Immature personality disorder

Diagnosis

Immature personality (321) appeared as a personality trait disturbance in the first edition of the DSM, separate from personality disorders. In DSM-II it became a type specifier for Other personality disorder (301.89), remaining unchanged in DSM-III, and does not appear in later editions. The ICD listed it as Immature personality (321) in ICD-6 and ICD-7; ICD-8 introduced Other personality disorder (301.8) with immature as a specifier, which continued through ICD-9 and ICD-10, but the specifier was removed in ICD-11.

Mechanics

The underlying mechanism was explained either as fixation—certain character patterns persisting from childhood—or as a regressive reaction due to severe stress. Poor emotional control requires quick mobilization of defense, usually explosive, for ego protection. In dependency there is a predominant child-parent relationship; the morbid resentment of the aggressive type results from deep dependency hidden by reaction formation. IPD involves ego weakness limiting impulse restraint and anxiety modeling, and can be caused by neurobiological immaturity of brain functioning, childhood trauma, or other means.

Epidemiology

Determining prevalence in the general population is difficult because the disorder has not had a separate diagnosis since World War II. As part of Other personality disorder, it can be estimated as a fraction of 1.6% in the United States and 2.4% in Denmark. A Russian study of military age persons in the Tomsk region between 2016 and 2018 found that 3.6% of recruits could be diagnosed with immature personality disorder.

Society and culture

Immature personality disorder was frequently cited by the Roman Catholic Church during the 1980s to justify annulling marriages that were no longer wanted. In 1978, David Augustine Walton of Barbados was tried for murdering two strangers who had offered a ride to his mother and girlfriend; his defense of diminished capacity due to the disorder failed, and he was convicted. A 1989 discrimination lawsuit from a former Wisconsin Department of Transportation employee, who claimed he was fired because of immature personality disorder and a fetish involving placing chocolate bars under female drivers being tested, was thrown out.

A 1994 Australian benefits case ruled that while personal dislike of a job is irrelevant, a condition like this can block otherwise viable work options. A 2017 study documented a case where a person with immature personality disorder was permitted to die under Belgian euthanasia laws, which require a lifelong medical condition that harms well-being.