Book Reviews -- the Dependent Personality by Robert Bornstein
Lewis, Bradley, American Journal of Psychotherapy
Dependent Personality Disorder, a diagnostic category that is only a decade old, is attracting extensive research attention. Robert Bornstein's purpose in writing The Dependent Personality is to review the empirical literature on Dependent Personality Disorder and integrate the findings for a broader perspective on dependency. The amount of research reviewed is staggering (there are 37 pages of references), yet Bornstein still must limit himself to investigations where dependency was directly assessed. His intended audience is developmental researchers, social psychologists, and clinical researchers and his efforts should be a welcome overview for that group. The Dependent Personality will be less helpful to clinicians, however, because, through it all, it teaches us more about the category of Dependent Personality Disorder than about the people who struggle with dependency.
The Dependent Personality begins with a review of theoretical models, particularly psychoanalytic and social learning models, followed by a review of empirical testing methods for dependency. Then there is a discussion of the etiology of dependency and a review of the influence of dependency on social behavior. There is an extensive review on the correlation between dependency and other areas of psychopathology: depression, phobias, alcohol abuse, tobacco abuse, substance abuse, and eating disorders. Bornstein found a strong correlation between dependency and depression, phobias, and smoking. He found inconclusive results for obesity and substance abuse, and, most interestingly, he found counterintuitive results for alcohol abuse. Consistent with Valliant's classic work on alcohol abuse, The Natural History of Alcoholism, Bornstein found that alcoholism seems to cause dependency traits rather than the other way around. There is also a detailed discussion of the category of DPD, a review of dependency and physical disorders, and a review of dependency and patienthood.
The final chapter develops an integrated model of dependent personality disorder. Bornstein concludes that overprotective, authoritarian parenting and rigid sex-role socialization for women are the primary causes of dependency. He leaves some room for the possibility that parental overprotection could be a response to an unusually needful childhood constitution, but his focus is on the environmental causes. Authoritarian parenting and rigid sex-role socialization result in cognitive structures of powerlessness, motivational desires for excess nurturance, extensive help-seeking behaviors, and affective fears of abandonment and failure. Bornstein gives suggestions for further research, particularly in the cognitive structures of dependency. …