Passive-Aggressive Disorder

Passive-Aggressive Disorder Passive-aggressive personality disorder is a psychological condition in which a person may seem willing to carry out a request, but actually reacts negatively and resists passively. The client who is passive aggressive is often cynical, feels under-appreciated, and may be resentful of the demands of others.
Causes
The exact cause of passive aggressive behavior is unknown. However, the following factors are thought to play a role:
Genetics
Environmental Factors
Risk Factors
Abuse or neglect during childhood
Severe punishment
Frequently taken advantage of
Signs and Symptoms
Behavioral
Forgetfulness
Easily offended
Impatient
Suppressed hostility
Stubborn
Resentful
Physical
Intentional procrastination
Deliberate inefficiency
Argumentative
Constantly blames others
Treatment
Psychotherapy- Psychotherapy is the treatment of choice for passive aggressive personality disorder. The main focus during therapy is going back in the clients life and finding out what started this behavior. The therapist will also help the client identify what triggers their behavior.
Medications-
*There are no FDA approved medications to specifically treat passive aggressive behavior. Medications will only be administered to treat symptoms such as anxiety and depression.
Anti-anxiety/Benzodiazepines- Alprazolam (Xanax), Lorazepam (Ativan), Diazepam (Valium)
Antidepressants (SSRIs)- Fluoxetine (Prozac), Paroxetine (Paxil), Sertraline (Zoloft)
Goals of Treatment
Client is patient when dealing with others
Client does not show resentment toward others
Client accepts responsibility for his/her own actions (does not blame others)

Nursing Interventions
1.
Educate the client about their condition and allow them to ask questions. Rationale: The more educated the client is about their condition, the more likely they are to seek help.
2. Use therapeutic communication techniques while interacting with the client. Rationale: Using therapeutic communication can help develop a trusting relationship between the client and nurse.
3. Help the client identify what triggers their passive-aggressive behavior. Rationale: Identifying triggers is one of the first interventions when undergoing therapy.
4. Administer Diazepam (Valium) per order for symptoms of anxiety. Rationale: Anxiety often is a side effect of passive aggressive disorder. A) Monitor for therapeutic effects. Rationale: Expect maximum effect in 1-2 weeks. B) Monitor for sedation and hypotension. Rationale: Common side effects of Diazepam (Valium).
5. Encourage client to seek professional counseling. Rationale: A therapist can develop a more detailed, long term plan of care and prescribe medications if
needed.
6. Educate family about passive aggressive disorder. Rationale: The clients loved ones may be more supportive if they know the client has a real disorder.
7. Encourage client to follow up with their therapist and take their medications as ordered. Rationale: Therapy will be more effective if followed correctly.

Expected Outcomes
The client's relationships are improved
The client is not resentful of the wishes of others
The client does not display behavior that may damage working relationships