Unusually strong assurances of unconditional

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unusually strong assurances of unconditional acceptancePrevalence is about 2.4% and equal in men and womenClinical PictureAwkward and uncomfortable in social situationsSeen as timid, withdrawn or cold and strangeThose close to them know about sensitivities, touchiness, evasiveness and mistrustful qualitiesSpeech is slow and constrained, with frequent hesitations, fragmentary thought sequences, occasional confused and irrelevant digressionLonely and express feelings of being unwantedView others as critical, betraying and humiliatingThey desire close friends, but avoid them because of rejectionDepression, anxiety and anger at oneself for failing to develop social relations are commonPredisposing FactorsNo clear causeContributing factors most likely combo of biological, genetic, and psychosocial influencesInfants with hyperirritability, crankiness, tension and withdrawal behaviors may possess a temperamental dispositiontoward avoidant patternPrimary psychosocial predisposing influence is parental rejection and censure (reinforced by peers)Reared in families in which they are belittled, abandoned, criticized, so that natural optimism is extinguished and replaced with feelings of low self-worth and social alienationLearn to be suspicious and to view the world as hostile and dangerous85
9. Dependent Personality DisorderDefinition and Epidemiological Statistics“A pattern of relying excessively on others for emotional support”Evident in tendency to allow others to make decisions, to feel helpless when alone, to act submissively, to subordinate needs to others, to tolerate mistreatment by others, to demean oneself to gain acceptance, and to fail to function adequately in situations that require assertive or dominant behaviorRelatively common and more common in women than men; more common in youngest children of a familyClinical PictureNotable lack of self-confidence that is often apparent in their posture, voice, mannerismsTypically passive and acquiescent to the desires of othersOverly generous and thoughtful and underplay their own attractiveness and achievementsAppear to others to “see the world through rose-colored glasses”, but alone they feel pessimistic, discouraged, and dejectedOthers don’t know about suffering, they suffer in silenceAssume passive and submissive role in relationshipsWilling to let others make important decisionsFeel fearful and vulnerable because they lack confidence to care for themselves when relationships endMay hastily and indiscriminately attempt to establish another relationship with someone they feel can care and nurture themAvoid positions of responsibility and become anxious when forced into themFeelings of low self-worth and easily hurt by criticism and disapprovalWill do almost anything (even if unpleasant or demeaning) for acceptance of othersPredisposing FactorsInfant can be genetically predisposed

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