{"id":1720,"date":"2020-09-09T16:32:58","date_gmt":"2020-09-09T16:32:58","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/abnormalpsych\/?post_type=chapter&#038;p=1720"},"modified":"2022-07-26T20:07:01","modified_gmt":"2022-07-26T20:07:01","slug":"narcissistic-personality-disorder","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/chapter\/narcissistic-personality-disorder\/","title":{"raw":"Narcissistic Personality Disorder","rendered":"Narcissistic Personality Disorder"},"content":{"raw":"<div class=\"textbox learning-objectives\">\r\n<h3>Learning Objectives<\/h3>\r\n<ul>\r\n \t<li>Describe the characteristics and diagnosis of narcissistic personality disorder<\/li>\r\n<\/ul>\r\n<\/div>\r\n<span style=\"font-size: 1rem; text-align: initial;\">Now we will review\u00a0<\/span><span style=\"font-size: 1rem; text-align: initial;\">another Cluster B personality disorder: n<\/span>arcissistic personality disorder.\r\n<table summary=\"A table provides basic descriptions of the DSM-5 personality disorders and their associated clusters. Cluster A includes Paranoid (harbors a pervasive and unjustifiable suspiciousness and mistrust of others; reluctant to confide in or become close to others; reads hidden demeaning or threatening meaning into benign remarks or events; takes offense easily and bears grudges; not due to schizophrenia or other psychotic disorders), Schizoid (lacks interest and desire to form relationships with others; aloof and shows emotional coldness and detachment; indifferent to approval or criticism of others; lacks close friends or confidants; not due to schizophrenia or other psychotic disorders, not an autism spectrum disorder), and Schizotypal (exhibits eccentricities in thought, perception, emotion, speech, and behavior; shows suspiciousness or paranoia; has unusual perceptual experiences; speech is often idiosyncratic; displays inappropriate emotions; lacks friends or confidants; not due to schizophrenia or other psychotic disorder, or to autism spectrum disorder). Cluster B includes Antisocial (continuously violates the rights of others; history of antisocial tendencies prior to age 15; often lies, fights, and has problems with the law; impulsive and fails to think ahead; can be deceitful and manipulative in order to gain profit or pleasure; irresponsible and often fails to hold down a job or pay financial debts; lacks feelings for others and remorse over misdeeds), Histrionic (excessively overdramatic, emotional, and theatrical; feels uncomfortable when not the center of others\u2019 attention; behavior is often inappropriately seductive or provocative; speech is highly emotional but often vague and diffuse; emotions are shallow and often shift rapidly; may alienate friends with demands for constant attention), Narcissistic (overinflated and unjustified sense of self-importance and preoccupied with fantasies of success; believes he is entitled to special treatment from others; shows arrogant attitudes and behaviors; takes advantage of others; lacks empathy), and Borderline (unstable in self-image, mood, and behavior; cannot tolerate being alone and experiences chronic feelings of emptiness; unstable and intense relationships with others; behavior is impulsive, unpredictable, and sometimes self-damaging; shows inappropriate and intense anger; makes suicidal gestures). Cluster C includes Avoidant (socially inhibited and oversensitive to negative evaluation; avoids occupations that involve interpersonal contact because of fears of criticism or rejection; avoids relationships with others unless guaranteed to be accepted unconditionally; feels inadequate and views self as socially inept and unappealing; unwilling to take risks or engage in new activities if they may prove embarrassing), Dependent (allows others to take over and run her life; is submissive, clingy, and fears separation; cannot make decisions without advice and reassurance from others; lacks self-confidence; cannot do things on her own; feels uncomfortable or helpless when alone), and Obsessive-Compulsive (pervasive need for perfectionism that interferes with the ability to complete tasks; preoccupied with details, rules, order, and schedules; excessively devoted to work at the expense of leisure and friendships; rigid, inflexible, and stubborn; insists things be done his way; miserly with money).