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What is Passive-Aggressive Personality Disorder: Causes, Symptoms, Treatments

What is Passive-Aggressive Personality Disorder?

A passive-aggressive personality disorder is when people express their negative feelings subtly rather than directly. According to the American Psychological Association, it is a long-standing personality disorder in which ambivalence towards others is expressed in the form of underlying negativism and passive aggression.(1)

There is a separation between what they say and what they do.

For example, if a person proposes a plan for any kind of work. The other person opposes it. But, instead of voicing their opinion, they say they agree to it. But as they are actually against the plan, they resist following it. This will make them miss deadlines, turn up late for the meetings, and undermine the plan in other ways.

The common signs of passive-aggressive behavior include:

  • Bitterness and hostility toward parents and other people
  • Intentionally delaying or making mistakes when dealing with other people’s request
  • Having a cynical, pessimistic, and aggressive behavior
  • Frequently complaining about feeling underappreciated or deceived

People with passive-aggressive personalities continue their passive behavior. Depending on the severity of the disorder it can interfere with interpersonal relationships, education, and work.
The Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition, described it as a negative personality disorder.(2)

Causes of Passive-Aggressive Personality Disorder

The cause of passive-aggressive personality disorder remains unclear. It is likely to develop due to the following:

  • Genetics
  • Growing up in an abusive environment
  • Being punished as a child when expressing anger or any negative emotion
  • Disruption of child’s relationship with authority figures such as parents, caretakers, and teachers.

Some can also experience passive-aggressive personality due to any other mental health conditions, such as:

Symptoms of Passive-Aggressive Personality Disorder

A passive-aggressive personality can manifest in a variety of ways. There are a few common symptoms experiences, which include:

  • Not completing the task that was initially volunteered to do
  • Making mistakes intentionally or missing deadlines for projects, tasks, or events
  • Stubborn attitude
  • Not showing up for the meeting, social events, or gatherings purposefully
  • Misplacing documents intentionally to avoid work projects, medical appointments, travel, or family gatherings
  • Being argumentative
  • Constantly complaining about misfortune
  • Alternating between hostility,  and contrition
  • Having an aggressive, pessimistic, and cynical demeanor
  • Acting cold and vindictive to others without any reason
  • Having a feeling of inadequacy and low self-esteem
  • Blaming others for one’s own feelings and actions

How is Passive-Aggressive Personality Diagnosed?

There is no specific way to diagnose passive-aggressive personality as it is not an actual medical condition.

A psychologist, a doctor, or a psychiatrist can help people identify their destructive behavior and patterns. They may use assessment tools to diagnose any other mental health condition if present along with the passive-aggressive disorder.

There may be a questionnaire to have a better understanding of an individual. It may include the questions regarding a person’s:

  • Suicidal thoughts
  • Emotional awareness
  • Perceived general personality traits and behaviors
  • Daily interactions, roles, and relationships
  • Feeling of hopelessness
  • Interpersonal values
  • Having a personal or family history of any mental health disorder or condition
  • Sensitivity to interpersonal behaviors
  • Ability to maintain healthy relationships
  • Substance use or abuse
  • Ability to function in everyday life
  • Social cognition and awareness

Treatment of Passive-Aggressive Disorder

If there is any other mental condition present with passive-aggressive personality disorder, a combination of therapy and medication is chosen by the mental health professional.

Commonly used therapy and medication for passive-aggressive personality disorder include:

  • Mood stabilizers
  • Attention deficit medications
  • Anti-anxiety medications
  • Harm reduction therapy
  • Antipsychotics
  • Cognitive behavior therapy
  • Peer support or group therapy
  • Inpatient or community-based substance abuse programs

Therapies that are used in the treatment of other personality disorders or any other mental health condition can be useful in treating passive-aggressive personality disorder.

During the treatment, the psychologist can help the person learn how to identify and address negative emotional and behavioral patterns.

The goal of the treatment is to:

  • Increase self-esteem and self-efficacy
  • Improve a person’s ability to express negative emotions
  • Developing neutral feeling towards others
  • Having realistic expectations of oneself, others, and interpersonal relationships
  • Improving the sense of self-control and reducing hopelessness
  • Eliminating suicidal thoughts if present
  • Identifying the cause of this behavior and trying out how to solve them and move ahead

A passive-aggressive personality disorder is having negative thoughts and feelings that contradict what a person says or does. If someone thinks they have it, consulting a healthcare provider as early as possible is better. Working out with a counselor can help develop coping strategies for a satisfying life.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:May 29, 2021

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