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It is estimated that NPD affects between zero and five percent of the population.<ref name=Cal2015>{{cite journal|last1=Caligor|first1=E|last2=Levy|first2=KN|last3=Yeomans|first3=FE|title=Narcissistic personality disorder: diagnostic and clinical challenges.|journal=The American journal of psychiatry|date=May 2015|volume=172|issue=5|pages=415–22|pmid=25930131}}</ref> Males are affected more often than females. First formulated in 1968, NPD was historically called [[megalomania]], and is a form of severe [[egocentrism]].<ref name="Kayne">{{cite web|url=http://www.wisegeek.org/what-is-megalomania.htm |title=What is Megalomania? |publisher=Conjecture |work=Wise Geek |date=4 March 2013 |accessdate=16 April 2014 |author=R. Kayne, ed. L.S. Wynn |format=Internet Archive |deadurl=yes |archiveurl=https://web.archive.org/web/20130311080518/http://www.wisegeek.org/what-is-megalomania.htm |archivedate=11 March 2013 }}</ref> |
It is estimated that NPD affects between zero and five percent of the population.<ref name=Cal2015>{{cite journal|last1=Caligor|first1=E|last2=Levy|first2=KN|last3=Yeomans|first3=FE|title=Narcissistic personality disorder: diagnostic and clinical challenges.|journal=The American journal of psychiatry|date=May 2015|volume=172|issue=5|pages=415–22|pmid=25930131}}</ref> Males are affected more often than females. First formulated in 1968, NPD was historically called [[megalomania]], and is a form of severe [[egocentrism]].<ref name="Kayne">{{cite web|url=http://www.wisegeek.org/what-is-megalomania.htm |title=What is Megalomania? |publisher=Conjecture |work=Wise Geek |date=4 March 2013 |accessdate=16 April 2014 |author=R. Kayne, ed. L.S. Wynn |format=Internet Archive |deadurl=yes |archiveurl=https://web.archive.org/web/20130311080518/http://www.wisegeek.org/what-is-megalomania.htm |archivedate=11 March 2013 }}</ref> |
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==Signs and symptoms== |
==Signs and symptoms== |
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People with narcissistic personality disorder are characterized by their persistent [[grandiosity]], |
People with narcissistic personality disorder are characterized by their persistent [[grandiosity]], excessive need for accolades, and willful lack of [[empathy]] for others.<ref name=medline>{{cite|last=Berger|first=FK|date=31 Oct 2014|website=MedlinePlus|publisher=U.S. National Library of Medicine|title=Medical Encyclopedia: Narcissistic personality disorder|accessdate=29 Apr 2016}}</ref><ref name=dsm5>{{cite|author=American Psychiatric Association|year=2013|title=Diagnostic and Statistical Manual of Mental Disorders (5th ed.)|location=Arlington|publisher=American Psychiatric Publishing|pages=669–672|isbn=0890425558}}</ref> These individuals often display arrogance, a sense of superiority, and [[Power (social and political)|power-seeking]] behaviors.<ref name="pmid21430487">{{cite journal | author = Ronningstam E | title = Narcissistic personality disorder: a clinical perspective | journal = J Psychiatr Pract | volume = 17 | issue = 2 | pages = 89–99 | year = 2011 | pmid = 21430487 | doi = 10.1097/01.pra.0000396060.67150.40 }}</ref> Narcissistic personality disorder is different than having a strong sense of self-confidence; people with NPD value themselves over others to the extent that they disregard the feelings and wishes of others and expect to be treated as superior regardless of their actual status or achievements.<ref name=dsm5/><ref name=mayo>{{cite|author=Mayo Clinic Staff|title=Narcissistic personality disorder: Symptoms|website=Mayo Clinic|publisher=Mayo Foundation for Medical Education and Research|date=18 Nov 2014|accessdate=29 Apr 2016|url=http://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/con-20025568}}</ref> In addition, people with NPD usually have fragile [[Self-concept|egos]], an inability to tolerate criticism, and tend to belittle others in an attempt to validate their own superiority.<ref name=mayo/> |
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Individuals with NPD have most or all of the following symptoms, typically without commensurate qualities or accomplishments:<ref name=dsm5/><ref name=mayo/> |
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* Grandiosity with expectations of superior treatment from others |
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* Fixated on fantasies of power, success, intelligence, attractiveness, etc. |
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* Self-perception of being unique, superior and associated with high-status people and institutions |
