The following case study illustrates the use of cognitive therapy for treating depression that co-occurs with behaviors associated with passive-aggressive personality disorder (PAPD). Depression and co-occurring PAPD-associated behaviors present several challenges for treatment, including the transient nature of PAPD-associated behaviors and the effect of these behaviors on the effective treatment and remission of depression. Cognitive therapy was initially effective at treating depression and PAPD tendencies. As treatment progressed, dysfunctional interactions with the environment resulted in the reemergence of PAPD-associated behaviors as these behaviors were reinforced and assertive behaviors punished. With the continued use of cognitive therapy, PAPD tendencies were once again reduced and depressive status remained in remission. The present case study highlights the importance of targeting behaviors associated with personality pathology when co-occurring with depression.
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