Passive–aggressive personality disorder

Passive–aggressive personality disorder (PAPD), also known as negativistic personality disorder, is a personality disorder characterized by a pervasive pattern of negativistic attitudes and passive resistance to demands for adequate performance in social and occupational situations. This disorder was once classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM), but in the current edition, DSM-5, it is no longer listed as a distinct personality disorder. However, traits of passive-aggressive behavior can still be found under other personality disorders, including Personality Disorders Not Otherwise Specified.

Symptoms and Characteristics

Individuals with passive–aggressive personality disorder often exhibit a pattern of passive resistance to expected work, opposition, sullenness, stubbornness, and negative attitudes in response to requirements for normal performance levels expected by others. These behaviors are often justified by the individual as a defense against what they perceive as unreasonable demands or expectations from others.

Common characteristics include:

• Procrastination and intentional mistakes in response to others' demands
• A pervasive pattern of criticism of others, often while denying their own inadequacies
• A sense of personal aggrievement and unjust treatment
• Avoidance of direct confrontation
• Frequent complaints about feeling underappreciated or cheated

Diagnosis

The diagnosis of passive–aggressive personality disorder was more common when the disorder was included in previous versions of the DSM. With its removal, mental health professionals now tend to diagnose individuals exhibiting these behaviors with other personality disorders, particularly those that include features of negativism or oppositionality. Diagnosis involves a clinical assessment, including a detailed interview and, when appropriate, collateral information from family or friends.

Treatment

Treatment for individuals showing passive–aggressive behaviors focuses on improving social and interpersonal functioning. This may include:

• Psychotherapy, particularly cognitive behavioral therapy (CBT), to help the individual recognize and change problematic thinking patterns and behaviors.
• Group therapy, which can provide a supportive environment to explore interpersonal relationships and behaviors.
• In some cases, medication may be prescribed to address co-occurring issues such as depression or anxiety, though there is no specific medication for PAPD itself.

Controversy and Criticism

The removal of passive–aggressive personality disorder from the DSM has been a subject of controversy among mental health professionals. Some argue that the behaviors associated with PAPD are better understood as symptoms of other disorders, while others believe that the distinct pattern of passive-aggressiveness warrants recognition as a separate disorder. The debate reflects broader discussions about the categorization and diagnosis of personality disorders in general.

See Also

• Personality disorder
• Diagnostic and Statistical Manual of Mental Disorders
• Cognitive behavioral therapy