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* Needing constant admiration from others |
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* Sense of entitlement to special treatment and obedience from others |
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* Exploitative of others to achieve personal gain |
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* Unwilling to empathize with others' feelings, wishes, or needs |
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* Intensely jealous of others and the belief that others are equally jealous of them |
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* Pompous and arrogant demeanor |
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NPD develops by [[adolescence]] or early adulthood.<ref name=dsm5/> It is not uncommon for children and teens to display ''some'' traits similar to NPD, but these are typically transient without meeting full criteria for the diagnosis.<ref name=mayo/> True NPD symptoms are pervasive and apparent in various situations, as well as rigid, remaining consistent over time. According to the [[DSM-5]], these traits must differ substantially from the cultural norms of the individual's society in order to qualify as symptoms of NPD.<ref name=dsm5/> For a person with NPD, these traits are pervasive and significantly impair the individual's ability to develop meaningful relationships with others and frequently limits their ability to function at work, school, or in other settings.<ref name=dsm5/> |
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People with NPD tend to exaggerate their skills and accomplishments as well as their level of intimacy with people they consider to be high-status. Their sense of superiority may cause them to monopolize conversations,<ref name=mayo/> but they occasionally isolate or appear withdrawn when they fear that their flaws may be revealed. If their ego is wounded by a real or perceived criticism, their anger can be disproportionate to the comment or event,<ref name=mayo/> but typically, their actions and responses are deliberate and calculated.<ref name=dsm5/> Despite occasional flare-ups of insecurity, their self-image is primarily stable (i.e., overinflated).<ref name=dsm5/> |
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==Causes== |
==Causes== |
Revision as of 07:52, 29 April 2016
Narcissistic personality disorder | |
---|---|
Specialty | Psychiatry |
Personality disorders |
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Cluster A (odd) |
Cluster B (dramatic) |
Cluster C (anxious) |
Not otherwise specified |
Depressive |
Others |
Narcissistic personality disorder (NPD) is a personality disorder, characterized by exaggerated feelings of self-importance, excessive need for admiration, and lack of empathy for others.[1] People with the disorder often come across as arrogant, callous, and envious, tend to be exploitative in their interpersonal relationships, and can be excessively preoccupied with personal adequacy, power, prestige and vanity. As a personality disorder, those with NPD generally have poor insight into their condition and may not acknowledge that their behavior causes problems for others or themselves.
It is classified as a cluster B personality disorder by the Diagnostic and Statistical Manual of Mental Disorders.[2]
It is estimated that NPD affects between zero and five percent of the population.[1] Males are affected more often than females. First formulated in 1968, NPD was historically called megalomania, and is a form of severe egocentrism.[3]
Signs and symptoms
People with narcissistic personality disorder are characterized by their persistent grandiosity, excessive need for accolades, and willful lack of empathy for others.[4][5] These individuals often display arrogance, a sense of superiority, and power-seeking behaviors.[6] Narcissistic personality disorder is different than having a strong sense of self-confidence; people with NPD value themselves over others to the extent that they disregard the feelings and wishes of others and expect to be treated as superior regardless of their actual status or achievements.[5][7] In addition, people with NPD usually have fragile egos, an inability to tolerate criticism, and tend to belittle others in an attempt to validate their own superiority.[7]
Individuals with NPD have most or all of the following symptoms, typically without commensurate qualities or accomplishments:[5][7]
- Grandiosity with expectations of superior treatment from others
- Fixated on fantasies of power, success, intelligence, attractiveness, etc.
