the Differences Between Antisocial and Passive-Aggressive Personalities - Psychiatry

Dr. Chen Wenke reply Psychiatry

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According to the DSM-IV diagnostic criteria, the descriptions of Antisocial Personality Disorder and Passive-Aggressive Personality Disorder are as follows: Antisocial Personality Disorder is characterized by deceit and manipulation of others, which are core traits of this disorder.
Passive-Aggressive Personality Disorder is primarily characterized by a negative attitude and passive resistance towards the demands of authority figures.
To compare the differences between Antisocial Personality Disorder and Passive-Aggressive Personality Disorder, one can examine four aspects: 1.
Cognition; 2.
Emotionality; 3.
Interpersonal functioning; 4.
Conflict resolution.
The following are the relevant diagnostic criteria: Individuals with Antisocial Personality Disorder exhibit high levels of impulsivity and aggression, rarely considering the negative consequences of their rule-breaking behavior.
They often engage in unplanned criminal acts driven by sudden impulses and lack the ability to learn from their experiences, leading to a cycle of repeated offenses and recidivism.
Other common issues include an inability to tolerate feelings of failure, a lack of social adaptability, and an inability to maintain stable employment.
Research indicates that the prevalence of Antisocial Personality Disorder is about 3% in males and 1% in females, with contributing factors including genetic predispositions and developmental learning experiences.
Factors such as parental loss during childhood, lack of parental discipline, absence of maternal affection, having a parent with Antisocial Personality Disorder, inconsistent or contradictory parental behavior, and children developing habits to attract attention to meet excessive needs may contribute to the formation of Antisocial Personality Disorder.
The fundamental characteristic of Antisocial Personality Disorder is a pervasive pattern of disregard for and violation of the rights of others, which begins in childhood or early adolescence and continues into adulthood.
Antisocial Personality Disorder appears to be associated with lower socioeconomic status and urban environments.
It is more prevalent in males than females, with even higher rates observed in substance abuse treatment facilities and correctional or judicial settings.
When antisocial behavior in adults occurs alongside substance use disorders, a diagnosis of Antisocial Personality Disorder should only be made if symptoms were present since childhood and persisted into adulthood.
If antisocial behavior occurs solely during the course of schizophrenia or manic episodes, a diagnosis of Antisocial Personality Disorder is not appropriate.
A diagnosis can be established if three or more of the following behaviors are present, typically after the age of eighteen, although symptoms of conduct disorder before age fifteen are necessary for this diagnosis: 1.
Failure to conform to social norms, often operating on the fringes of the law.
2.
Lack of morality, conscience, and cold indifference, even when witnessing the suffering of others.
3.
Frequent lying and deceit for personal gain.
4.
Impulsive personality with an inability to make long-term plans.
5.
Emotional instability and aggression, often resulting in physical altercations.
6.
Indifference to personal and others' safety, such as reckless driving.
7.
Lack of professionalism and irresponsibility at work, such as writing bad checks.
The diagnosis of Passive-Aggressive Personality Disorder has generated some controversy due to two main reasons.
First, there is conceptual ambiguity, as a person can be viewed as both passive and actively aggressive, which are seemingly opposing behaviors.
Second, there is limited empirical support for the reliability and validity of this diagnosis (Penna, 1986).
Patients with this disorder typically express hostility in indirect and non-violent ways, such as intentional delays, procrastination, sulking, forgetfulness, stubbornness, pouting, and refusal to cooperate.
Individuals with Passive-Aggressive Personality Disorder appear obstinate, harboring feelings of resentment and dissatisfaction, and are unwilling to fully comply with the demands imposed by others.
These behaviors are primarily manifested in their workplace but can also occur in their social relationships.
Their most typical behavior is resentment towards authority figures, accompanied by a lack of decisiveness.
The diagnostic criteria for Passive-Aggressive Personality Disorder are as follows: 1.
The behavior begins before early adulthood and manifests in various environmental contexts as a pervasive pattern of negative attitudes and passive resistance to reasonable demands from others, with at least four of the following behaviors: 1.
Passive resistance to the performance of routine social and occupational tasks.
2.
Complaining of being misunderstood and unappreciated by others.
3.
Sullen and argumentative demeanor.
4.
Unreasonable criticism and disdain for authority figures.
5.
Expressing envy and resentment towards those who are obviously fortunate.
6.
Complaining excessively about personal misfortunes in an exaggerated manner.
7.
Fluctuating between hostility and contrition.
2.
The behaviors do not occur exclusively during episodes of major depressive disorder and cannot be better explained by a mood disorder.

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Reply Date: 2003/05/10