Journal of Personality Disorders, 21(1), 28–41, 2007  2007 The Guilford Press THE VALIDITY OF DSM-IV PASSIVE-AGGRESSIVE (NEGATIVISTIC) PERSONALITY DISORDER Ora H. Rotenstein, MA, Wilson McDermut, PhD, Andrea Bergman, PhD, Diane Young, PhD, Mark Zimmerman, MD, and Iwona Chelminski, PhD Passive-Aggressive (Negativistic) Personality Disorder (NEGPD), listed in Appendix B of the DSM-IV, is not an officially recognized personality disorder. Its future as a discrete disorder is uncertain (Widiger, 2003). Yet, NEGPD occupies a role in some theoretical formulations of person- ality pathology (Millon & Davis, 1996), and many clinicians believe that passive-aggressive traits are not adequately represented by other PDs (Westen, 1997). In this study, 1158 psychiatric outpatients were as- sessed for Axis I and Axis II disorders. Thirty-five (3.02%) met criteria for NEGPD. Participants with NEGPD did not differ significantly from those without NEGPD on demographic variables. The internal consis- tency of the DSM-IV’s seven NEGPD items was 0.50. Corrected item- total correlations for the 7 criteria averaged 0.27. Participants with NEGPD had higher rates of lifetime anxiety disorders, and almost 90% had an additional PD. An exploratory factor analysis suggested a two- factor solution that accounted for 43.4% of the variance. The first factor reflected the belief that life is unfair, while the second factor seemed to reflect modes of anger expression. A confirmatory factor analysis showed that the two-factor model fit the data better than a unidimen- sional model. We discuss implications of these results for the future of the NEGPD diagnosis. Passive-Aggressive (Negativistic) Personality Disorder (NEGPD) has a long history in the classification of mental disorders. In fact, descriptive fea- tures that typify the disorder have been depicted in significant detail by many prominent clinicians for nearly a century under a variety of headings (Millon & Radovanov, 1995).Years before World War II, clinical theorists portrayed diversely labeled “characters” and “dispositions” whose charac- teristics might now be classified under the passive-aggressive personality disorder designation (Millon, 1993). From St. John’s University (O. R., W. M., A. B.); and Rhode Island Hospital and Brown Uni- versity School of Medicine (M. Z., D. Y., I. C.). Address correspondence to Wilson McDermut, PhD, Assistant Professor of Psychology, Maril- lac Hall, Room SB15-9, St. John’s University, 8000 Utopia Parkway, Jamaica, NY 11439; E-mail: mcdermuw@stjohns.edu 28