- Self-perception of being unique, superior and associated with high-status people and institutions
- Needing constant admiration from others
- Sense of entitlement to special treatment and obedience from others
- Exploitative of others to achieve personal gain
- Unwilling to empathize with others' feelings, wishes, or needs
- Intensely jealous of others and the belief that others are equally jealous of them
- Pompous and arrogant demeanor
NPD develops by adolescence or early adulthood.[5] It is not uncommon for children and teens to display some traits similar to NPD, but these are typically transient without meeting full criteria for the diagnosis.[7] True NPD symptoms are pervasive and apparent in various situations, as well as rigid, remaining consistent over time. According to the DSM-5, these traits must differ substantially from the cultural norms of the individual's society in order to qualify as symptoms of NPD.[5] For a person with NPD, these traits are pervasive and significantly impair the individual's ability to develop meaningful relationships with others and frequently limits their ability to function at work, school, or in other settings.[5]
People with NPD tend to exaggerate their skills and accomplishments as well as their level of intimacy with people they consider to be high-status. Their sense of superiority may cause them to monopolize conversations,[7] but they occasionally isolate or appear withdrawn when they fear that their flaws may be revealed. If their ego is wounded by a real or perceived criticism, their anger can be disproportionate to the comment or event,[7] but typically, their actions and responses are deliberate and calculated.[5] Despite occasional flare-ups of insecurity, their self-image is primarily stable (i.e., overinflated).[5]
Causes
The cause of this disorder is unknown. However, Groopman and Cooper (2006) listed the following factors identified by various researchers as possibilities:[8]
- An oversensitive temperament (personality traits) at birth.
- Excessive admiration that is never balanced with realistic feedback.
- Excessive praise for good behaviors or excessive criticism for bad behaviors in childhood.
- Overindulgence and overvaluation by parents, other family members, or peers.
- Being praised for perceived exceptional looks or abilities by adults.
- Severe emotional abuse in childhood.
- Unpredictable or unreliable caregiving from parents.
- Learning manipulative behaviors from parents or peers.
- Valued by parents as a means to regulate their own self-esteem.
Some narcissistic traits are common with a normal developmental phase. When these traits are compounded by a failure of the interpersonal environment and continue into adulthood, they may intensify to the point where NPD is diagnosed.[9]
There is evidence that narcissistic personality disorder is heritable. Studies on the occurrence of personality disorders in twins determined that there is a moderate to high heritability for narcissistic personality disorder.[10][11] The specific genes that contribute to the etiology of this disorder have yet to be determined, as no studies on its molecular genetics have been conducted on it.
Neurobiology
There is little research into the neurological underpinnings of narcissistic personality disorder. Nevertheless, recent research has identified a structural abnormality in the brains of those with narcissistic personality disorder, specifically noting less volume of gray matter in the left anterior insula.[12][13] Another study has associated the condition with reduced gray matter in the prefrontal cortex.[14] The brain regions identified in these studies are associated with empathy, compassion, emotional regulation, and cognitive functioning. These findings suggest that narcissistic personality disorder is related to a compromised capacity for emotional empathy and emotional regulation.[15]
Children
In children, inflated self-views and grandiose feelings, which are characteristics of narcissism, are part of the normal development. Children typically cannot understand the difference between their actual and their ideal self, which causes an unrealistic perception of the self. After about age 8, views of the self, both positive and negative, begin to develop based on comparisons of peers, and become more realistic. Two factors that cause self-view to remain unrealistic are dysfunctional interactions with parents that can be either excessive attention[16] or a lack thereof. For example, but not limited to, the excessive attention and lack of attention go hand in hand when a child’s parents are divorced. Usually, one is overindulgent (typically the one seeing the child less) and the other shows less affection.[17] The child either compensates for lack of attention or acts in terms of unrealistic self-perception.[18]
Theories
Pathological narcissism occurs in a spectrum of severity. In its more extreme forms, it is narcissistic personality disorder (NPD). NPD is considered to result from a person's belief that they are flawed in a way that makes them fundamentally unacceptable to others.[19] This belief is held below the person's conscious awareness; such a person would, if questioned, typically deny thinking such a thing. To protect themselves against the intolerably painful rejection and isolation that (they imagine) would follow if others recognized their (perceived) defective nature, such people make strong attempts to control others’ views of them and behavior towards them.
