Letters to the Editor
Dependent Personality Disorder as a Marker of “Battered Husband Syndrome”: A Case Exemplar
Dear Editor:
I describe the case of a male victim of a female spouse batterer.
Case Report
The phenomenon of husband battering is a not uncommon occurrence that tends to be ignored, dismissed, or selectively attended to. Why men do not report their victimization and why they stay in abusive situations are well-documented (1), if not often documented because of deeply ingrained myths regarding both the potential for, and incidence of, violence in women and the vulnerability of men to such victimization—myths that have led to gross underestimation of the high rates of female perpetrators in abusive families (2).
Dependency has been documented as a risk factor for becoming a victim of spousal abuse (3). This is understandable, given both the characteristic features of dependent personality disorder (for example, submission and over- compliance to the wishes of others to maintain an overwhelming need for support and security and to avoid abandonment) and the associated or comorbid characteristics of the disorder (for example, generalized anxiety and depression, with their associated configuration of such symptoms as low self-esteem and a weak and fragile self-image) (4,5).
Gudjonsson developed a psychometric questionnaire–scale to assess an individual’s susceptibility to complying with the demands of police interrogators (6). The personality characteristics measured by this instrument (for example, eagerness to please and avoid confrontation, along with fear and apprehension when in the company of people making demands and difficulties in coping with pressure) were found to be closely related, if not conceptually identical, to Millon’s conceptualization of dependent personality disorder (4), which in turn has been espoused as conceptually related to the DSM-IV-TR criteria for the disorder (5). Gudjonnson has shown that psychological characteristics such as elevated suggestibility (or being easily persuaded), hypercompliance, unassertiveness, low self-esteem, and anxiety proneness—all of which are features or associated features of dependent personality disorder—can render individuals so vulnerable to psychological pressure and coercion that they will falsely confess to having committed a crime when pressured to do so by police interrogators (7).
Within the context of a legal dispute, a 57-year-old man who was a store manager and retired, pensioned autoworker with a Grade 12 education, was referred by his lawyer for examination to determine his susceptibility to involuntarily succumbing to psychological pressure and coercion. Upon separation from his common-law spouse, he was intimidated and coerced by her into signing an agreement that included giving up his financial assets to her (for example, his house and pension). During their relationship, she was controlling, critical, and violent (for example, at one point, she hit him over the head with a broom handle with such force that the handle broke). She micromanaged his behaviour and assailed him when his assigned list of weekly chores were not done to her exact specifications (for example, cutting up the vegetables in a particular way when doing his assigned cooking chore). He had no safe place in his house, although at times he attempted to protect himself from her onslaughts by barricading himself in a room with a sofa that he could push up against the door. His spouse behaved well when socializing with others, however, and was also quite pleasant to him between abusive episodes. He never told anyone about the abuse, owing to the embarrassment of being a male victim of a female spouse batterer. The abuse continued following the separation and he had to have his telephone calls blocked and to obtain a restraining order.
The patient’s developmental history included a substantial amount of verbal and physical abuse directed at both himself and his father by his mother (in one incident, for example, his mother went after his father with a paring knife).
The results of psychometric examinations of the patient’s fluid intelligence according to the Test of Nonverbal Intelligence-Third Edition (TONI-3) and psychological status according to the Millon Clinical Multiaxial Inventory-II (MCMI-II), the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), and the Personality Assessment Inventory (PAI) indicated that the patient was somewhat cognitively limited (that is, within the low average range), that he was suffering from a dependent personality disorder in association with generalized anxiety and dysthymia, that he displayed an unassertive and hyperacquiescent interpersonal style, and that he possessed a poor self-concept with limited personal resources for coping with problems and stresses.
This case provided a pellucid illustration of how the presence of a specific diagnosable psychological disorder; namely, dependent personality disorder, can be a marker or significant risk factor for becoming a victim of interpersonal abuse, especially when combined with some of the disorder’s comorbid conditions.
References
1. Steinmetz SK. The battered husband syndrome. Victimology: An International Journal 1978;2:499–509.
2. Biller HB. The battered spouse may be male. Brown University Child and Adolescent Behavior Letter [serial online] March 1995.
3. Bornstein RF. The dependent personality. New York: Guilford Press; 1993.
4. Millon T, Davis RD. Disorders of personality: DSM-IV and beyond. New York: John Wiley and Sons; 1995.
5. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Text revision. Washington (DC): APA; 2000.
6. Gudjonsson GH. Compliance in an interrogative situation: a new scale. Pers Individ Diff 1989;10:535–40.
7. Gudjonsson GH. The psychology of interrogations, confessions and testimony. Chichester (UK):Wiley and Sons; 1992.
Larry C Litman, PhD, CPsych, FACAPP, FPPR, FSMI, FICPP, FSICPP
London, Ontario
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