| Self-defeating personality disorder | |
| Synonyms: | Masochistic personality disorder |
| Specialty: | Psychiatry |
| Complications: | Dysthymia, major depressive episode |
| Onset: | Early adulthood |
| Risks: | Family history, abuse |
| Differential: | physical, sexual or psychological abuse, major depressive disorder |
Self-defeating personality disorder (also known as masochistic personality disorder) was a proposed personality disorder. As a descriptor for "Other personality disorder" it was included in the DSM-III in 1980.[1] . It was discussed in an appendix of the revised DSM-III-R in 1987,[2] but was never formally admitted into the manual. The distinction was not seen as clinically valuable because of its significant overlap with other personality disorders (borderline, avoidant and dependent).[3] Both the DSM-III and DSM-III-R separated the condition from sexual masochism.[1] [2]
It was entirely excluded from the DSM-IV. Since the DSM-5, the diagnoses other specified / unspecified personality disorder have mostly replaced its use.[4]
Self-defeating personality disorder is:
A) A pervasive pattern of self-defeating behavior, beginning by early adulthood and present in a variety of contexts. The person may often avoid or undermine pleasurable experiences, be drawn to situations or relationships in which they will suffer, and prevent others from helping them, as indicated by at least five of the following:
B) The behaviors in A do not occur exclusively in response to, or in anticipation of, being physically, sexually, or psychologically abused.
C) The behaviors in A do not occur only when the person is depressed.[2]
Historically, masochism has been associated with submissiveness. This disorder became politically controversial when associated with domestic violence, which was considered to be mostly caused by males.[5] However, a number of studies suggest that the disorder is common.[6] [7] In spite of its exclusion from DSM-IV in 1994, it continues to enjoy widespread currency amongst clinicians as a construct that explains many facets of human behaviour.[5]
Theodore Millon has proposed four subtypes of masochist. Any individual masochist may fit into none, one or more of the following subtypes:[8]
| Subtype | Description | Personality traits | |
|---|---|---|---|
| Virtuous masochist | Including histrionic features | Proudly unselfish, self-denying, and self-sacrificial; self-ascetic; weighty burdens are judged noble, righteous, and saintly; others must recognize loyalty and faithfulness; gratitude and appreciation expected for altruism and forbearance. | |
| Possessive masochist | Including negativistic features | Bewitches and ensnares by becoming jealous, overprotective, and indispensable; entraps, takes control, conquers, enslaves, and dominates others by being sacrificial to a fault; control by obligatory dependence. | |
| Self-undoing masochist | Including avoidant features | Is "wrecked by success"; experiences "victory through defeat"; gratified by personal misfortunes, failures, humiliations, and ordeals; eschews best interests; chooses to be victimized, ruined, disgraced. | |
| Oppressed masochist | Including depressive features | Experiences genuine misery, despair, hardship, anguish, torment, illness; grievances used to create guilt in others; resentments vented by exempting from responsibilities and burdening "oppressors". |