\"><caption>Table 1. Cluster B Personality Disorders<\/caption>\r\n<thead><\/thead>\r\n<tbody>\r\n<tr>\r\n<td>Antisocial<\/td>\r\n<td>continuously violates the rights of others; history of antisocial tendencies prior to age 15; often lies, fights, and has problems with the law; impulsive and fails to think ahead; can be deceitful and manipulative in order to gain profit or pleasure; irresponsible and often fails to hold down a job or pay financial debts; lacks feelings for others and remorse over misdeeds<\/td>\r\n<td>B<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Histrionic<\/td>\r\n<td>excessively overdramatic, emotional, and theatrical; feels uncomfortable when not the center of others\u2019 attention; behavior is often inappropriately seductive or provocative; speech is highly emotional but often vague and diffuse; emotions are shallow and often shift rapidly; may alienate friends with demands for constant attention<\/td>\r\n<td>B<\/td>\r\n<\/tr>\r\n<tr>\r\n<td><strong>Narcissistic<\/strong><\/td>\r\n<td>overinflated and unjustified sense of self-importance and preoccupied with fantasies of success; feels entitled to special treatment from others; shows arrogant attitudes and behaviors; takes advantage of others; lacks empathy<\/td>\r\n<td>B<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Borderline<\/td>\r\n<td>unstable in self-image, mood, and behavior; cannot tolerate being alone and experiences chronic feelings of emptiness; unstable and intense relationships with others; behavior is impulsive, unpredictable, and sometimes self-damaging; shows inappropriate and intense anger; makes suicidal gestures<\/td>\r\n<td>B<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<strong>Narcissistic personality disorder (NPD)<\/strong> is characterized by the personality traits of persistent\u00a0grandiosity, an excessive need for\u00a0admiration, and a personal disdain and lack of\u00a0empathy\u00a0for other people.\u00a0As such, an individual with narcissistic personality disorder (NPD) usually displays arrogance and a distorted sense of personal superiority and seeks to establish\u00a0abusive power and control\u00a0over others. Self-confidence\u00a0(a strong sense of self) is a personality trait different from the traits of narcissistic personality disorder; thus, people with narcissistic personality disorder (NPD) typically value themselves over others, to the extent of openly disregarding the wishes and feelings of anyone else, and expect to be treated as superior, regardless of their actual status or achievements.\u00a0Socially, the person with NPD usually exhibits a fragile ego (self-concept), intolerance of criticism, and a tendency to belittle other people in order to validate their own superiority.\r\n\r\nThe\u00a0DSM-5 indicates that a person with NPD possesses at least five of the following nine criteria, typically without possessing the commensurate personal qualities or accomplishments for which they demands respect and status:\r\n<ul>\r\n \t<li>has a grandiose sense of self-importance (e.g. exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).\r\n\r\n[caption id=\"attachment_4315\" align=\"alignright\" width=\"204\"]<img class=\"wp-image-4315\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/09\/12062813\/self-love-65693_1920-225x300.jpg\" alt=\"A person kissing their own reflection in a mirror.\" width=\"204\" height=\"272\" \/> <strong>Figure 1.\u00a0<\/strong>Individuals with NPD typically value themselves over anyone else.[\/caption]<\/li>\r\n \t<li>is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.<\/li>\r\n \t<li>believes that they are special and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).<\/li>\r\n \t<li>requires excessive admiration.<\/li>\r\n \t<li>has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with their expectations).<\/li>\r\n \t<li>is interpersonally exploitative (i.e., takes advantage of others to achieve their own ends).<\/li>\r\n \t<li>lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.<\/li>\r\n \t<li>is often envious of others or believes that others are envious of them.<\/li>\r\n \t<li>shows arrogant, haughty behaviors or attitudes.<sup id=\"cite_ref-dsm5_7-2\" class=\"reference\"><\/sup><sup id=\"cite_ref-mayo1_10-2\" class=\"reference\"><\/sup><\/li>\r\n<\/ul>\r\n<h2>Narcissistic Personality Disorder<\/h2>\r\n<b>NPD<\/b>\u00a0is a\u00a0personality disorder\u00a0characterized by a long-term pattern of\u00a0exaggerated feelings of self-importance, an excessive craving for\u00a0admiration, and struggles with\u00a0empathy.\u00a0People with NPD often spend much time daydreaming about achieving\u00a0power\u00a0and success, or on their\u00a0appearance.