Pathological narcissism can develop from an impairment in the quality of the person's relationship with their primary caregivers, usually their parents, in that the parents could not form a healthy and empathic attachment to them.[20] This results in the child's perception of himself/herself as unimportant and unconnected to others. The child typically comes to believe they have some personality defect that makes them unvalued and unwanted.[21]
To the extent that people are pathologically narcissistic, they can be controlling, blaming, self-absorbed, intolerant of others’ views, unaware of others' needs and of the effects of their behavior on others, and insistent that others see them as they wish to be seen.[22]
Narcissistic individuals use various strategies to protect the self at the expense of others. They tend to devalue, derogate, insult, blame others and they often respond to threatening feedback with anger and hostility.[23]
People who are narcissistic commonly feel rejected, humiliated and threatened when criticised. To protect themselves from these dangers, they often react with disdain, rage, and/or defiance to any slight criticism, real or imagined.[24] To avoid such situations, some narcissistic people withdraw socially and may feign modesty or humility. In cases where the narcissistic personality-disordered individual feels a lack of admiration, adulation, attention and affirmation, they may also manifest a desire to be feared and be notorious (narcissistic supply).
Although individuals with NPD are often ambitious and capable, the inability to tolerate setbacks, disagreements or criticism, along with lack of empathy, make it difficult for such individuals to work cooperatively with others or to maintain long-term professional achievements.[25] With narcissistic personality disorder, the individual's self-perceived fantastic grandiosity, often coupled with a hypomanic mood, is typically not commensurate with his or her real accomplishments.
Splitting
People who are diagnosed with narcissistic personality disorder use splitting as a central defense mechanism. According to psychoanalyst Kernberg, "The normal tension between actual self on the one hand, and ideal object on the other, is eliminated by the building up of an inflated self-concept within which the actual self and the ideal self and ideal object are confused. At the same time, the remnants of the unacceptable images are repressed and projected onto external objects, or people, which are devalued."[26]
The merging of the "inflated self-concept" and the "actual self" is seen in the inherent grandiosity of narcissistic personality disorder. Also inherent in this process are the defense mechanisms of devaluation, idealization and denial.[27] Other people are either manipulated as an extension of one's own self, who serve the sole role of giving "admiration and approval"[26] or they are seen as worthless (because they cannot collude with the narcissist's grandiosity).[26]
Shame
It has been suggested that narcissistic personality disorder may be related to defenses against shame.[28] Psychiatrist Glen Gabbard suggested NPD could be broken down into two subtypes.[29] He saw the "oblivious" subtype as being grandiose, arrogant, and thick-skinned, and the "hypervigilant" subtype as being easily hurt, oversensitive, and ashamed. In his view, the oblivious subtype presents for admiration, envy, and appreciation of a powerful, grandiose self that is the antithesis of a weak internalized self, which hides in shame, while the hypervigilant subtype neutralizes devaluation by seeing others as unjust abusers. Jeffrey Young, who developed schema therapy based on the work psychiatrist Aaron T. Beck and others, also links NPD and shame. He sees the so-called Defectiveness Schema as a core schema of NPD, along with the Emotional Deprivation and Entitlement Schemas.[30][better source needed]
Diagnosis
DSM-5
The formulation of narcissistic personality disorder in DSM-IV was criticised for failing to describe the range and complexity of the disorder. Critics say it focuses overly on "the narcissistic individual's external, symptomatic, or social interpersonal patterns—at the expense of ... internal complexity and individual suffering," which reduces its clinical utility.[31]
The Personality and Personality Disorders Work Group originally proposed the elimination of NPD as a distinct disorder in DSM-5 as part of a major revamping of the diagnostic criteria for personality disorders,[32][33] replacing a categorical with a dimensional approach based on the severity of dysfunctional personality trait domains.
