Avoidant Personality Disorder Vs. Dependent Personality Disorders

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Ever found yourself mixing up avoidant and dependent personality disorders? You're not alone. This episode delivers a crystal-clear framework to distinguish between these commonly confused diagnoses—essential knowledge for passing your licensing exam.

Dr. Linton Hutchinson cuts through the complexity to reveal the golden difference: motivation. While both disorders share features like interpersonal difficulties, low self-esteem, and comorbidity with anxiety and depression, they stem from fundamentally different fears. Avoidant personality disorder (APD) is driven by fear of criticism and rejection—these clients believe they're "not good enough" and withdraw to protect themselves. Dependent personality disorder (DPD), however, is fueled by fear of abandonment and self-doubt—these clients cling to relationships because they believe they "can't handle life alone."

Through compelling case studies of Sarah and Mark, Dr. Hutchinson demonstrates how these patterns play out in real life. When relationships end, APD clients retreat further into isolation while DPD clients immediately seek replacements. Treatment approaches differ significantly too: APD therapy focuses on gradual exposure and challenging negative self-beliefs, while DPD treatment emphasizes building self-efficacy and independence. For your exam, remember to identify the core motivation—is the client avoiding potential hurt or seeking someone to depend on?

Whether you're preparing for licensing exams or simply want to sharpen your diagnostic skills, this episode provides the clarity you need. Subscribe now for more clinical insights that will elevate your therapeutic practice and help you pass your exams with confidence!

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This podcast is not associated with the NBCC, AMFTRB, ASW, ANCC, NASP, NAADAC, CCMC, NCPG, CRCC, or any state or governmental agency responsible for licensure.

Episode Transcript

Linton (00:12):
Welcome all you soon-to-be therapists.
I'm Dr Linton Hutchinson, andtoday we're exploringa topic you
need to know Distinguishingbetween avoidant personality
disorder and dependentpersonality disorder.
By now I'm sure you're way deepreviewing for your licensing
exam and you know knowing thedifference between these two

(00:34):
diagnoses might give you justthat extra point to help you
pass the exam.
So listen up.
Both disorders can beparticularly tricky because they
share some common overlappingfeatures.
But don't worry, by the end ofthe next eight minutes you'll
have a clear framework fordifferentiating between them.

(00:57):
Let's start with avoidantpersonality disorder, or APD.
According to the DSM-5-TR, thisdisorder is characterized by a
persuasive pattern of socialinhibition.
This disorder is characterizedby a persuasive pattern of
social inhibition, feelings ofinadequacy and hypersensitivity
to negative evaluation.
The key word here is avoidance.

(01:19):
These clients desperately wantconnection, but fear rejection
so intensely that they alwayswithdraw always withdrawal.
For diagnosis you need at leastfour of the seven criteria,
including avoiding occupationalactivities with significant
interpersonal contact.
Unwilling to get involvedunless sure of being liked.

(01:40):
Restraint in intimaterelationships due to fear of
shame.
Preoccupation with criticism insocial situations.
Inhibition in new interpersonalsituations.
Viewing themselves as sociallyinept or inferior and reluctance
to take any personal risk.

(02:01):
Now, on the other hand,dependent Personality Disorder,
or DPD, presents quitedifferently.
Disorder or DPD, presents quitedifferently.
This disorder involves apersuasive and excessive need to
be taken care of, leading tosubmissive and clinging kinds of
behavior.
The key word here is dependence.
These clients can't imaginethat they could ever function

(02:24):
without somebody else's support.
For DPT you need five of eightcriteria Difficulty making
everyday decisions withoutexcessive advice.
Needing others to assumeresponsibility for major life
areas.
Loss of support.
Difficulty initiating projectsdue to lack of self-confidence.

(02:47):
Going to excessive length toobtain nurturance.
Feeling helpless when alone.
Urgently seeking newrelationships when one ends.
And unrealistic preoccupationwith fears of being left alone.
Remember, both disorderstypically begin in when In early

(03:09):
childhood and are presentedacross various contexts.
In other words, they do it athome, they do it at work, they
do it at school.
Remembering that will beessential for your exam.
It has to occur in manydifferent situations.
Now here's where it gets trickyfor exam takers.

