DSM-5 Paper: Narcissistic Personality Disorder

Narcissistic Personality Disorder

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The Narcissistic Personality Disorder or NPD is a type of personality disorder defined by an acute lack of empathy coupled with a severe sense of grandiosity. According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association, NPD is placed in the cluster B of personality disorders. The definition of NPD can be confused with ‘narcissism’ or harmless ‘overconfidence’ as the need for constant admiration as a result of a sensitive ego can occur without it being a personality disorder per se. However, the DSM-5 clarifies that it is clinically NPD only if the traits diagnostically associated with NPD are consistently present to an alarming degree with no flexibility and have the tendency to lead to dangerous behavior.

The most basic behavioral giveaway of the Narcissistic Personality Disorder is a drastic lack of empathy. Someone with NPD is prone to being unaware of other people’s needs. They will gaslight anyone affected by their own selfish behavior and would rather have them insulted and devalued in order to protect the inflated self. People with NPD can grow tired, restless or outright unable of watching someone talk about themselves. The grandiosity convinces them of superiority over others and hence enables the idea that their need for attention and spotlight must come at the expense of others. Although the DSM officially included NPD as a personality disorder in 1980 in its third edition, there was never a detailed criterion for pointing out this lack of empathy that was so prevalent in clinical cases of NPD. It has now been established through experimental research that NPD impairs emotional empathy while leaving cognitive empathy intact. CITATION Kat11 \l 1033 (Kathrin Ritter, 2011) It is also, perhaps, the reason why those affected by NPD are capable of maintaining a stable self-image as well as a relatively convincing outlook of a normal emotional state.

One of the most challenging features of the Narcissistic Personality Disorder that characterizes a general difficulty in its clinical diagnosis as well as in its public understanding is the heterogeneity it can claim. CITATION Eve15 \l 1033 (Eve Caligor, 2015) Although NPD is generally associated with lack of empathy, the visual manifestation of this disorder can have striking variance in the people affected by the disorder. A sense of grandiosity that harbors a need for admiration and an intense fear of failure can turn someone with NPD into a person incapable of holding a steady profession. The need for success and praise, however, can also turn the person ambitious enough to be wildly successful in the profession they pursue. Inability to take the faintest criticism of any sort can cripple the person’s social interactions. However, grandiosity and an inflated sense of self can also lead to someone with NPD forcefully entering themselves in conversations and scenarios where they enjoy limelight and attention. The DSM-5 solves this dilemma to some degree by characterizing NPD with four narrow and unrelenting features including grandiosity whether in behavior or fantasy, entitlement, lack of empathy and a need for admiration.

Another issue with the Narcissistic Personality Disorder that affects reliability in clinical diagnosis is its association with a myriad of other disorders. Studies have been conducted to examine the comorbidity patterns of the Narcissistic Personality Disorder. These usually revolve around two transdiagnostic factors while research has related NPD to both. CITATION Nic16 \l 1033 (Nicholas R. Eaton, 2016) The NPD is often also related to substance abuse and a string of other personality disorders which become the externalizing transdiagnostic factors. NPD also manifests a connection with multiple anxiety disorder which is an example for internalizing transdiagnostic factors.

Causes that can contribute to NPD have not been officially understood. However, a causative relationship to a certain extent has been developed using a biopsychosocial model. CITATION Joe14 \l 1033 (Paris, 2014) Under studies pertaining to this idea, it has been established that biological or genetic factors can contribute to about 40% of the total variance. This proves that heritable traits are significant, and it is improbable for a person to develop NPD without having family history with NPD. An observation of environmental factors left open by the genetic studies proves that although predisposed to biological factors, environmental enabling also plays a vital part in development and enhancement of NPD over time. Studies revolving around the sociocultural factors that lead to NPD have also been conducted. People from different parts of the world tend to have different ideas of vanity and sense of self.

The Narcissistic Personality Disorder is therefore a complex personality disorder with a heterogenous manifestation of its symptoms and a list of interlinked causative agents. The DSM-5 lists its pathological and behavioral components in detail.

References

BIBLIOGRAPHY Eve Caligor, K. N. (2015). Narcissistic Personality Disorder: Diagnostic and Clinical Challenges. American Journal of Psychiatry, 415-422.

Kathrin Ritter, I. D.-H. (2011). Lack of empathy in patients with narcissistic personality disorder. Psychiatry Research, 241-247.

Nicholas R. Eaton, C. R.-S. (2016). Narcissistic Personality Disorder and the Structure of Common Mental Disorders. Journal of Personality Disorders, 1-13.

Paris, J. (2014). Modernity and Narcissistic Personality Disorder. Personality Disorders: Theory, Research, and Treatment, 220-226.