Some clinicians objected to this, characterizing the new diagnostic system as an "unwieldy conglomeration of disparate models that cannot happily coexist" and may have limited usefulness in clinical practice.[34]
In July 2011, the Work Group came back with a major revision to their original proposal. In this revision, NPD was reinstated with dramatic changes to its definition.[35] The general move towards a dimensional (personality trait-based) view of the Personality Disorders has been maintained despite the reintroduction of NPD.
ICD-10
The World Health Organization's ICD-10 lists narcissistic personality disorder under (F60.8) Other specific personality disorders.[36]
It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.
Subtypes
Theodore Millon identifies five narcissist subtypes,[37][38] however, there are few pure variants of any subtype,[38] and the subtypes are not recognized in the DSM or ICD.
Subtype | Description | Personality Traits |
---|---|---|
Unprincipled narcissist | Including antisocial features. | Deficient conscience; unscrupulous, amoral, disloyal, fraudulent, deceptive, arrogant, exploitive; a con man and charlatan; dominating, contemptuous, vindictive. |
Amorous narcissist | Including histrionic features. | Sexually seductive, enticing, beguiling, tantalizing; glib and clever; disinclines real intimacy; indulges hedonistic desires; bewitches and inveigles others; pathological lying and swindling. |
Compensatory narcissist | Including negativistic and avoidant features | Seeks to counteract or cancel out deep feelings of inferiority and lack of self-esteem; offsets deficits by creating illusions of being superior, exceptional, admirable, noteworthy; self-worth results from self-enhancement. |
Elitist narcissist | Variant of “pure” pattern. | Feels privileged and empowered by virtue of special childhood status and pseudo achievements; entitled façade bears little relation to reality; seeks favored and good life; is upwardly mobile; cultivates special status and advantages by association. |
Malignant narcissist | Including antisocial, sadistic and paranoid features. | Fearless, guiltless, remorseless, calculating, ruthless, inhumane, callous, brutal, rancorous, aggressive, biting, merciless, vicious, cruel, spiteful, ; hateful and jealous; anticipates betrayal and seeks punishment; desires revenge; Has been isolated, and is often suicidal, and is homicidal. |
Will Titshaw also identified three sub-types of narcissistic personality disorder which are not officially recognized in any editions of the DSM or the ICD.
Subtype | Description | Description |
---|---|---|
Pure Narcissist | Mainly just NPD characteristics. | Someone who has narcissistic features described in the DSM and ICD and lacks features from other personality disorders. |
Attention Narcissist | Including histrionic (HPD) features. | They display the traditional NPD characteristics described in the ICD & DSM along with histrionic features due to the fact that they think they're superior and therefore they should have everyone's attention, and when they don't have everyone's attention they go out of their way to capture the attention of as many people as possible. |
Beyond The Rules Narcissist | Including antisocial (ASPD) features. | This type of narcissist thinks that because they're so superior to everyone they don't have to follow the rules like most people and therefore because of this reason shows behavior included in the ICD for dissocial personality disorder and behavior included in the DSM for antisocial personality disorder. |
Other theorists have identified two types of narcissism. Those narcissists who have been diagnosed with narcissistic grandiosity express behavior "through interpersonally exploitative acts, lack of empathy, intense envy, aggression, and exhibitionism."[39] Another type of narcissism is narcissistic vulnerability. It entails (on a conscious level) "helplessness, emptiness, low self-esteem, and shame, which can be expressed in the behavior as being socially avoidant in situations where their self-presentation is not possible so they withdraw, or the approval they need/expect is not being met."[39]
Treatment