(03:30):
Both disorders share severalfeatures that can cause
confusion.
Both involve significantinterpersonal difficulties and
low esteem.
Both can lead to socialisolation and occupational
impairment.
Both often co-occur withanxiety disorders and depression
.
So if you see an anxietydisorder and depression, you may

(03:54):
be seeing these other diagnosesas well.
And, lastly, both representstable, long-term patterns that
significantly impact functioning, so it's not going to be a
situational, one-off kind ofoccurrence.
The overlap is significant, buthere's where your clinical eye

(04:16):
needs to focus the coredifference and this is golden.
So listen up the key lies in theclient's motivation.
Apd is driven by fear ofcriticism and rejection.
These clients think not goodenough, and if I let people get
close, they'll see I'm a fraudand will probably end up

(04:37):
ghosting me.
Dbt, on the other hand, isdriven by fear of abandonment
and the belief that they cannotcare for themselves.
These clients will think Ican't handle life alone.
I need someone to take care ofme or I'm gonna die.
So here we go.

(04:57):
Apd clients avoid relationshipsunless they are guaranteed
acceptance.
Dpd clients are desperatelyseeking relationships for the
purpose of being taken care of.
When relationships end, apdclients retreat further into
isolation.
They think, well, see, I knew Iwas going to be rejected, I

(05:20):
knew it all along.
And see, it did happen.
Dpd clients do somethingdifferent.
They immediately seekreplacement relationships.
I need someone, I need anybody,and I need them now.
In social situations, apdclients are inhibited and
withdrawn, while DPD clients canbe quite engaging as they seek

(05:46):
support and approval.
Apd clients are capable ofindependence, but choose
isolation to avoid pain.
Dpd clients believe they cannotfunction by themselves or
independently.
Let me give you two cases thatmight bring that home.
Sarah, 28, works from home as afreelance designer specifically

(06:11):
to avoid interactions withcolleagues.
She hasn't even dated becausewhy?
She's positive that she'll berejected.
She has one friend she textsbut rarely sees.
She desperately wantsconnection but fear keeps her
isolated.
When invited to social events,she always has an excuse.
She describes herself asfundamentally flawed.

(06:33):
An excuse she describes herselfas fundamentally flawed.
Then there's Mark.
Mark, 32, recently ended hissixth serious relationship and
immediately jumped on eHarmony,explaining that he can't be
alone.
Despite having worked at Publixat the sushi counter for a
decade and acquired skills thatcould have led to advancement,
he remains in the same positionbecause he believes he requires

(06:56):
continuous oversight.
He constantly agrees withothers' opinions to maintain
their support.
When left unsupervised, hedescribes feeling completely
lost.
Sarah completely shows APD theavoidance, fear of rejection and
self-imposed isolation.
Those are the key things thatyou need to see.

(07:18):
Mark shows DPD his urgent needfor relationships like jumping
back on eHarmony, inability tomake decisions and his fear of
abandonment meet diagnosticcriteria.
Okay, for the licensing exam.
Be aware that treatment approachdiffers significantly.
Apd treatment focus on gradualexposure to social situations,

(07:43):
challenging negativeself-beliefs and building social
skills through role play andbehavioral experiments.
The therapeutic relationshipitself becomes a corrective
experience where the clientlearns that they won't always be
rejected.
Dpd treatments focus ondeveloping self-efficacy and

(08:04):
independence through a series ofgraduated tasks, assertiveness
training and the enhancement ofproblem-solving skills.
The therapist that's you mustcarefully balance support while
encouraging autonomy, avoidingbecoming another figure that the
client excessively depends on.
So think about that, make sureyou don't fall into that trap.

(08:27):
But you probably know that bothof them benefit from what Bingo
, you guessed it that both ofthem benefit from what Bingo,
you guessed it.
Cognitive behavioral therapy.
But the focus and pacing differdepending on the core fears
being addressed.
Okay, and we're sort of down tothe wire for that eight minutes
.
So, if nothing else, rememberthese key differences.

(09:07):
Fear of rejection, avoidsrelationship capable but
withdrawn, self-imp, being alone, are all characteristics of
dependent personality disorder.
When you see questions aboutpersonality disorder, first
thing that you need to do isidentify the core motivations in

(09:29):
the narrative.
If the client is avoidingpotential hurt or are they
seeking someone to be dependenton?
Don't go down the rabbit holeof situation-specific
presentations.
Keep studying, trust yourprocess and if you see these
disorders on your exam, you'llknow exactly how to
differentiate them.

(09:49):
And remember it's in there.