narcissistic personality disorder

Narcissistic personality disorder

Narcissistic personality disorder (NPD) is a complex and heterogeneous personality disorder characterized by patterns of grandiosity, entitlement, low empathy, and interpersonal difficulties, which can manifest as either grandiose ("thick-skinned") or vulnerable ("thin-skinned") forms. Grandiose individuals display arrogance, social dominance, and exploitative behaviors, while vulnerable individuals show shame, inferiority, hypersensitivity, and extreme reactions to criticism. NPD often involves impaired emotional empathy, superficial relationships, and difficulty tolerating disagreement. It is often co-morbid with other mental disorders and associated with significant functional impairment and psychosocial disability. There are two definitions of NPD in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM); whereas the primary definition is categorical and stems from previous DSM editions, the other definition – part of the Alternative DSM-5 model for personality disorders – is based on dimensional measures of severity of the disorder as well as on specific pathological traits. The International Classification of Diseases (ICD) defines only a general personality disorder since the introduction of the latest edition; hence, it does not include an NPD category. There is no standard treatment for NPD. Its high comorbidity with other mental disorders influences treatment and outcomes. Psychotherapeutic treatments generally fall into two categories: psychoanalytic/psychodynamic and cognitive behavioral therapy, with growing suppor...