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Current Psychiatry Reports
Erschienen in: Current Psychiatry Reports 1/2010

01.02.2010

Narcissistic Personality Disorder: A Current Review

verfasst von: Elsa Ronningstam

Erschienen in: Current Psychiatry Reports | Ausgabe 1/2010

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Abstract

The diagnosis of narcissistic personality disorder in the DSM-IV has been criticized foremost for its limitations in capturing the range and complexity of narcissistic pathology. The attention to the narcissistic individual’s external, symptomatic, or social interpersonal patterns—at the expense of his or her internal complexity and individual suffering—has also added to the diagnosis’ low clinical utility and limited guidance for treatment. Recent studies and reviews have pointed to the need for change in the diagnostic approach to and formulation of narcissism. This review focuses specifically on studies of features that add to the identification, understanding, and treatment of patients with pathological narcissistic functioning and narcissistic personality disorder. They have been integrated into a regulatory model that includes the functions and fluctuations of internal control, self-esteem, perfectionism with accompanying self-criticism, shame, and empathic ability and functioning.
Literatur
1.
Ronningstam E: Identifying and Understanding the Narcissistic Personality. New York: Oxford University Press; 2008.
2.
•• Russ E, Shedler J, Bradley R, Westen D: Refining the construct of narcissistic personality disorder: diagnostic criteria and subtypes. Am J Psychiatry 2008, 165:1473–1481. This important study of clinicians’ ratings of patients with NPD and Q-factor analysis suggests clinically relevant subtypes and features of NPD. It confirms the range of clinically identified characteristics, especially patients’ internal experiences and suffering, as well as the range of adaptation and functioning.CrossRefPubMed
3.
•• Cain NM, Pincus AL, Ansell EB: Narcissism at the crossroads: phenotypic description of pathological narcissism across clinical theory, social/personality psychology, and psychiatric diagnosis. Clin Psychol Rev 2008, 28:638–656. This review outlines the clinical theories of narcissism and discusses recent social- and personality-focused research using the Narcissistic Personality Inventory, which has added relevant facts about pathological narcissism. The authors argue convincingly for two phenotypic presentations, the grandiose and the vulnerable aspects of narcissism, and suggest further assessments of the spectrum of healthy and pathological narcissism as well as the phenomenologic range.CrossRefPubMed
4.
•• Ronningstam E: Narcissistic personality disorder: facing DSM-V. Psychiatr Ann 2009, 39:111–121. In this review, I discuss four aspects relevant to the diagnosis of pathological narcissism: its self-regulatory nature, the phenomenologic and functional range, self-esteem regulation with reactivity and self-enhancing strivings, and empathic ability and functioning. Implications for and reformulation of the diagnostic criteria for NPD are suggested and discussed.CrossRef
5.
Akhtar S: Narcissistic personality disorder: descriptive features and differential diagnosis. Psychiatr Clin North Am 1989, 2:505–530.
6.
Fossati A, Beauchaine TP, Grazioli F, et al.: A latent structure analysis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, narcissistic personality disorder criteria. Compr Psychiatry 2005, 46:361–367.CrossRefPubMed
7.
Perry JDC, Perry JC: Conflicts, defenses and the stability of narcissistic personality features. Psychiatry 2004, 27:310–330.
8.
Kernberg OF: Borderline Conditions and Pathological Narcissism. New York: Jason Aronson; 1975.
9.
Kernberg OF: Severe Personality Disorders. New Haven, CT: Yale University Press; 1984.
10.
Kohut H: The Analysis of the Self. New York: International Universities Press; 1971.
11.
Ronningstam E: Pathological narcissism and narcissistic personality disorder in Axis I disorders. Harv Rev Psychiatry 1996, 3:326–340.CrossRefPubMed
12.
Morey LC, Jones JK: Empirical studies of the construct validity of narcissistic personality disorder. In Disorders of Narcissism: Diagnostic, Clinical and Empirical Implications. Edited by Ronningstam E. Washington, DC: American Psychiatric Press; 1998:351–373.
13.
•• Stinson FS, Dawson DA, Goldstein RB, et al.: Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2008, 69:1033–1045. This most recent epidemiologic study provides extensive information from a relatively large sample of people with NPD in the United States. Results indicate noticeable prevalence (6.2%) and considerable mental disability, especially among men, including substance use, mood and anxiety, and personality disorders.CrossRefPubMed
14.
•• Miller JD, Campbell WK, Pilkonis PA: Narcissistic personality disorder: relations with distress and functional impairment. Compr Psychiatry 2007, 48:170–177. In this study, the authors highlight the interpersonal distress and consequences caused by people with NPD, suggesting their own distress is secondary in response to problems and failures in specific areas of life, including work, romance, and friendships.CrossRefPubMed
15.
