Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Passive-Aggressive Personality Disorder


Related Terms

  • Negative Personality Disorder

Differential Diagnosis

Specialists

  • Clinical Psychologist
  • Psychiatrist

Comorbid Conditions

Factors Influencing Duration

The progress and effectiveness of psychotherapy and the individual's level of functioning all affect the length of disability. Instability associated with the failure of support systems will lengthen disability. Substance abuse, suicidal gestures, and coexisting depression and anxiety can prolong recovery.

Medical Codes

ICD-9-CM:
301.84 - Passive-aggressive Personality Disorder

Overview

The catchword for this personality disorder is "ambivalence." Persons with this disorder have been referred to as "negativistic personalities" because of their underlying aggression, which is expressed passively. Individuals with this disorder display covert obstructionism, procrastination, stubbornness, and inefficiency. They tend to be constantly complaining, sulky, pessimistic, and unaccommodating. They find themselves in dependent relationships, yet resist demands for adequate performance, find excuses for delays, and find fault with those on whom they depend.

They usually lack assertiveness by failing to express their needs and wishes directly, and they often fail to ask needed questions to discover what is expected of them. They are generally pessimistic about the future, and lack self-confidence. In relationships, they often get others to do their errands and chores and tend to dampen everyone's spirits.

Individuals with passive-aggressive personality disorder may be irritable or even agitated, with low frustration tolerance and vacillating moods changing in rapid succession. They seem fidgety and impatient with others, and their moods of excitement and cheerfulness are usually short-lived. They often feel discontented, mistreated, cheated, and unappreciated and tend to see themselves as victims of circumstance. Although they are often aware of solutions to their problems, they are unwilling to implement them. They resent being criticized but often find fault with those in authority.

Source: Medical Disability Advisor



Diagnosis

History: The psychiatric interview and mental status exam are the primary tools used to diagnose passive-aggressive personality disorder. Diagnostic criteria utilizing the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision) require a pervasive pattern of negativistic attitudes and passive resistance to demands for adequate performance, beginning by early adulthood and present in a variety of contexts, with four or more of the following: resists fulfilling routine social and occupational tasks, complains of being misunderstood and unappreciated by others, is sullen and argumentative, unreasonably criticizes and scorns authority, expresses envy and resentment toward those apparently more fortunate, voices exaggerated and persistent complaints of personal misfortune, and alternates between hostile defiance and contrition. The diagnosis cannot be made if the behavior occurs exclusively during major depressive episodes, or if it is better accounted for by dysthymic disorder.

Physical exam: A physical exam is not helpful in diagnosing this disorder. Observation of the individual's orientation, dress, mannerisms, behavior, and content of speech may be helpful.

Tests: A variety of psychological tests can be employed to help identify and classify personality disorders. The interpretation of these tests by a professional is used in conjunction with the history.

Source: Medical Disability Advisor



Treatment

Individuals with passive-aggressive personality disorder tend to do well with an individual or a one-to-one supportive psychotherapy or psychoanalytic approach. Good outcomes have been reported. Therapy is difficult, usually lasting longer than 1 year, and utilizes gentle confrontation about the individual's behavior and the consequences of that behavior.

When clinical depression is present, antidepressants should be used. Benzodiazepines or anti-anxiety drugs may be used when anxiety is present.

Source: Medical Disability Advisor



Prognosis

Prognosis is fairly good for those who are willing to seek and accept supportive psychotherapy. Personality disorders tend to persist but may burn out with therapy or as they are modified by life experiences.

Source: Medical Disability Advisor



Complications

Passive-aggressives tend to be in a state of turmoil and discontentment. Complications occur when there is a perceived or real lack of stability in the individual's life. This instability can occur in any area of life: social, occupational, legal, spiritual, or financial. Complications may occur when there is continued support of their behavior and their demands, without confrontation. Confronting them can be equally harmful and is usually viewed as rejection. Rejection is often internalized, and the individual will often have suicidal thoughts or ideation. Coexisting personality disorders, substance abuse, and other psychiatric disorders may also complicate the course, progress, and outcome.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

These individuals require stability and need to work in an environment where there is little change. Changes in shift, work site, co-workers, or team members should be avoided. Individually appropriate, close supervision is recommended, given their tendency to shirk work-related responsibility.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Does individual fit the criteria for passive-aggressive personality disorder?
  • Has the diagnosis been confirmed?
  • Does individual's behavior appear to be separate from other psychological disorders, such as dysthymic disorder or a major depressive episode?
  • Have underlying medical conditions and substance abuse been ruled out?

Regarding treatment:

  • Is individual currently on medication?
  • If depression and / or anxiety are also present, would medication be a beneficial adjunct to the treatment regimen?
  • In what type of psychotherapy is individual currently involved?
  • Is individual receptive to gentle confrontation about his or her behavior and the consequences of such behavior?

Regarding prognosis:

  • To what degree does the passive-aggressive behavior still interfere with social or occupational function?
  • Does individual's work environment involve shift changes, moving from one work site to another, or frequent change of coworkers/team members?
  • Can anything be done to provide more stabilization in individual's work and / or social environment?
  • Are coexisting personality traits, substance abuse, or other psychiatric disorders complicating the course, progress, and outcome of this disorder? Are these disorders being appropriately addressed?

Source: Medical Disability Advisor



References

Cited

Frances, Allen, ed. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). 4th ed. Washington, DC: American Psychiatric Association, 2000.

Source: Medical Disability Advisor






Feedback
Send us comments, suggestions, corrections, or anything you would like us to hear. If you are not logged in, you must include your email address, in order for us to respond. We cannot, unfortunately, respond to every comment. If you are seeking medical advice, please contact your physician. Thank you!
Send this comment to:
Sales Customer Support Content Development
 
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is published with the understanding that the author, editors, and publisher are not engaged in rendering medical, legal, accounting or other professional service. If medical, legal, or other expert assistance is required, the service of a competent professional should be sought. We are unable to respond to requests for advice. Any Sales inquiries should include an email address or other means of communication.