\u00a0People with the diagnosis in recent years have spoken out about its stigma in media, and possible links to abusive situations and childhood trauma. Such narcissistic behavior typically begins by early adulthood and occurs across a broad range of situations.\r\n<h3>Epidemiology<\/h3>\r\nThe lifetime rates of narcissistic personality disorder are estimated at 1% in the general population; and between two to 16% in the clinical population.<sup id=\"cite_ref-bd2011_35-0\" class=\"reference\"><\/sup>\r\n\r\nNarcissistic personality disorder usually develops either in adolescence or in early adulthood,\u00a0<sup id=\"cite_ref-dsm5_7-3\" class=\"reference\"><\/sup>and it is common for children and adolescents to display personality traits that resemble NPD, but such occurrences are usually transient, and register below the clinical criteria for a formal diagnosis of NPD.\u00a0<sup id=\"cite_ref-mayo1_10-3\" class=\"reference\"><\/sup>True symptoms of NPD are pervasive, apparent in varied social situations, and rigidly consistent over time. Severe symptoms of NPD can significantly impair the person's mental capabilities to develop meaningful human relationships, such as friendship, kinship, and marriage. The DSM-5 indicates that, in order to qualify as symptomatic of NPD, the person's manifested personality traits must substantially differ from the cultural norms of society.<sup id=\"cite_ref-dsm5_7-4\" class=\"reference\"><\/sup>\r\n<h3>Etiology<\/h3>\r\nThe causes of narcissistic personality disorder are unknown, but theorized to be linked to certain types of traumas.<sup id=\"cite_ref-Sed2009_4-2\" class=\"reference\"><\/sup>\u00a0A combination of genetic, environmental, and social factors are involved in narcissistic personality disorder.\u00a0<sup id=\"cite_ref-Paris_15-2\" class=\"reference\"><\/sup>\r\n\r\nNarcissistic personality disorder usually develops either in adolescence or in early adulthood,\u00a0and it is common for children and adolescents to display personality traits that resemble NPD, but such occurrences are usually transient and register below the clinical criteria for a formal diagnosis of NPD.\u00a0True symptoms of NPD are pervasive, apparent in varied social situations, and are rigidly consistent over time. Severe symptoms of NPD can significantly impair the person's mental capabilities to develop meaningful human relationships, such as friendship, kinship, and marriage. Generally, the symptoms of NPD also impair the person's psychological abilities to function socially, either at work, or at school, or within important societal settings. The DSM-5 indicates that, in order to qualify as symptomatic of NPD, the person's manifested personality traits must substantially differ from the cultural norms of society.\r\n<h3>Treatment<\/h3>\r\n[caption id=\"attachment_4317\" align=\"alignright\" width=\"261\"]<img class=\"wp-image-4317\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/09\/12064141\/Psychotherapy-300x225.jpeg\" alt=\"A person laying on a sofa and talking to a psychotherapist.\" width=\"261\" height=\"196\" \/> <strong>Figure 2.\u00a0<\/strong>NPD can give individuals inflated perceptions about themselves.[\/caption]\r\n\r\nNarcissistic personality disorder is rarely the primary reason for which people seek mental health treatment. Therapy\u00a0is difficult because people with narcissistic personality disorder usually do not consider their own issues as symptoms, despite mental distress.\u00a0When people with NPD enter treatment, they usually are prompted by difficulties in their lives, or are seeking relief from some other disorder of their mental health, such as a\u00a0major depressive disorder, drug addiction, or manic depression.<sup id=\"cite_ref-ronningstam2016_8-4\" class=\"reference\"><\/sup>\r\n\r\nThe reason for such an indirect path to psychotherapy is partly because an individually with NPD\u00a0generally possess poor\u00a0insight, and are unaware that their actions produced their mentally unhealthy circumstance, and so\u00a0fail to recognize\u00a0that their perceptions and behaviors are socially inappropriate and problematic, because of their very positive\u00a0self-image\u00a0(inflated self-concept).\r\n<h3>Comorbidity<\/h3>\r\nThe occurrence of narcissistic personality disorder presents a high rate of\u00a0comorbidity\u00a0with other mental disorders.\u00a0People with NPD are prone to bouts of psychological depression, often to the degree that meets the clinical criteria for a co-occurring\u00a0depressive disorder.\u00a0Moreover, the occurrence of NPD is further associated with the occurrence of\u00a0bipolar disorder\u00a0and\u00a0substance use disorders,\u00a0especially\u00a0cocaine use disorder.