scholarly journals Narcissistic Personality Disorder: Are Psychodynamic Theories and the Alternative DSM-5 Model for Personality Disorders Finally Going to Meet?

2021 ◽  
Vol 12 ◽  
Author(s):  
Frans Schalkwijk ◽  
Patrick Luyten ◽  
Theo Ingenhoven ◽  
Jack Dekker
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Hierarchical Model ◽  
Interpersonal Functioning ◽  
Narcissistic Personality Disorder ◽  
Pathological Narcissism ◽  
Dsm 5 ◽  
Narcissistic Personality ◽  
Psychodynamically Oriented ◽  
Recent Developments

Narcissistic Personality Disorder is the new borderline personality disorder of our current era. There have been recent developments on narcissism that are certainly worthwhile examining. Firstly, relational and intersubjective psychoanalysts have been rethinking the underlying concepts of narcissism, focusing on the development of self and relations to others. Secondly, in the DSM-5, the Alternative DSM-5 Model for Personality Disorders (AMPD) was presented for a dimensional evaluation of the severity of personality disorder pathology. The combined dimensional and trait conceptualization of NPD opened the door to new integrated diagnostic perspectives, including both internal and interpersonal functioning. Finally, Pincus and Lukowitsky encourage clinicians to use a hierarchical model of pathological narcissism, as it opens up opportunities for shared points of interest in empirical research from different scholarly perspectives. As for most non-psychodynamic clinicians and researchers the DSM-5 clearly bears dominant weight in their work, we will take the AMPD model for NPD as our point of reference. We will discuss the narcissist's unique pattern of self-impairments in identity and self-direction, and of interpersonal disfunctioning (evaluated by assessing empathy and intimacy). Subsequently, we will examine how contemporary psychodynamic theories and the hierarchical model of Pincus and Lukowitsky additionally inform or contradict the AMPD. For us, one of the big advantages of the AMPD is the use of structured clinical evaluations of disturbances of the self and interpersonal functioning and the dimensional evaluation of severity. As psychodynamically oriented therapists, we are enthusiastic about the opportunities for inclusion of psychodynamic concepts, but we also discuss a number of sticking points.

scholarly journals Narcissism and Narcissistic Personality Disorder

2017 ◽  
Vol 2 (2) ◽  
pp. 020229
Author(s):  
Gerhard Dammann
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Narcissistic Personality Disorder ◽  
Pathological Narcissism ◽  
Narcissistic Personality ◽  
Practical Recommendations

This a video is one of the series of lectures about personality disorders. It covers the concept of narcissism and the concept of narcissism personality disorder.  The lecture is mainly focused on the differences between normal and pathological narcissism as well as etiology, diagnosis and practical recommendations on treatment of narcissism personality disorder.

Narcissistic Personality Disorder: The Diagnostic Process

2012 ◽  
pp. 526-548
Author(s):  
Elsa Ronningstam
Keyword(s):  
Personality Disorder ◽  
Diagnosis And Treatment ◽  
Narcissistic Personality Disorder ◽  
Diagnostic Process ◽  
Pathological Narcissism ◽  
Dsm 5 ◽  
The Past ◽  
Narcissistic Personality ◽  
Specific Focus ◽  
Alliance Building

The diagnosis of narcissistic personality disorder (NPD) evolving over the past 40 years within several fields of inquiry—clinical and psychoanalytic as well as psychiatric and empirical—is discussed in this chapter. The inclusion of NPD as a separate personality disorder in the latest proposal of DSM-5 has warranted continuing studies and development of the diagnosis and treatment of pathological narcissism and NPD. Specific focus is on capturing the complexity of narcissistic pathology, identifying narcissistic core traits in the context of regulatory and dynamic variability, and incorporating the functional and phenotypic range of NPD. The diagnostic process, that is, identifying narcissistic traits in a collaborative alliance-building context between patient and clinician, aims at establishing a meaningful diagnosis that can inform patient and relatives and serve to guide treatment. Concluding guidelines for enhancing accuracy and meaningfulness of the NPD diagnosis are proposed.

