Passive-aggressive individuals easily become irritable, gloomy, and despondent; they are resentful, sullen and discontent with life. The affective pattern is characterized by turning anger against the self, which may take form of self-destructive behaviour. Hostility, although covert, is never entirely concealed and may be detected by the therapist. Accumulated anger may be expressed by verbal acting-out, after which passive-aggressive individuals feel guilty and gloomy. Since they have difficulties in expressing emotions directly, they are prone to diffuse somatic complaints, hypochondriasis, and psychosomatic disorders.

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