\r\n<div class=\"textbox examples\">\r\n<h3>Watch It<\/h3>\r\nThis video further explains and gives examples of narcissism.\r\n\r\nhttps:\/\/www.youtube.com\/watch?v=arJLy3hX1E8&amp;feature=youtu.be\r\n\r\nYou can view the <a href=\"https:\/\/course-building.s3-us-west-2.amazonaws.com\/Abnormal+Psychology\/transcripts\/ThePsychologyOfNarcissismWKeithCampbell_transcript.txt\" target=\"_blank\" rel=\"noopener\">transcript for \"The psychology of narcissism - W. Keith Campbell\" here (opens in new window)<\/a>.\r\n\r\n<\/div>\r\n<div class=\"textbox key-takeaways\">\r\n<h3>Key Takeaways:\u00a0Narcissistic Personality Disorder<\/h3>\r\n<iframe src=\"https:\/\/lumenlearning.h5p.com\/content\/1291235959349871308\/embed\" width=\"1088\" height=\"637\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><script src=\"https:\/\/lumenlearning.h5p.com\/js\/h5p-resizer.js\" charset=\"UTF-8\"><\/script>\r\n\r\n<\/div>\r\n<div class=\"textbox exercises\">\r\n<h3>Case Study: Narcissistic Personality Disorder<\/h3>\r\nA 42-year-old male professional in public office, Edgar, was forced to resign after being arrested when visiting a brothel. In the aftermath, he suffered from depression,\u00a0considerable alcohol consumption, and was admitted for a three-month treatment. He stopped drinking, but his depression remained unresponsive to anti-depressant medication. Still, without meaningful activities, he felt empty,\u00a0restless, and\u00a0was eventually referred to psychotherapy.\r\n\r\nDevelopmental history indicates that at age five, Edgar's father left the family and they did not meet again until he was in law school. He was always ahead of his age and went through school without difficulty. In law school, he got high marks without hard work. He had many acquaintances, but no close friendships, and always\u00a0felt like an outsider. He got married and had two children. Reaching his mid-thirties, Edgar felt bored. He had everything: house, career, and family. He was respected and accomplished but felt he didn\u2019t belong. He started drinking heavily and visiting brothels.\r\n\r\nThe psychotherapist found him self-assured, easily irritated, and quick to make\u00a0devaluing remarks.\u00a0Interactions during weekly appointments were extremely difficult. Unwilling to explore his situation or his feelings, he blamed the therapist for the impasse and told the therapist that he would not change and that the therapist could not help. The therapist dreaded the appointments, while the patient, despite finding the sessions unhelpful, always showed up. When the therapist announced a three-week break, Edgar suggested the treatment end and did not return. Nine months later, Edgar informed the therapist that he moved to another city, had a leading position working with international trade, and was greeted as a king. He said nothing about his wife and children. Nor did he indicate how he felt about the treatment.\r\n\r\n<\/div>\r\n<section>\r\n<div class=\"textbox tryit\">\r\n<h3>Try IT<\/h3>\r\nhttps:\/\/assess.lumenlearning.com\/practice\/010f872a-02f3-41ed-a3a4-188efc1f26f1\r\n\r\n<\/div>\r\n<\/section>\r\n<div class=\"textbox learning-objectives\">\r\n<h3>Glossary<\/h3>\r\n<strong>narcissistic personality disorder:<\/strong>\u00a0a Cluster B personality disorder characterized by a pattern of grandiosity, a need for admiration, and a lack of empathy.\r\n\r\n<\/div>","rendered":"<div class=\"textbox learning-objectives\">\n<h3>Learning Objectives<\/h3>\n<ul>\n<li>Describe the characteristics and diagnosis of narcissistic personality disorder<\/li>\n<\/ul>\n<\/div>\n<p><span style=\"font-size: 1rem; text-align: initial;\">Now we will review\u00a0<\/span><span style=\"font-size: 1rem; text-align: initial;\">another Cluster B personality disorder: n<\/span>arcissistic personality disorder.<\/p>\n<table summary=\"A table provides basic descriptions of the DSM-5 personality disorders and their associated clusters. Cluster A includes Paranoid (harbors a pervasive and unjustifiable suspiciousness and mistrust of others; reluctant to confide in or become close to others; reads hidden demeaning or threatening meaning into benign remarks or events; takes offense easily and bears grudges; not due to schizophrenia or other psychotic disorders), Schizoid (lacks interest and desire to form relationships with others; aloof and shows emotional coldness and detachment; indifferent to approval or criticism of others; lacks close friends or confidants; not due to schizophrenia or other psychotic disorders, not an autism spectrum disorder), and