People rarely seek therapy for Narcissistic Personality Disorder. This is partly because those afflicted by NPD deny they have a problem and fail to see their condition as being the source of their problems. Most cannot see the damage caused to themselves and others as being a result of their actions, and usually only seek treatment at the insistence of relatives and friends.[17]
Psychotherapy is used to treat NPD.[7] Clinical strategies are outlined by Heinz Kohut, Stephen M. Johnson and James F. Masterson, while Johns[21] discusses a continuum of severity and the kinds of therapy most effective in different cases. Schema therapy, a form of therapy developed by Jeffrey Young that integrates several therapeutic approaches (psychodynamic, cognitive, behavioral etc.), also offers an approach for the treatment of NPD.[40] Unconscious fears of exposure or inadequacy often cause defensive disdain of therapeutic processes.[41][42] Pattern change strategies, done over a long period of time, are used to increase the ability of those with NPD to become more empathetic in everyday relationships. To help modify their sense of entitlement and self-centeredness schema, the strategy is to help them identify how to utilize their unique talents and to help others for reasons other than their own personal gain. This is not so much to change their self-perception of their "entitlement" feeling but more to help them empathize with others. Another type of treatment would be temperament change.[43]
Anger, rage, impulsivity and impatience can be worked on with skill training. Therapy is not one hundred percent effective because patients receive feedback poorly and defensively. Anxiety disorders and somatoma dysfunctions are prevalent but the most common would be depression. Medication has proven ineffective for treating narcissistic personality disorder, but psychoanalytic psychotherapy has a higher success rate. Therapists must recognize the patient’s traits and use caution in tearing down narcissistic defenses too quickly.
Group treatment has its benefits as the effectiveness of receiving peer feedback rather than the clinician’s may be more accepted, but group therapy can also contradict itself as the patient may show "demandingness, egocentrism, social isolation and withdrawal, and socially deviant behavior." Researchers originally thought group therapy among patients with would fail because it was believed that group therapy required empathy that NPD patients lack. However, studies show group therapy does hold value for patients with NPD because it lets them explore boundaries, develop trust, increase self-awareness, and accept feedback.[17] Relationship therapy stresses the importance of learning and applying four basic interpersonal skills: "...effective expression, empathy, discussion and problem solving/conflict resolution."[17]
Marital/relationship therapy is most beneficial when both partners participate.[43]
Epidemiology
Lifetime prevalence is estimated at 1% in the general population and 2% to 16% in clinical populations.[8][44]
In 2009, Twenge and Campbell conducted studies suggesting that the incidence of NPD had more than doubled in the US in the prior 10 years, and that 1 in 16 of the population have experienced NPD.[45]
"A nationwide study in the United States found that 7.7 percent of men and 4.8 percent of women could be diagnosed with narcissistic personality disorder (Stinson et al., 2008). These data also suggest that narcissistic personality disorder is more prevalent among younger adults, possibly supporting the impression that narcissistic personality disorder is on the rise as a result of social and economic conditions that support more extreme versions of self-focused individualism (Bender, 2012)."[46]
History
The use of the term "narcissism" to describe excessive vanity and self-centeredness predates by many years the modern medical classification of narcissistic personality disorder. The condition was named after Narcissus, a mythological Greek youth who became infatuated with his own reflection in a lake. He did not realize at first that it was his own reflection, but when he did, he died out of grief for having fallen in love with someone that did not exist outside of himself.
