Based on 28 clinical cases, clinical characteristics, causative factor, and therapeutic approach of passive aggressive personality disorder were identified.
Diagnosis of the passive-aggressive personality disorder was not so easy in initial evaluation. Two third of initial diagnosis was wrong because of various superficial manifestations; such as depression, borderline personality disorder,
alcoholism,
and
even schizophrenia. Successful and correct diagnosis could be made by understanding of dynamic meaning of manifested behavior.
Initial problematic behavior.
Initial problematic behavior was observed in late adolescent period; late junior and early high school period. In their clinical course, four stages could be identified; the submissive phase, the frustration phase, the submissive phase, the
frustration
phase, the procrastination phase and the acting-out phase.
Most of them was grown up in the successful and upper or middle class family. Two characteristic parental attitude toward the patient could be crystalized. One is early overprotection and later overconcern, in which the patients are easily
frustrated by
their parental demands because they have no ability to cope with hardship . The other is continuous parental abuse, physically or emotionally, of the patients since early childhood, in which the patients' aggression are manifested by passive way.
In all cases, parental overconcerns and demands with frequent abuse are closely related to parental educational fever which press the patients to study hard. Recently, this passive aggressive behavior has become numerous in number and serious
family
problem. By such a reason, the passive aggressive personality disorder could be proposed as a culture bound syndrome of young people in Korea.
As a therapeutic process of the passive aggressive behavior, the authors proposed three stages. The first stage is "focusing" in which precipitating situation of the behavior was identified. The second stage is :defocusing" in which parents try
not
to
concern and demand the desirable behavior from the patients and finally neglect patients' passive aggressive behavior. The third stage is insight therapy for the patients. This three stage appraoch was crucial in successful treatment.
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