Schizotypal (exhibits eccentricities in thought, perception, emotion, speech, and behavior; shows suspiciousness or paranoia; has unusual perceptual experiences; speech is often idiosyncratic; displays inappropriate emotions; lacks friends or confidants; not due to schizophrenia or other psychotic disorder, or to autism spectrum disorder). Cluster B includes Antisocial (continuously violates the rights of others; history of antisocial tendencies prior to age 15; often lies, fights, and has problems with the law; impulsive and fails to think ahead; can be deceitful and manipulative in order to gain profit or pleasure; irresponsible and often fails to hold down a job or pay financial debts; lacks feelings for others and remorse over misdeeds), Histrionic (excessively overdramatic, emotional, and theatrical; feels uncomfortable when not the center of others\u2019 attention; behavior is often inappropriately seductive or provocative; speech is highly emotional but often vague and diffuse; emotions are shallow and often shift rapidly; may alienate friends with demands for constant attention), Narcissistic (overinflated and unjustified sense of self-importance and preoccupied with fantasies of success; believes he is entitled to special treatment from others; shows arrogant attitudes and behaviors; takes advantage of others; lacks empathy), and Borderline (unstable in self-image, mood, and behavior; cannot tolerate being alone and experiences chronic feelings of emptiness; unstable and intense relationships with others; behavior is impulsive, unpredictable, and sometimes self-damaging; shows inappropriate and intense anger; makes suicidal gestures). Cluster C includes Avoidant (socially inhibited and oversensitive to negative evaluation; avoids occupations that involve interpersonal contact because of fears of criticism or rejection; avoids relationships with others unless guaranteed to be accepted unconditionally; feels inadequate and views self as socially inept and unappealing; unwilling to take risks or engage in new activities if they may prove embarrassing), Dependent (allows others to take over and run her life; is submissive, clingy, and fears separation; cannot make decisions without advice and reassurance from others; lacks self-confidence; cannot do things on her own; feels uncomfortable or helpless when alone), and Obsessive-Compulsive (pervasive need for perfectionism that interferes with the ability to complete tasks; preoccupied with details, rules, order, and schedules; excessively devoted to work at the expense of leisure and friendships; rigid, inflexible, and stubborn; insists things be done his way; miserly with money).\">\n<caption>Table 1. Cluster B Personality Disorders<\/caption>\n<thead><\/thead>\n<tbody>\n<tr>\n<td>Antisocial<\/td>\n<td>continuously violates the rights of others; history of antisocial tendencies prior to age 15; often lies, fights, and has problems with the law; impulsive and fails to think ahead; can be deceitful and manipulative in order to gain profit or pleasure; irresponsible and often fails to hold down a job or pay financial debts; lacks feelings for others and remorse over misdeeds<\/td>\n<td>B<\/td>\n<\/tr>\n<tr>\n<td>Histrionic<\/td>\n<td>excessively overdramatic, emotional, and theatrical; feels uncomfortable when not the center of others\u2019 attention; behavior is often inappropriately seductive or provocative; speech is highly emotional but often vague and diffuse; emotions are shallow and often shift rapidly; may alienate friends with demands for constant attention<\/td>\n<td>B<\/td>\n<\/tr>\n<tr>\n<td><strong>Narcissistic<\/strong><\/td>\n<td>overinflated and unjustified sense of self-importance and preoccupied with fantasies of success; feels entitled to special treatment from others; shows arrogant attitudes and behaviors; takes advantage of others; lacks empathy<\/td>\n<td>B<\/td>\n<\/tr>\n<tr>\n<td>Borderline<\/td>\n<td>unstable in self-image, mood, and behavior; cannot tolerate being alone and experiences chronic feelings of emptiness; unstable and intense relationships with others; behavior is impulsive, unpredictable, and sometimes self-damaging; shows inappropriate and intense anger; makes suicidal gestures<\/td>\n<td>B<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Narcissistic personality disorder (NPD)<\/strong> is characterized by the personality traits of persistent\u00a0grandiosity, an excessive need for\u00a0admiration, and a personal disdain and lack of\u00a0empathy\u00a0for other people.