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Anthony Ruocco

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2012-11-15 PERSONALITY DISORDERS – LEC 09 Narcissistic Personality Disorder NEWS: The large disagreement in proposals for DSM-V has most likely led to the committee to decide not to go along with any major changes. Diagnostic Criteria: • Apervasive pattern of grandiosity (in fantasy or behaviour), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated five (or more) of the following: o Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements). o Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. o Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions). o Requires excessive admiration. o Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations. o Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends. o Lack of empathy: is unwilling to recognize or identify with the feelings and needs of others. o Is often envious of others or believes that others are envious of him or her. o Shows arrogant, haughty behaviours or attitudes. • An example can be seen in the movie “There will be blood”.Another example is Charles Manson. History and Prevalence: • Comes from the Greek Myth of Narcissus. Narcissus mistook his own image for another, fell in love with that image, and died when it failed to love him back. • Approx. 1-5% of the general population, and 1-17% in clinical settings (although the latter may be misinterpreted, since it most likely comes from a forensic clinical setting). • There’s a huge comorbidity with antisocial personality disorder. • 80% of NPD patients also met criteria for borderline personality disorder. • Has high overlap with aitosicla, histrionic, borderline and “passive-aggressive PD”. • Do they have low-self esteem? *See below. Ronningstam (1996): • She is the “authority of narcissistic PD”. Has done a lot of work on this. • Found that 12-38% of NPD have a substance use disorders, and 4-47% have traits of bipolar disorder (especially the manic phase). • *The co-occurrence of BPD with other disorders is a major problem in justifying and maintaining its validity as a distinct entity. Two Faces of Narcissism (Overt vs. Covert): • (1) Grandiose Narcissist: associated with extraversion, self-assurance, exhibitionism, and aggression. • (2) Vulnerable Narcissist: associated with introversion, de
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