Transference-Focused Psychotherapy for Pathological Narcissism and Narcissistic Personality Disorder (TFP-N)

2021 ◽  
Vol 49 (2) ◽  
pp. 244-272
Author(s):  
Diana Diamond ◽  
Frank Yeomans ◽  
John R. Keefe
Keyword(s):  
Personality Disorder ◽  
Sense Of Self ◽  
Assessment Process ◽  
Narcissistic Personality Disorder ◽  
Object Relations Theory ◽  
Pathological Narcissism ◽  
Personality Functioning ◽  
Therapeutic Interaction ◽  
Narcissistic Personality ◽  
Transference Focused Psychotherapy

In this article, we provide an overview of transference-focused psychotherapy for patients with pathological narcissism and narcissistic personality disorder (TFP-N). In TFP-N we have modified and refined the tactics and techniques of TFP, an evidence-based treatment for borderline personality disorder, to meet the specific challenges of working with patients with narcissistic personality pathology whose retreat from reality into an illusory grandiosity makes them particularly difficult to engage in treatment. We first describe a model of narcissistic pathology based on considerations of psychological structure stemming from object relations theory. This model provides a unifying understanding of the core structure of narcissistic pathology, the pathological grandiose self, that underlies the impairments in self and interpersonal functioning of those with narcissistic pathology across the levels of personality organization (from high functioning to borderline to malignant). We then delineate the clinical process of working with patients with pathological narcissism and narcissistic personality disorder. Starting with the assessment process, using a detailed clinical example, we guide the reader through the progression of TFP-N as it helps the patient move from the distorted, unintegrated sense of self underlying the narcissistic presentation to the more integrated, realistic sense of self that characterizes healthier personality functioning. In TFP-N the focus on the disturbed interpersonal patterns of relating in the here and now of the therapeutic interaction is the vehicle to diminish grandiosity and improve relatedness, thereby effecting enduring changes in mental representation and real-world functioning.

Examining the Incremental Utility of DSM-5 Section III Traits and Impairment in Relation to Traditional Personality Disorder Scores in a Female Correctional Sample

2018 ◽  
Vol 32 (6) ◽  
pp. 738-752 ◽  
Author(s):  
Chelsea E. Sleep ◽  
Dustin B. Wygant ◽  
Joshua D. Miller
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Alternative Model ◽  
Female Inmates ◽  
Societal Costs ◽  
Dsm 5 ◽  
Narcissistic Personality ◽  
Categorical Models ◽  
Personality Psychopathology ◽  
Personality Disordered

Personality disorders (PDs) are challenging to assess and are associated with great individual and societal costs. In response to the limitations of categorical models, the DSM-5 included an alternative model (i.e., Section III), which uses impairment (Criterion A) and pathological traits (Criterion B) to diagnose PDs. Although numerous studies have illustrated dimensional trait models' ability to capture personality psychopathology, less attention has been paid to personality impairment. The present investigation sought to examine Criterion A's ability to contribute incrementally to the prediction of antisocial (ASPD), borderline (BPD), and narcissistic personality disorders (NPD), and Interpersonal-Affective (F1) and Impulsive-Antisocial (F2) features of psychopathy. The current study used 200 female inmates and found that impairment contributed to the prediction of BPD, NPD, and psychopathy F1 scores and did not add to the prediction of ASPD and psychopathy F2 scores. Difficulties in distinguishing between personality impairment and personality disordered traits are discussed.

scholarly journals Female Narcissism: Assessment, Aetiology, and Behavioural Manifestations

2021 ◽  
pp. 003329412110273
Author(s):  
Ava Green ◽  
Rory MacLean ◽  
Kathy Charles
Keyword(s):  
Personality Disorder ◽  
Partner Violence ◽  
Narcissistic Personality Disorder ◽  
Empirical Literature ◽  
Statistical Manual ◽  
Masculine Norms ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Narcissistic Personality

Despite putative gender differences in the expression of narcissism, prominent theories have virtually dismissed the role of females in the development and manifestation of narcissism. The contention that narcissism is a pathology of the self that may partly differ in males and females is further evident in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 reports that up to 75% of those diagnosed with Narcissistic Personality Disorder (NPD) are men. Such figures suggest that the representation of narcissism as codified in the DSM-5 may only be marginally applicable to females, given its prominent focus and nature on capturing grandiose themes which closely resemble commonly masculine norms. The overemphasis on grandiose features extends to the empirical literature which defines narcissism as a normative personality trait and is widely assessed using the Narcissistic Personality Inventory (NPI), on which males obtain significantly higher scores than females. As this review will demonstrate, one limitation frequently occurring in the literature is the attempt to comprehend narcissistic manifestations in females through the lens of what has commonly been defined as narcissism (DSM/NPI). In this review, the literature concerning the diagnostic assessment and conceptualization of narcissistic personality disorder, etiological factors, aggression, and partner violence perpetration will be discussed in relation to the importance of gender. This is followed by a review of existing gaps in theory and research, and suggestions for fruitful directions that can aid a richer and more meaningful literature on narcissism inclusive of gender issues.

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