\u00a0As such, an individual with narcissistic personality disorder (NPD) usually displays arrogance and a distorted sense of personal superiority and seeks to establish\u00a0abusive power and control\u00a0over others. Self-confidence\u00a0(a strong sense of self) is a personality trait different from the traits of narcissistic personality disorder; thus, people with narcissistic personality disorder (NPD) typically value themselves over others, to the extent of openly disregarding the wishes and feelings of anyone else, and expect to be treated as superior, regardless of their actual status or achievements.\u00a0Socially, the person with NPD usually exhibits a fragile ego (self-concept), intolerance of criticism, and a tendency to belittle other people in order to validate their own superiority.<\/p>\n<p>The\u00a0DSM-5 indicates that a person with NPD possesses at least five of the following nine criteria, typically without possessing the commensurate personal qualities or accomplishments for which they demands respect and status:<\/p>\n<ul>\n<li>has a grandiose sense of self-importance (e.g. exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).\n<div id=\"attachment_4315\" style=\"width: 214px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4315\" class=\"wp-image-4315\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/09\/12062813\/self-love-65693_1920-225x300.jpg\" alt=\"A person kissing their own reflection in a mirror.\" width=\"204\" height=\"272\" \/><\/p>\n<p id=\"caption-attachment-4315\" class=\"wp-caption-text\"><strong>Figure 1.\u00a0<\/strong>Individuals with NPD typically value themselves over anyone else.<\/p>\n<\/div>\n<\/li>\n<li>is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.<\/li>\n<li>believes that they are special and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).<\/li>\n<li>requires excessive admiration.<\/li>\n<li>has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with their expectations).<\/li>\n<li>is interpersonally exploitative (i.e., takes advantage of others to achieve their own ends).<\/li>\n<li>lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.<\/li>\n<li>is often envious of others or believes that others are envious of them.<\/li>\n<li>shows arrogant, haughty behaviors or attitudes.<sup id=\"cite_ref-dsm5_7-2\" class=\"reference\"><\/sup><sup id=\"cite_ref-mayo1_10-2\" class=\"reference\"><\/sup><\/li>\n<\/ul>\n<h2>Narcissistic Personality Disorder<\/h2>\n<p><b>NPD<\/b>\u00a0is a\u00a0personality disorder\u00a0characterized by a long-term pattern of\u00a0exaggerated feelings of self-importance, an excessive craving for\u00a0admiration, and struggles with\u00a0empathy.\u00a0People with NPD often spend much time daydreaming about achieving\u00a0power\u00a0and success, or on their\u00a0appearance.\u00a0People with the diagnosis in recent years have spoken out about its stigma in media, and possible links to abusive situations and childhood trauma. Such narcissistic behavior typically begins by early adulthood and occurs across a broad range of situations.<\/p>\n<h3>Epidemiology<\/h3>\n<p>The lifetime rates of narcissistic personality disorder are estimated at 1% in the general population; and between two to 16% in the clinical population.<sup id=\"cite_ref-bd2011_35-0\" class=\"reference\"><\/sup><\/p>\n<p>Narcissistic personality disorder usually develops either in adolescence or in early adulthood,\u00a0<sup id=\"cite_ref-dsm5_7-3\" class=\"reference\"><\/sup>and it is common for children and adolescents to display personality traits that resemble NPD, but such occurrences are usually transient, and register below the clinical criteria for a formal diagnosis of NPD.\u00a0<sup id=\"cite_ref-mayo1_10-3\" class=\"reference\"><\/sup>True symptoms of NPD are pervasive, apparent in varied social situations, and rigidly consistent over time. Severe symptoms of NPD can significantly impair the person&#8217;s mental capabilities to develop meaningful human relationships, such as friendship, kinship, and marriage. The DSM-5 indicates that, in order to qualify as symptomatic of NPD, the person&#8217;s manifested personality traits must substantially differ from the cultural norms of society.<sup id=\"cite_ref-dsm5_7-4\" class=\"reference\"><\/sup><\/p>\n<h3>Etiology<\/h3>\n<p>The causes of narcissistic personality disorder are unknown, but theorized to be linked to certain types of traumas.<sup id=\"cite_ref-Sed2009_4-2\" class=\"reference\"><\/sup>\u00a0A combination of genetic, environmental, and social factors are involved in narcissistic personality disorder.