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.
• 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
o Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or
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
o Lack of empathy: is unwilling to recognize or identify with the feelings and needs
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
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.
• 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
• (2) Vulnerable Narcissist: associated with introversion, de