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Passive Aggressive Personality Disorder

What is passive aggressive personality disorder?

People who have passive aggressive personality disorder (PAPD) seem to go along with what people want even though it upsets them. They tend to see others as nosy, demanding, and pushy. They do not express feelings directly, but instead find indirect ways to try to punish or control others.

This disorder usually starts in the early adult years.

What is the cause?

The cause of this disorder is not known. Experts think it may be caused by chemical differences in the brain or nervous system. It might also be related to problems in the family such as abuse, financial stresses, death of loved ones, or mental illness.

What are the symptoms?

People who have this disorder:

  • tend to be sullen and contrary without actually disagreeing
  • put things off or deliberately do them wrong
  • avoid responsibility by blaming others or claiming that they forgot
  • are easily offended and complain regularly
  • may be enthused for a short time, but then go back to being dissatisfied, critical, and envious
  • are often resentful
  • feel angry often but do not express it openly
  • may appear to be pleasantly social but then make critical or cruel comments
  • resist suggestions or help from others

How is it diagnosed?

Your healthcare provider or therapist will ask about your symptoms and examine you. He or she may also:

  • ask about your relationships with family, friends, and co-workers
  • suggest lab tests to rule out medical problems
  • make sure medicines are not causing or increasing your symptoms
  • rule out other mental health problems.

You may be asked to complete a personality test.

How is it treated?

Several kinds of therapy may be helpful:

  • psychotherapy
  • group therapy
  • cognitive-behavior therapy (CBT)

Psychotherapy can help you see yourself more clearly. It helps you understand the reasons for your behavior and to recognize the effects of your behavior on others. This can help you change behaviors that get in the way of living a satisfying life. Cognitive behavioral therapy (CBT) is a way to help you identify and change thoughts you have that are not realistic. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new thought and behavior patterns.

Medicine is not used to treat this disorder, but may help if you also have problems with anxiety or depression. You may be hospitalized if you are suicidal.

When should I seek help?

If your symptoms are seriously interfering with your daily life, seek help from your healthcare provider or a mental health professional. Treatment can make a big difference in the quality of your life. Without treatment this disorder will be lifelong.

Patient handouts provided by Merck Medicus. Copyright © 2012-2013 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.