The term "narcissistic personality structure" was introduced by Kernberg in 1967[47] and "narcissistic personality disorder" first proposed by Heinz Kohut in 1968.[48]
Narcissistic personality disorder in fiction
In the film To Die For, Nicole Kidman's character wants to appear on television at all costs, even if this involves murdering her husband. A psychiatric assessment of her character noted that she "was seen as a prototypical narcissistic person by the raters: on average, she satisfied 8 of 9 criteria for narcissistic personality disorder... had she been evaluated for personality disorders, she would receive a diagnosis of narcissistic personality disorder."[49]
Other examples in popular fiction include television characters Adam Demamp[50] (portrayed by Adam DeVine in Workaholics) and Dennis Reynolds[51] (portrayed by Glenn Howerton in It's Always Sunny in Philadelphia).
Criticism
A Norwegian study concluded that narcissism should be conceived as personality dimensions pertinent to the whole range of PDs rather than as a distinct diagnostic category.[52] Alarcón and Sarabia concluded that narcissistic personality disorder shows such inconsistency that it should be considered as a trait domain instead of as a type of disorder.[53]
See also
- Narcissistic leadership
- Narcissistic mortification
- Narcissistic neurosis
- Narcissistic parent
- Narcissistic Personality Inventory
- Narcissistic rage and narcissistic injury
- Narcissism of small differences
- Narcissistic supply
Associated
Case study
References
- ^ a b Caligor, E; Levy, KN; Yeomans, FE (May 2015). "Narcissistic personality disorder: diagnostic and clinical challenges". The American journal of psychiatry. 172 (5): 415–22. PMID 25930131.
- ^ Narcissistic personality disorder – Diagnostic and Statistical Manual of Mental Disorders Fourth edition Text Revision (DSM-IV-TR) American Psychiatric Association (2000)
- ^ R. Kayne, ed. L.S. Wynn (4 March 2013). "What is Megalomania?". Wise Geek. Conjecture. Archived from the original (Internet Archive) on 11 March 2013. Retrieved 16 April 2014.
{{cite web}}
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suggested) (help) - ^ Berger, FK (31 October 2014), "Medical Encyclopedia: Narcissistic personality disorder", MedlinePlus, U.S. National Library of Medicine
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requires|url=
(help); Missing or empty|url=
(help) - ^ a b c d e f g h American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing, pp. 669–672, ISBN 0890425558
- ^ Ronningstam E (2011). "Narcissistic personality disorder: a clinical perspective". J Psychiatr Pract. 17 (2): 89–99. doi:10.1097/01.pra.0000396060.67150.40. PMID 21430487.
- ^ a b c d e f g Mayo Clinic Staff (18 November 2014), "Narcissistic personality disorder: Symptoms", Mayo Clinic, Mayo Foundation for Medical Education and Research, retrieved 29 April 2016
- ^ a b Groopman, Leonard C. M.D.; Cooper, Arnold M. M.D. (2006). "Narcissistic Personality Disorder". Personality Disorders – Narcissistic Personality Disorder. Armenian Medical Network. Retrieved 14 February 2007.
- ^ Cooper AM: Narcissism in normal development, in Character Pathology. Edited by Zales M. New York, Brunner/Mazel, 1984, pp. 39–56.
- ^ Torgersen, S; Lygren, S; Oien, PA; Skre, I; Onstad, S; Edvardsen, J; Tambs, K; Kringlen, E (December 2000). "A twin study of personality disorders". Comprehensive psychiatry. 41 (6): 416–25. PMID 11086146.
- ^ Reichborn-Kjennerud, Ted (1 March 2010). "The genetic epidemiology of personality disorders". Dialogues in Clinical Neuroscience. 12 (1): 103–114. ISSN 1294-8322. PMID 20373672.
- ^ Schulze L, Dziobek I, Vater A, Heekeren HR, Bajbouj M, Renneberg B, Heuser I, Roepke S; Dziobek; Vater; Heekeren; Bajbouj; Renneberg; Heuser; Roepke (2013). "Gray matter abnormalities in patients with narcissistic personality disorder". J Psychiatr Res. 47 (10): 1363–9. doi:10.1016/j.jpsychires.2013.05.017. PMID 23777939.