Gunderson J, Ronningstam E: Differentiating antisocial and narcissistic personality disorder. J Pers Disord 2001, 15:103–109.CrossRefPubMed
16.
Ronningstam E, Gunderson J: Discriminating criteria for identifying narcissistic personality disorder. Am J Psychiatry1990, 147:918–922.PubMed
17.
Jang KL, Livesley WJ, Vernon PA, Jackson DN: Heritability of personality disorder traits: a twin study. Acta Psychiatr Scand 1996, 94:438–444.CrossRefPubMed
18.
Torgersen S, Kringlen E, Cramer V: The prevalence of personality disorders in a community sample. Arch Gen Psychiatry 2001, 58:590–596.CrossRefPubMed
19.
Schore A: Affect Regulation and the Origin of the Self. Hillsdale, NJ: Lawrence Erlbaum Associates; 1994.
20.
Fonagy P, Gergely G, Jurist EL, Target M: Affect Regulation, Mentalization, and the Development of the Self. New York: Other Press; 2003.
21.
Imbesi L: On the etiology of narcissistic personality disorder. Issues Psychoanal Psychol 2000, 22:43–58.
22.
Kernberg P: Narcissistic personality disorder in childhood. Psychiatr Clin North Am 1989, 12:671–694.PubMed
23.
Otway LJ, Vignoles VL: Narcissism and childhood recollections: a quantitative test of psychoanalytic predictions. Pers Soc Psychol Bull 2006, 32:104–116.CrossRefPubMed
24.
Smolewska K, Dion KL: Narcissism and adult attachment: a multivariate approach. Self Identity 2005, 4:59–68.CrossRef
25.
Simon RI: Distinguishing trauma-associated narcissistic symptoms from posttraumatic stress disorder: a diagnostic challenge. Harv Rev Psychiatry 2001, 10:28–36.CrossRef
26.
Bachar E, Hadar H, Shalev AY: Narcissistic vulnerability and the development of PTSD. A prospective study. J Nerv Ment Dis 2005, 193:762–765.CrossRefPubMed
27.
Morf CC, Rhodewalt F: Unraveling the paradoxes of narcissism: a dynamic self-regulatory processing model. Psychol Inq 2001, 12:177–196.CrossRef
28.
Maldonado JL: Narcissistic resistances in the analytic experience. Int J Psychoanal 1999, 80:1131–1146.CrossRefPubMed
29.
Almond R: “I can do it (all) myself.” Clinical technique with defensive narcissistic self-sufficiency. Psychoanal Psychol 2004, 21:371–384.CrossRef
30.
Shilkret CJ: Endangered by interpretations. Treatment by attitude of the narcissistically vulnerable patient. Psychoanal Psychol 2006, 23:30–42.
31.
Ronningstam E, Gunderson J, Lyons M: Changes in pathological narcissism. Am J Psychiatry 1995, 152:253–257.PubMed
32.
Rhodewalt F, Morf CC: On self-aggrandizement and anger: a temporal analysis of narcissism and affective reactions to success and failure. J Pers Soc Psychol 1998, 74:672–685.CrossRefPubMed
33.
Kernis MH, Cornell DP, Sun C-R, et al.: There’s more to self-esteem than whether it is high or low: the importance of stability of self-esteem. J Pers Soc Psychol 1993, 65:1190–1204.CrossRefPubMed
34.
•• Hewitt PL, Habke AM, Lee-Baggley DL, et al.: The impact of perfectionist self-presentation on the cognitive, affective and physiological experience of a clinical interview. Psychiatry 2008, 71:93–122. In this informative article, based on their extensive research, the authors outline the range and dimensions of perfectionism and explore the implications of perfectionistic self-presentation in a clinical interview. Implications for forming a therapeutic alliance and engaging and benefiting from treatment are discussed.PubMed
35.
Hewitt PL, Flett GL, Sherry SB, et al.: The interpersonal expression of perfectionism: perfectionistic self-presentation and psychological distress. J Pers Soc Psychol 2003, 84:1303–1325.CrossRefPubMed
36.
Rothstein A: The Narcissistic Pursuit for Perfection. New York: International Universities Press; 1980.
37.
38.
Kris A: Helping patients by analyzing self criticism. J Am Psychoanal Assoc 1990, 38:605–636.CrossRefPubMed
39.
Tangney JP, Wagner P, Fletcher C, Gramzow R: Shamed into anger? The relation of shame and guilt to anger and self-reported aggression. J Pers Soc Psychol 1992, 62:669–675.CrossRefPubMed
40.
Trumbull D: Shame: an acute stress response to interpersonal traumatization. Psychiatry 2003, 66:53–64.PubMed
41.
Decety J, Lamm C: Human empathy through the lens of social neuroscience. ScientificWorld Journal 2006, 6:1146–1163.CrossRefPubMed
42.
Decety J, Jackson PL: The functional architecture of human empathy. Behav Cogn Neurosci Rev 2004, 3:71–100.CrossRefPubMed
43.
• Ritter K, Dziobek I, Preibler S, et al.: Lack if empathy in patients with narcissistic personality disorder. Paper presented at the XI ISSPD International Congress. New York; August 21–23, 2009. The differentiation between emotional and cognitive empathy prompted this first exploration of empathic functioning in patients with NPD. Results suggest deficits in emotional empathic capability and intact cognitive empathic functioning in NPD. The authors encourage a multidimensional assessment of empathy in NPD and reformulation of the corresponding DSM diagnostic criteria.
44.
Glasser M: Problems in the psychoanalysis of certain narcissistic disorders. Int J Psychoanal 1992, 73:493–503.PubMed
Metadaten
Titel
Narcissistic Personality Disorder: A Current Review
verfasst von
Elsa Ronningstam
Publikationsdatum
01.02.2010
Verlag
Current Science Inc.
Erschienen in
Current Psychiatry Reports / Ausgabe 1/2010
Print ISSN: 1523-3812
Elektronische ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-009-0084-z

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