Diagnostic validity of the passive-aggressive personality disorder: suggestions for reform

Numerous problems have plagued the diagnosis of the passive-aggressive (P-A) personality disorder. Based on criteria established to evaluate the functional utility of diagnostic categories, the P-A personality disorder does not appear to be an adequate psychiatric diagnosis. However, the concept of passive-aggressiveness may be retained as a useful psychiatric construct when viewed from a dimensional rather than a categorical perspective. A model is presented that describes passive-aggressiveness as consisting of five interrelated psychological factors: rigidity, resentment, resistance, reactance, and reversed reinforcement. This interactive model provides a more detailed and richer description of the P-A style than what is captured in the current diagnostic nomenclature. It is hoped that the model's characterization of P-A in concrete and testable terms will facilitate research into the utility of the passive-aggressiveness construct.