Prevalence
Data and Gender Issues
Zimmerman and Coryell (1990) cite overall
prevalence
data for Dependent Personality Disorder as 1.7% with equal
distribution between males and females. Bornstein (1993) cites
the prevalence of
Dependent Personality Disorder as 21% in psychiatric inpatients and as
having the highest prevalence (8%) among Axis II disorders based on a
1983 community sample (pp.127-128). In Bornstein's comparison of
prevalence studies he found that the base rate of Dependent Personality
Disorder is much higher in women (11%) than in men (8%), (p.130).
These gender differences may be based on real differences in the
prevalence for women, however, some postulate they are due to bias on
the part
of
the clinician and/or in the diagnostic criteria themselves.
Anderson, Sankis, and Widiger (2001) note that the
authors of each edition of the DSM have been overwhelmingly male, 78%
for the DSM-IV. They believe that it may be possible that these
committees
unconsciously pathologized those traits associated with femininity over
those associated with masculinity (p.661). Anderson, Sankis and Widiger
further found that there was a
"significant difference across gender in the frequency of dependent
criteria but not in pathology" (p.666). This can be interpreted
to mean that clinicians may expect to see pathological levels of
dependency more often in women, but see it as equally maladaptive in
either gender.
Interestingly, Bornstein (1993) in his
summation of
numerous studies on dependency found that women self-report much higher
levels of dependency than men. However, when projective measures
are used, the levels are nearly equivalent (pp.46-47). Bornstein
notes that this is most likely due to the high face validity of
self-report measures, men are generally socialized to be less open to
acknowledging dependency, especially on a potentially pathological
level. Further, socialization patterns tend to support women
overtly expressing their dependency needs versus an indirect expression
in men; the former being reflected in the make up of most self-report
measures (pp.47,50).
Although studies have been inconclusive as to
whether the gender difference in diagnosis of Dependent Personality
Disorder is a true reflection or due to bias, it seems that the DSM
criteria "appear to be gender neutral with respect for their
implications for maladaptivity" (Anderson, Sankis, and Widiger, 2001,
p.668). There are two ways to interpret this finding; firstly it
may be the way in which clinicians apply the DSM criteria. The
more probable answer is that Dependent Personality Disorder simply
occurs more often in women. Research to determine why women
suffer from this and other disorders at a higher frequency than men is
needed.