\u00a0<sup id=\"cite_ref-Paris_15-2\" class=\"reference\"><\/sup><\/p>\n<p>Narcissistic personality disorder usually develops either in adolescence or in early adulthood,\u00a0and it is common for children and adolescents to display personality traits that resemble NPD, but such occurrences are usually transient and register below the clinical criteria for a formal diagnosis of NPD.\u00a0True symptoms of NPD are pervasive, apparent in varied social situations, and are rigidly consistent over time. Severe symptoms of NPD can significantly impair the person&#8217;s mental capabilities to develop meaningful human relationships, such as friendship, kinship, and marriage. Generally, the symptoms of NPD also impair the person&#8217;s psychological abilities to function socially, either at work, or at school, or within important societal settings. The DSM-5 indicates that, in order to qualify as symptomatic of NPD, the person&#8217;s manifested personality traits must substantially differ from the cultural norms of society.<\/p>\n<h3>Treatment<\/h3>\n<div id=\"attachment_4317\" style=\"width: 271px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4317\" class=\"wp-image-4317\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/09\/12064141\/Psychotherapy-300x225.jpeg\" alt=\"A person laying on a sofa and talking to a psychotherapist.\" width=\"261\" height=\"196\" \/><\/p>\n<p id=\"caption-attachment-4317\" class=\"wp-caption-text\"><strong>Figure 2.\u00a0<\/strong>NPD can give individuals inflated perceptions about themselves.<\/p>\n<\/div>\n<p>Narcissistic personality disorder is rarely the primary reason for which people seek mental health treatment. Therapy\u00a0is difficult because people with narcissistic personality disorder usually do not consider their own issues as symptoms, despite mental distress.\u00a0When people with NPD enter treatment, they usually are prompted by difficulties in their lives, or are seeking relief from some other disorder of their mental health, such as a\u00a0major depressive disorder, drug addiction, or manic depression.<sup id=\"cite_ref-ronningstam2016_8-4\" class=\"reference\"><\/sup><\/p>\n<p>The reason for such an indirect path to psychotherapy is partly because an individually with NPD\u00a0generally possess poor\u00a0insight, and are unaware that their actions produced their mentally unhealthy circumstance, and so\u00a0fail to recognize\u00a0that their perceptions and behaviors are socially inappropriate and problematic, because of their very positive\u00a0self-image\u00a0(inflated self-concept).<\/p>\n<h3>Comorbidity<\/h3>\n<p>The occurrence of narcissistic personality disorder presents a high rate of\u00a0comorbidity\u00a0with other mental disorders.\u00a0People with NPD are prone to bouts of psychological depression, often to the degree that meets the clinical criteria for a co-occurring\u00a0depressive disorder.\u00a0Moreover, the occurrence of NPD is further associated with the occurrence of\u00a0bipolar disorder\u00a0and\u00a0substance use disorders,\u00a0especially\u00a0cocaine use disorder.<\/p>\n<div class=\"textbox examples\">\n<h3>Watch It<\/h3>\n<p>This video further explains and gives examples of narcissism.<\/p>\n<p><iframe loading=\"lazy\" id=\"oembed-1\" title=\"The psychology of narcissism - W. Keith Campbell\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/arJLy3hX1E8?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>You can view the <a href=\"https:\/\/course-building.s3-us-west-2.amazonaws.com\/Abnormal+Psychology\/transcripts\/ThePsychologyOfNarcissismWKeithCampbell_transcript.txt\" target=\"_blank\" rel=\"noopener\">transcript for &#8220;The psychology of narcissism &#8211; W. Keith Campbell&#8221; here (opens in new window)<\/a>.<\/p>\n<\/div>\n<div class=\"textbox key-takeaways\">\n<h3>Key Takeaways:\u00a0Narcissistic Personality Disorder<\/h3>\n<p><iframe loading=\"lazy\" src=\"https:\/\/lumenlearning.h5p.com\/content\/1291235959349871308\/embed\" width=\"1088\" height=\"637\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><script src=\"https:\/\/lumenlearning.h5p.com\/js\/h5p-resizer.js\" charset=\"UTF-8\"><\/script><\/p>\n<\/div>\n<div class=\"textbox exercises\">\n<h3>Case Study: Narcissistic Personality Disorder<\/h3>\n<p>A 42-year-old male professional in public office, Edgar, was forced to resign after being arrested when visiting a brothel. In the aftermath, he suffered from depression,\u00a0considerable alcohol consumption, and was admitted for a three-month treatment. He stopped drinking, but his depression remained unresponsive to anti-depressant medication. Still, without meaningful activities, he felt empty,\u00a0restless, and\u00a0was eventually referred to psychotherapy.