Dependent Personality Disorder 677
preoccupied with fears of being left to care fo r themselves (Criterion 8). They see themselves
as so totally dependent on the advice and help  of an important other person that they worry
about being abandoned by that person when ther e are no grounds to justify such fears. To be
considered as evidence of this criterion, the fears must be ex cessive and unrealistic. For ex-
ample, an elderly man with cancer who moves into his son’s household for care is exhibiting
dependent behavior that is appropriate given this person’s life circumstances.
Associated Features Supporting Diagnosis
Individuals with dependent personality diso rder are often charac terized by pessimism
and self-doubt, tend to belittl e their abilities and assets, and may constantly refer to them-
selves as “stupid.” They take criticism and disapproval as proof of their worthlessness and
lose faith in themselves. They may seek ov erprotection and dominance from others. Oc-
cupational functioning may be impaired if in dependent initiative is required. They may
avoid positions of responsibility and become anxious when faced with decisions. Social re-
lations tend to be limited to those few people  on whom the individual is dependent. There
may be an increased risk of depressive disorders, anxiety disorders, and adjustment dis-
orders. Dependent personality disorder often co-occurs with other personality disorders,
especially borderline, avoidant, and histrion ic personality disorders. Chronic physical ill-
ness or separation anxiety disorder in childhood or adolescence may predispose the indi-
vidual to the development of this disorder.
Prevalence
Data from the 2001–2002 National Epidemio logic Survey on Alcohol and Related Condi-
tions yielded an estimated prevalence of depe ndent personality disorder of 0.49%, and de-