traits interfere with someone’s ability to function, and simply having some of these traits is insufficient for diagnosis.

Obsessive-Compulsive Personality Disorder

Individuals with Cluster C personality disorders often exhibit nervous and fearful behaviors. This cluster comprises avoidant, dependent, and obsessive-compulsive personality disorders. It is important to distinguish obsessive-compulsive personality disorder from the separate diagnosis of obsessive-compulsive disorder (OCD).

Personality Disorders Cluster C

Robitz, R. (2018, November). What are Personality Disorders? What Are Personality Disorders? https://www.psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders. 

What are Personality Disorders? General summary

Kahn, A. (2018, September 29). Dependent Personality Disorder: Causes, Symptoms, and Support. Healthline. https://www.healthline.com/health/dependent-personality-disorder. 

DPD citation

Marked by social deficits, social anxiety that does not decrease with familiarity, eccentric behavior, bizarre thinking, and odd speech characteristic of schizophrenia.  Often these individuals are preoccupied with superstitious beliefs about the supernatural. 
Though symptoms are very similar to schizophrenia, and often is confused for this diagnosis, the main difference lies in the presence or duration of psychotic episodes. People with schizotypal personality disorder may have brief, not very intense, and infrequent psychotic episodes, unlike in schizophrenia. Another key difference is that those with SPD can be made aware of their eccentricities, whereas it is very difficult to impossible to sway individuals with schizophrenia away from their delusions. 


Schizotypal Personality Disorder

A disorder marked by consistent avoidance of social interaction, a disinterest in others, and flat emotional affect. Very uncommon, it only affects less than 1% of the population. Though symptoms are similar to schizotypal personality disorder and schizophrenia, those with schizoid personality disorder have not lost touch with reality (no hallucinations or delusions), and their speech is coherent and rational. Also, these individuals are not anxious about their lack of social contact, unlike in schizotypal personality disorder. 

Schizoid Personality Disorder

As the name implies, this disorder is characterized by paranoia and distrust. It is also characterized by excessive sensitivity to failure, tendency to hold grudges, aggressive sense of complacency, excessive self-restraint, and the belief of conspiracy theories. Individuals with this diagnosis cannot have their cognition explained by delusional disorder or schizophrenia. PPD is not psychosis, as the patient has not lost touch with reality. 

Paranoid Personality Disorder

As the name implies, this disorder involves having a grandiose sense of self-importance. In addition to having an egocentric world view, associated symptoms include a hankering for attention, troubled relationships, and lacking empathy for others. However, often, those with this disorder truly have a low and fragile self-esteem, using their narcissism as a coping mechanism. Criticism is not handled well, and most problems are projected to being the faults of others to avoid damage to this ego. 

Narcissistic Personality Disorder

Characterized by extreme attention-seeking behavior, individuals with this disorder have a distorted self-image that requires the approval of others. Often these individuals will act in bizarre or promiscuous ways to get the attention they crave. Symptoms include excessive concern over personal appearance, discomfort unless the center of attention, easily influenced by others, act rashly, have difficulty maintaining relationships, and self-absorption. 

Histrionic Personality Disorder

Dependent Personality Disorder

Borderline Personality Disorder (BPD) is primarily defined by a pervasive pattern of instability across interpersonal relationships, self-image, and mood, combined with significant impulsivity. Individuals with this disorder often experience intense emotions and may engage in frantic behaviors to manage their profound fear of abandonment.

Borderline Personality Disorder

Otherwise known as Cluster C personality disorder, this disorder is characterized by extreme shyness, socially inhibited behavior, feelings of inadequacy, and fear of rejection and criticism. To avoid rejection, a pattern of avoidance is displayed, resulting in social isolation. Often, this disorder coincides with social anxiety disorder. Some symptoms include anhedonia (lack of enjoyment in activities), social anxiety, avoiding social situations (like conflict and relationships), feelings of inadequacy, and constant fear of disapproval.

Avoidant Personality Disorder

Marked by the consistent lack of regard for the rights of others and social norms. Often, people with this disorder can be deceitful and lacking remorse. Modern diagnoses consider this disorder to be related to psychopathy and sociopathy. To be diagnosed with ASPD, someone must be older than 18. 
- Sociopathy
- Psychopathy

Antisocial Personality Disorder

OCPD is a common personality disorder that is prevalent in about 2.1 to 7.9% of the general population. Men are twice as likely as women to be diagnosed with OCPD.

Prevalence of OCPD

A key difference in OCPD and OCD is that OCPD is considered ego-syntonic and people with OCPD do not see their behavior and preoccupation as problematic, whereas OCD is ego-dystonic and people with OCD are acutely aware of how their affliction harms them.

Another difference includes that the underlying motivations behind obsessive-compulsive behaviors. Those with OCPD aim to have control over the environment, whereas individuals with OCD engage in compulsive behaviors to mitigate distress from obsessions. 

Differences between OCPD and OCD

Individuals with an ego-syntonic disorder have symptoms that align with their worldview and thus do not believe their thoughts and behaviors are detrimental to themselves or are inappropriate.

Ego-Syntonic

Obsessive‐compulsive personality disorder (OCPD) has historically been understudied. However, links between physical health outcomes and OCPD/OCPD traits have been documented.

Long‐term physical health outcomes of
obsessive‐compulsive personality disorder traits

- Psychodynamic psychotherapy
- Cognitive-behavioral therapy
- Medication

Treatment of OCPD

Some of the goals of radically open dialectical behavior therapy (RO DBT) that differ from traditional dialectical behavior therapy (DBT) include:
- Encourage independence of action and opinion, emphasize self-enquiry and self-discovery
- Primary therapeutic focus is external: social-signaling, openness, and social connectedness skills
- Teach clients to increase openness, flexible responding, enhance social connectedness, and vulnerable expression of emotion
- Emphasize self-enquiry and self-discovery rather than impulse control
- Target bio-temperament with specific skills via activation of neural substrates

Goals of Radically Open Dialectical Behavior Therapy

- Developed for overcontrolled clients with cluster A and C personality styles
- Used to treat avoidant, obsessive compulsive, paranoid and schizoid personality disorders, but also chronic depression and anorexia nervosa
- Used for clients with avoidant attachment styles
- Core problems of clients include social signaling deficits, low openness, and aloofness

Purpose of Radically Open Dialectical Behavior Therapy

A manager is described by their employees as being extremely rigid. They insist that every project must follow a precise, multi-step process, often getting so lost in the details that deadlines are missed. The manager rarely delegates important tasks, believing that no one else can meet their high standards. They sacrifice evenings and weekends for work, not because of a heavy workload, but due to re-doing tasks to their own exacting specifications. Based on this pattern of behavior, which of the following is the most likely underlying driver?

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