The Surprising History of Passive-Aggressive Personality Disorder Christopher Lane NORTHWESTERN UNIVERSITY ABSTRACT. The history of passive-aggressive personality disorder (PAPD) reveals many things about American psychiatry, including how its use and understanding of diagnostic categories have in recent decades changed. The disorder is thus a useful litmus test for establishing whether categories in the Diagnostic and Statistical Manual of Mental Disorders (DSM) have under- gone a type of “diagnostic bracket creep” (Peter Kramer’s term) with sig- nificant effects on the wider culture. The history of PAPD also allows us to assess whether psychiatry has encroached on routine traits and everyday practices, pathologizing behavior that was once considered normal. While the expansion of the DSM has generated widespread commentary and analy- sis, less has been written about PAPD, including how it came to be recog- nized and why its diagnostic parameters expanded so dramatically in each edition of the DSM.After tracing its roots to World War II, the essay reveals how the disorder came to be applied to ever-larger numbers of the civilian population. Original research drives the argument: previously unpublished memoranda from the American Psychiatric Association’s archive that not only reveal the back-story to the disorder’s expansion, but also cast new light on the organization’s methodology, including its practical and theoretical difficulties in differentiating normal from pathological behavior. KEY WORDS: DSM, history of psychiatry, misdiagnosis, passive-aggressive, personality disorders The history of passive-aggressive personality disorder (PAPD) offers a significant window onto broader changes in American psychiatry over the last century. Watching how the personality disorder has evolved since the Second World War tells us a lot about how the profession has characterized dysfunction, aberrant behavior, and the underlying etiology of psychiatric disorders. Passive-aggressive personality disorder more than illustrates those changes; it also reveals what hap- pens, clinically and theoretically, when a disorder enters popular culture and comes to be known by everyday language. THEORY &PSYCHOLOGY Copyright © 2009 Sage Publications. VOL. 19(1): 55–70 DOI: 10.1177/0959354308101419 http://tap.sagepub.com at NORTHWESTERN UNIV LIBRARY on February 19, 2009 http://tap.sagepub.com Downloaded from