Pathological dependency: distinguishing functional from emotional dependency.

Ng and Bornstein (this issue) conclude from their meta-analysis that the DSM assertion that dependent personality disorder (DPD) shows significant comorbidity with anxiety disorders (ADs) appears to be overstated. In this comment it is argued that the DSM assertion may be not overstated. It is reasoned that an increase of 10% ADs associated with the observed average r is not so small, given a number of reasons, including imperfect reliability and validity of assessments, multiple causation of ADs, and incomplete coverage of ADs and DPD by DSM criteria. A plea is made to extend the DSM concept of psychopathological dependency, which is mostly based on functional dependency, with emotional dependency. Based on theoretical, etiological, and empirical arguments it is argued that these forms of dependency should be differentiated from each other. Emotional dependency might constitute a separate risk factor for ADs.