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It is a personality trait marked by a pervasive pattern of negative attitudes and passive, usually disavowed resistance in interpersonal or occupational situations.
It can manifest itself as learned helplessness, procrastination, stubbornness, resentment, sullenness, or deliberate/repeated failure to accomplish requested tasks for which one is (often explicitly) responsible. It is a defense mechanism, and usually only partly conscious.
Passive aggressive behavior was first clinically used in the context of defying authoritative figures. But noncompliance is not indicative of true passive aggressive behavior, which is the manifestation of emotions that have been repressed based on a self-imposed need for acceptance.
In DSM-1 in 1952, the passive-aggressive was defined in a narrow way, grouped together with the passive-dependent. This is similar to the circuitous negativist (see below) where the negativist has dependent features.
Signs of passive-aggressive behavior
The book Living with the Passive-Aggressive Man lists 11 responses that may help identify passive-aggressive behavior. 
- Ambiguity or speaking cryptically: a means of engendering a feeling of insecurity in others
- Chronically being late and forgetting things: another way to exert control or to punish.
- Fear of competition
- Fear of dependency
- Fear of intimacy as a means to act out anger: The passive aggressive often cannot trust. Because of this, they guard themselves against becoming intimately attached to someone.
- Making chaotic situations
- Making excuses for non-performance in work teams
- Victimization response: instead of recognizing one's own weaknesses, tendency to blame others for own failures.
A passive-aggressive person may not have all of these behaviors, and may have other non-passive-aggressive traits.
Diagnostic criteria (DSM-IV Appendix B)
Passive-aggressive personality disorder was listed as an Axis II personality disorder in the DSM-III-R, but was moved in the DSM-IV to Appendix B ("Criteria Sets and Axes Provided for Further Study") because of controversy and the need for further research on how to also categorize the behaviors in a future edition. As an alternative, the diagnosis Personality disorder not otherwise specified may be used instead. The DSM-IV Appendix B definition is as follows:
- A) A pervasive pattern of negativistic attitudes and passive resistance to demands for adequate performance, beginning by early adulthood and present in a variety of contexts, as indicted by four (or more) of the following:
- passively resists fulfilling routine social and occupational tasks
- complains of being misunderstood and unappreciated by others
- is sullen and argumentative
- unreasonably criticizes and scorns authority
- expresses envy and resentment toward those apparently more fortunate
- voices exaggerated and persistent complaints of personal misfortune
- alternates between hostile defiance and contrition
- B) Does not occur exclusively during major depressive episodes and is not better accounted for by dysthymic disorder.
Diagnostic criteria (ICD-10)
It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.
- circuitous negativist - including dependent features
- abrasive negativist - including sadistic features
- discontented negativist - including depressive features
- vacillating negativist - including borderline features
Differential diagnosis: associated and overlapping conditions
Passive aggressive disorder may stem from a specific childhood stimulus (e.g., alcohol/drug addicted parents) in an environment where it was not safe to express frustration or anger. Families in which honest expression of feelings was forbidden tend to teach children to repress and deny their feelings and to use other channels to express their frustration.
Children who sugarcoat their hostility do not grow beyond it. Never developing better coping strategies or skills sets for self-expression, they can become adults who, beneath the seductive veneer, harbor vindictive intent.
Martin Kantor suggests a treatment approach using psychodynamic, supportive, cognitive, behavioral and interpersonal therapeutic methods. These methods apply to both the passive aggressive person and their target victim.
- ↑ 1.0 1.1 Millon, Theodore, Personality Disorders in Modern Life, 2004
- ↑ Scott Wetzler, Ph.D.. "Living with the Passive-Aggressive Man". URL accessed on 2009-03-21.
- ↑ Diagnostic and Statistical Manual of Mental Disorders Fourth edition Text Revision (DSM-IV-TR) American Psychiatric Association (2000)
- ↑ Murphy, Tim and Hoff Oberlin, Loriann: Overcoming Passive Aggression, page 48. Marlowe & Company, New York, 2005
- ↑ Kantor, Martin, Passive-Aggression. A Guide for the Therapist, the Patient and the Victim, Praeger Publishers, Westport, Connecticut 2002
|Cluster A (Odd) - Schizotypal, Schizoid, Paranoid|
|Cluster B (Dramatic) - Antisocial, Borderline, Histrionic, Narcissistic|
|Cluster C (Anxious) - Dependent, Obsessive-Compulsive, Avoidant|
|Level 1 - Pathological|
|Level 2 - Immature|
|Level 3 - Neurotic|
|Level 4 - Mature|
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