Self-directed passive-aggressive behaviour as an essential component of depression: findings from two cross-sectional observational studies

Background The self-control model of depression suggests depressive symptoms to derive from distorted self-monitoring, dysfunctional self-evaluation and reduced self-reward as well as increased self-punishment.

Building on this model a relationship between self-directed passive-aggressive behaviour, that is, harmful inactivity, and depression has been assumed.

This association has been supported by a recent study in an inpatient sample.

However, it remains unclear if patients with depressive disorders report more self-directed passive-aggressive behaviour than patients without depressive disorders and if self-directed passive aggression mediates the associations between distorted self-monitoring and dysfunctional self-evaluation with depressive symptoms.

Methods Study 1 compared self-directed passive-aggressive behaviour levels between 220 psychotherapy outpatients with ( n  = 140; 67.9% female; M _ age  = 40.0) and without ( n  = 80; 65.0% female; M _ age  = 36.2) depressive disorders.

Diagnoses were made based on the Structured Clinical Interview for DSM-IV.

Study 2 examined self-directed passive-aggressive behaviour as a mediator of the relationship between distorted self-monitoring and dysfunctional self-evaluation and self-reported depressive symptoms in 200 undergraduate Psychology students.

Results Compared to outpatients without depressive disorders, outpatients with depressive disorder reported significantly more self-directed passive aggression ( d  = 0.51).

Furthermore, Study 2 verified self-directed passive-aggressive behaviour as a partial mediator of the relationship between dysfunctional attitudes ( ab _ cs  = .22, 95%-CI: .14, .31), attributional style ( ab _ cs  = .20, 95%-CI: .13, .27), ruminative response style ( ab _ cs  = .15, 95%-CI: .09, .21) and depressive symptoms.

Conclusion Self-directed passive-aggressive behaviour partially mediates the association between distorted self-monitoring and dysfunctional self-evaluation with depressive symptoms.

Future longitudinal studies need to examine a potential causal relationship that would form a base to include interventions targeting self-directed passive-aggressive behaviour in prevention and treatment of depression.

Trial registration Both studies were preregistered at the German Clinical Trials Register ( DRKS00014005 and DRKS00019020 ).