Passive-Aggressive Personality Disorder | The Lost Personality Disorder

welcome to my scientifically informed insider look at mental health topics if you find this video to be interesting or helpful please like it and subscribe to my channel well this is dr. grande today's question asks what was passive-aggressive personality this word and I've also had some other questions about the same construct like what is passive-aggressive personality and some want to know kind of what the history was behind the personality disorder and why we no longer have it here in the DSM today so the term passive-aggressive was first used clinically speaking during World War two and it was used to describe soldiers who refused to comply with the orders of officers but the construct of passive aggressive actually existed before that and it was really central to some of the clinical theory that we saw from that time period passive aggressive behavior has been shown to undermine successful treatment so if somebody has another disorder like a major mood disorder like depression passive-aggressive behavior can get in the way of that disorder being treated so the construct is important but of course the personality disorder is no longer in the DSM and I'm going to explain that history and then I'm going to explain one of the models of passive-aggressive behavior that I think is particularly useful in terms of understanding how it works so to understand passive-aggressive person dies or derpy APD we have to go back to the very first Diagnostic and Statistical Manual the DSM that was released in 1952 in that edition of DSM we saw that passive-aggressive person I swear was really conceptualized as having three types passive dependent which was somebody who is helpless indecisive and clingy this eventually became dependent personality disorder which is currently in the DSM it's a cluster C personality the next type was the passive-aggressive type which was pouty stubborn inefficient and prone to procrastination and obstruction we also saw an aggressive type and here we saw behaviors like being irritable destructive and resentful now this aggressive type was thought to still have a dependency factor to it so this is what differentiated the aggressive type from antisocial personality now the features of the passive-aggressive type in the aggressive type were merged together in DSM 2 which came out in 1968 and here we saw the PAPD symptoms included obstructionism pouting procrastination intentional inefficiency and stubbornness and each of these were thought to reflect hostility that the individual was unable to express openly so that's how the pathology was conceptualized for PAPD in 1968 now moving to the DSM 3 which came out in 1980 and here's where things really started to change for this particular personality disorder we see that in 1980 the workgroup member so these are the people to decide if a disorder is to stay or go we see that they were really kind of having difficulty with this disorder whose controversial at that time although technically of course that was retained in 1980 in DSM 3 but of course there still were a lot of criticisms the passive-aggressive symptoms reflected a specific behavioral response that was to particular situations rather than a broad personality syndrome which is how the other personalities workers were conceptualized so again it was retained by clinicians could only diagnose PAPD if a client did not meet the criteria for any other personality disorder so really in DSM 3 things weren't looking too good for PAPD now interestingly with DSM 3r which came out in 1987 the criteria for PAPD were expanded to include more negative emotional features like sulking irritability and argumentativeness and in addition to the changes here the irritability we also saw that the exclusion criterion was dropped so clinicians now could diagnose PAPD even if the Krait for another person a sorter were met so in 1987 look like maybe passive-aggressive precise order was making a bit of a comeback but it was short-lived in the dsm-4 which came out in 1994 the diagnostic criteria were expanded even more the disorder was renamed negativistic person a nice word and it was also put in the appendix of that version of the DSM so is labeled for further study and this was really the end of passive-aggressive personality it really ended in 1994 for all intents and purposes so we see the passive-aggressive person I sought her had kind of a shaky run started off strong in the original DSM and then by DSM 4 it was essentially gone so what happened here we see the passive-aggressive personality is a real thing so why couldn't the disorder stay in the DSM while there were a number of problems the disorder had not received will have acceptance in clinical literature so people that were researching the disorder really weren't satisfied with it the definition was too narrow and behavioral passive-aggressive was too situational did not appear to reflect a syndrome the definition of PAPD seemed to involve motivation during a time and personality disorder criteria were really just descriptive so in order to diagnose PAPD a clinical inference was required again that just wasn't popular during this time for personality sores also this disorder overlapped quite a bit with other person a sorter so we see a number of problems that really seemed to cause the demise of this particular personality disorder another possible cause for the demise of PAPD was that that negativistic part was added and that really made it to the person a sorter they're not hold together as well so if they had kind of left the negativistic pieces away from PAPD it may still be around today so again there are a lot of factors that go into this including the personalities of the people trying to decide whether to keep a personality swear or not so we see a lot of different opinions in different directions and PAPD just didn't make it past really DSM three are again being moved to the appendix in DSM for the solve course is fairly interesting because passive aggressive behavior is narrow and behavioral but it's understood in critical theory to be driven by relatively stable personality dynamics so it does kind of seem like a good candidate for being a personality sorter and there are still a number of experts that believe it still really is a personality sorter even though it's not technically the diagnosis that it still exists in the form that it was described years ago so even though the personality disorder is gone we know that there are many consequences to having passive-aggressive personality I mentioned before it's linked to poor response of treatment for other disorders we know that it seems to be related to issues around autonomy we see that it's associated with high levels of neuroticism manipulative Ness aggression and lower levels of agreeableness and