Self-Directed Passive Aggressive Behaviour as an Essential Component of Depression: Findings from two observational studies

Abstract Background Self-directed passive aggressive behaviour is defined as self-harm by inactivity or omission. Based on the self-control model of depression suggesting depressive symptoms to derive from distorted self-monitoring, self-evaluation and reduced self-reward as well as increased self-punishment and reduced self-reward, a relationship between self-directed passive aggressive behaviour and depression had been assumed. First evidence for this notion derives form a recent study, demonstrating a correlation between self-directed passive aggressive behaviour and depressive symptoms. 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 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; Mage = 40.0) and without (n = 80; 65.0% female; Mage = 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 mediator of the relationship between distorted self-monitoring and self-evaluation and depressive symptoms in 200 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 partial mediator of the relationship between dysfunctional attitudes (abcs = .22, 95%-CI = .14 − .31), attributional style (abcs = .20, 95%-CI = .13 − .27), ruminative response style (abcs = .15, 95%-CI = .09 − .21) and depressive symptoms.Conclusion Self-directed passive aggressive behaviour partially mediates the association between distorted self-monitoring and self-evaluation with depressive symptoms and might represent a core component of depressive disorders.Trial registration: Both studies were preregistered at the German Clinical Trials Register (DRKS000140051 and DRKS000190201).