<\/p>\n<p>Developmental history indicates that at age five, Edgar&#8217;s father left the family and they did not meet again until he was in law school. He was always ahead of his age and went through school without difficulty. In law school, he got high marks without hard work. He had many acquaintances, but no close friendships, and always\u00a0felt like an outsider. He got married and had two children. Reaching his mid-thirties, Edgar felt bored. He had everything: house, career, and family. He was respected and accomplished but felt he didn\u2019t belong. He started drinking heavily and visiting brothels.<\/p>\n<p>The psychotherapist found him self-assured, easily irritated, and quick to make\u00a0devaluing remarks.\u00a0Interactions during weekly appointments were extremely difficult. Unwilling to explore his situation or his feelings, he blamed the therapist for the impasse and told the therapist that he would not change and that the therapist could not help. The therapist dreaded the appointments, while the patient, despite finding the sessions unhelpful, always showed up. When the therapist announced a three-week break, Edgar suggested the treatment end and did not return. Nine months later, Edgar informed the therapist that he moved to another city, had a leading position working with international trade, and was greeted as a king. He said nothing about his wife and children. Nor did he indicate how he felt about the treatment.<\/p>\n<\/div>\n<section>\n<div class=\"textbox tryit\">\n<h3>Try IT<\/h3>\n<p>\t<iframe id=\"assessment_practice_010f872a-02f3-41ed-a3a4-188efc1f26f1\" class=\"resizable\" src=\"https:\/\/assess.lumenlearning.com\/practice\/010f872a-02f3-41ed-a3a4-188efc1f26f1?iframe_resize_id=assessment_practice_id_010f872a-02f3-41ed-a3a4-188efc1f26f1\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:300px;\"><br \/>\n\t<\/iframe><\/p>\n<\/div>\n<\/section>\n<div class=\"textbox learning-objectives\">\n<h3>Glossary<\/h3>\n<p><strong>narcissistic personality disorder:<\/strong>\u00a0a Cluster B personality disorder characterized by a pattern of grandiosity, a need for admiration, and a lack of empathy.<\/p>\n<\/div>\n\n\t\t\t <section class=\"citations-section\" role=\"contentinfo\">\n\t\t\t <h3>Candela Citations<\/h3>\n\t\t\t\t\t <div>\n\t\t\t\t\t\t <div id=\"citation-list-1720\">\n\t\t\t\t\t\t\t <div class=\"licensing\"><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Shared previously<\/div><ul class=\"citation-list\"><li>Textbook of Psychiatry. <strong>Authored by<\/strong>: Wikibooks. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikibooks.org\/wiki\/Textbook_of_Psychiatry\/Print_version#Cluster_B\">https:\/\/en.wikibooks.org\/wiki\/Textbook_of_Psychiatry\/Print_version#Cluster_B<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Narcissistic Personality Disorder. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Narcissistic_personality_disorder\">https:\/\/en.wikipedia.org\/wiki\/Narcissistic_personality_disorder<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Modification, adaptation, and original content. <strong>Authored by<\/strong>: Julie Manley for Lumen Learning. <strong>Provided by<\/strong>: Lumen Learning. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Psychotherapy. <strong>Authored by<\/strong>: Jty33. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Psychotherapy.JPG\">https:\/\/commons.wikimedia.org\/wiki\/File:Psychotherapy.JPG<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">All rights reserved content<\/div><ul class=\"citation-list\"><li>The psychology of narcissism. <strong>Provided by<\/strong>: Ted-Ed. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.youtube.com\/watch?v=arJLy3hX1E8&#038;feature=youtu.be\">https:\/\/www.youtube.com\/watch?v=arJLy3hX1E8&#038;feature=youtu.be<\/a>. <strong>License<\/strong>: <em>Other<\/em>. <strong>License Terms<\/strong>: Standard YouTube License<\/li><\/ul><\/div>\n\t\t\t\t\t\t <\/div>\n\t\t\t\t\t <\/div>\n\t\t\t <\/section>","protected":false},"author":29,"menu_order":10,"template":"","meta":{"_candela_citation":"[{\"type\":\"cc\",\"description\":\"Textbook of Psychiatry\",\"author\":\"Wikibooks\",\"organization\":\"\",\"url\":\"https:\/\/en.wikibooks.org\/wiki\/Textbook_of_Psychiatry\/Print_version#Cluster_B\",\"project\":\"\",\"license\":\"cc-by-sa\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Narcissistic Personality 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