conscientiousness so passive-aggressive personality still exists it's not recognized as a disorder but we can still study it and kind of see how these symptoms are manifested and we can also see that appears to overlap a lot with other percentage sorters so as we kind of study passive-aggressive personality you can see how again it's in the population we can observe it but it does seem to have this problem of running into the territory of other personality sorters so this brings me to looking at five different factors that appear to be related to passive-aggressive behavior and of course they're also related to each other in a specific way which I'll talk about when I'm finished describing these five factors so these five factors related to passive-aggressive behavior include rigidity resentment resistance reactance and reversed reinforcement so they all begin with the letter R so the first factor rigidity we see here someone who's inflexible maladaptive stubborn authoritative and dogmatic so they believe that things should be done in a certain way so again we know this exists we know that some people are rigid but of course this has a lot of overlap with obsessive-compulsive personality which of course is a cluster C personality sorter moving to resentment we see anger irritability being cynical skeptical low on trust also having jealousy paranoia and having shame over expressing anger and having a lot of anger turned inward so again we know all these characteristics exist when no resentment exists but we can see a lot of overlap we see with the sceptical well on trust and paranoid characteristics those relate to paranoid personality we see the anger and irritability and to some extent being cynical seem to have a relation to antisocial personality and of course jealousy has an association with narcissistic personality or so a number of personality suitors there seem to be in that same area of resentment as it's defined here as it's related to passive-aggressive behavior the next factor is resistance and here we see low self-esteem theory is that somebody's too weak to directly express dissatisfaction so at this resistance piece people reject useful advice and they're inactive so they just refuse to do any work or engage in activity and they have oppositional attitudes toward Authority which of course we see with antisocial personality disorder although it's not specifically listed as a characteristic of that disorder we know it's an associated characteristic so moving to reactance here we see procrastination and really reactance occurs because somebody believes that one of their behavioral options is being threatened so the range of options they have available is being restricted and this causes this reactance so for example somebody could agree to cooperate to help you on a project and then back out at the last moment this is really classic reactance as it relates to passive aggressive behavior what this does is other than being frustrated for the other person as it restores an individual's perceived freedom of choice so their sense of control is taint so by offering to be helpful by offering to cooperate with people and then pulling back at the last second they're holding on to control so this leads me to the last factor which is reversed reinforcement so what's happening here is that normally when problems occur this causes a feeling of distress so for people who aren't passive-aggressive something goes wrong they feel distressed but with reversed reinforcement when something goes wrong this actually leads to feelings of power and gratification so the somebody's passive-aggressive failure is kind of a good thing emotionally in a sense so for example somebody may agree to do something that they know they're probably not gonna enjoy like you may want somebody to go to a restaurant with you and try some different food so they agreed to do that it turns out badly and then they resent it and they may feel some sort of graphic ation from this resentment so in a sense with reversed reinforcement and passive-aggressive behavior somebody who has this has no way of losing they predict a bad outcome they cause that bad outcome or contribute to it and then they can say they are right all along so it doesn't really leave a way to reach negative emotions so in a sense it may be kind of protective like what we see with narcissistic personality disorder but either way that's the last factor here reversed reinforcement so how do all these factors relate to one another well we see that rigidity and resentment seem to lay the attitudinal and emotional foundation for resistance and reactance and resistance and reactance appear to lead to reversed reinforcement now this isn't a perfect model but I think it explains passive-aggressive behavior in a fairly clever way and a way that I can relate to my clinical experience in dealing with many people who have had passive-aggressive behavior these factors appear to make sense in light of what I've heard described by many people who have passive aggressive behavior so it's important to realize here that even though passive-aggressive personality sorter is gone somebody can still receive treatment for passive-aggressive behavior and of course you can still receive treatment if you've interacted with somebody who has that behavior and it's frustrating you or causing other symptoms in you so just because something is an official personality disorder or mental disorder of some type doesn't mean it can't be the focus of clinical treatment so passive-aggressive behavior is real even though the personality sorter is not really with us anymore and if we see passive-aggressive behavior from a clinical perspective like you're working with somebody in your clinician you may still be able to diagnose them with one or more the other personality sorters again because there's a lot of overlap between the construct of passive-aggressive behavior and the person is orders that are currently available in the DSM so I know whenever I talk about passive-aggressive behavior and personality sorters there gonna be a lot of different opinions if you agree or disagree with me on one of the points I made here in this video or have other opinions please put those in the comments as always I hope you found this description of passive-aggressive personality sorter to be interesting thanks for watching

Channel: Dr. Todd Grande

Views: 134,830

Keywords: passive-aggressive personality disorder, passive-aggressive personality, passive-aggressive, personality disorder, DSM I, DM II, DSM III, DSM IV, DSM-5, rigidity, resentment, resistance, reactance, reversed reinforcement, inflexible, maladaptive, authoritative, anger, irritability, cynical, skeptical, low on trust, jealousy, self-esteem, mental health, counseling

Id: HUv0eDPWffc

Length: 14min 33sec (873 seconds)

Published: Thu Apr 04 2019