{{cite journal}}
: CS1 maint: multiple names: authors list (link) - ^ "Narcissists' Lack of Empathy Tied to Less Gray Matter". PsychCentral. Retrieved 24 April 2014.
- ^ Nenadic, Igor; Güllmar, Daniel; Dietzek, Maren; Langbein, Kerstin; Steinke, Johanna; Gader, Christian (February 2015). "Brain structure in narcissistic personality disorder: A VBM and DTI pilot study". Psychiatry Research Neuroimaging. 231 (2). Elsevier Ireland: 184–186. doi:10.1016/j.pscychresns.2014.11.001. PMID 25492857.
- ^ Ronningstam, Elsa (19 January 2016). "Pathological Narcissism and Narcissistic Personality Disorder: Recent Research and Clinical Implications". Current Behavioral Neuroscience Reports. 3 (1). Springer International Publishing: 34–42. doi:10.1007/s40473-016-0060-y.
- ^ Brummelman, Eddie; et al. (March 2015), "Origins of narcissism in children", PNAS, 112 (10), doi:10.1073/pnas.1420870112
- ^ a b c d Freeman, Arthur; Angela Breitmeyer; Melissa Flint (2000). "The Challenges in Diagnosing Narcissistic Personality Disorder: Difficult to Define, but "We Know It When We See It"". Clinical Forum.
- ^ Development and Validation of the Childhood Narcissism Scale, SANDER THOMAES,1,2 HEDY STEGGE,1 BRAD J. BUSHMAN,3,4 TJEERT OLTHOF,1 AND JAAP DENISSEN. Department of Psychology, VU University, The Netherlands Department of Psychology, Utrecht University, The Netherlands Department of Psychology, University of Michigan Department of Communication Sciences, VU University, The Netherlands
- ^ Golomb, Elan PhD (1992). Trapped in the Mirror. New York: Morrow, pp. 19–20.
- ^ Ken Magid (1987). High risk children without a conscience. Bantam. p. 67. ISBN 0-553-05290-X. Retrieved 17 November 2012.
- ^ a b Stephen M. Johnson (1 May 1987). Humanizing the narcissistic style. W.W. Norton. p. 39. ISBN 978-0-393-70037-4. Retrieved 29 October 2013.
- ^ full list in DSM-IV-TR, p. 717.
- ^ Identifying and understanding the narcissistic personality Elsa F. Ronningstam. Oxfard University Press Inc.
- ^ American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC, American Psychiatric Association, 1994, p. 659.
- ^ Golomb, Elan PhD (1992). Trapped in the Mirror. New York: Morrow, p. 22.
- ^ a b c Kernberg OF (1970). "Factors in the psychoanalytic treatment of narcissistic personalities". J Am Psychoanal Assoc. 18 (1): 51–85. doi:10.1177/000306517001800103. PMID 5451020.
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Further reading
Professional
- Masterson, James F (1 June 1981). The Narcissistic and Borderline Disorders: An Integrated Developmental Approach (First ed.). London: Routledge. ISBN 978-0876302927.
General public
- Brown, Nina W (1 April 2008). Children of the Self-Absorbed (Second ed.). Oakland: New Harbinger Publications. ISBN 978-0743214285.
- Behary, Wendy (1 July 2013). Disarming the Narcissist (Second ed.). Oakland: New Harbinger Publications. ISBN 978-1608827602.
- Hotchkiss, Sandy (7 August 2003). Why Is It Always About You? (Reprint ed.). Florence: Free Press. ISBN 978-1572245617.
- Jean M. Twenge, Ph.D. and W. Keith Campbell, Ph.D., The Narcissism Epidemic, New York, Free Press 2009 ISBN 978-1-4165-7625-9
External links
- Narcissistic personality disorder PubMed
- Narcissistic personality disorder Mayo Clinic
- Narcissistic Personality Disorder Cleveland Clinic
- famous-people with narcissistic personality disorder
- Narcissistic personality disorder: research summarized PubMed