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Narcissistic Personality Disorder

Narcissistic personality disorder is a rigid and persistent disorder that causes great distress and functional difficulties. This disorder will typically start in early adulthood when an individual cannot outgrow the normal narcissism that is found between infancy and adolescence.

Diagnosis Criteria

Five of the following areas need to be present before a psychologist can diagnosis someone with narcissistic personality disorder:

• An exaggerated sense of self-importance, such as expecting to be seen a superior.
• Their life is preoccupied with fantasies of unlimited success, power, brilliance, beauty and/or ideal love.
• A belief that they individual is special and/or unique. Some times they feel they can only be understood by other people of equal important status.
• Excessive admiration is often required of other people.
• There is a strong sense of entitlement, such as expecting unreasonable favorable treatment.
• To achieve their own needs and wants they will take advantage of others.
• They are unwilling to recognize the feelings and/or needs of others and my often refuse to even identify them to the point that they lack empathy for others.
• Is either envious of others or believes that other are or should be envious of them.
• Typically have behaviors that are haughty with arrogant attitudes.

Prevalence of Narcissistic Personality Disorder

Less that one percent of the adult population today has narcissistic personality disorder. There are no conclusive studies that have proven whether or not certain ethnic, social, cultural, economic, genetic or professional individuals have increased likelihood of developing narcissistic personality disorder.

Narcissistic personality disorder is more common in adolescents, but they typically grow out of this behavior later in life. For people with the disorder the behavior continues later in adulthood and it will often intensify to the point that a psychologist will diagnosis the person with narcissistic personality disorder.
Both men and women have an equal chance of developing narcissistic personality disorder. However, recent studies have shown a shift towards women being more affected by the disorder with over seventy percent of the diagnosed cases being found in women.

Clinical Experience

Narcissism first occurs during infancy, childhood and early adolescence. Most of the time it is linked to childhood abuse and/or trauma that is caused by parents, authority figures or their peers. Narcissism is believed to be a defense mechanism that people use in an effort to deflect hurt and trauma by creating an invulnerable person.

When criticized a person with narcissistic personality disorder will often feel injured, humiliated and/or empty. Their responses may vary from disdain to rage to defiance. Other people with the disorder may also withdraw socially and use humility to mask their feeling of invulnerability. People with the disorder will often have a broad range of personalities, styles and reactions that can vary from mild which is reactive and transient to severe cases which are inflexible.

While many with this disorder are perfectly capable, their inability to tolerate any setbacks or criticism will often make it difficult for the person to cooperative with others and maintain long term achievements. A lack of empathy or disregard for others will also effects a persons interpersonal relationships.

Treatment and Prognosis

The most prescribed treatment for narcissistic personality disorder is a form of talk therapy. This is often a form of psychotherapy or cognitive-behavioral treatment. Some psychologists will prescribe medications to treat the conditions that accompany narcissistic personality disorder such as mood disorders or obsessive-compulsive disorders.

Many individuals who have narcissistic personality disorder will live a poor life unless it can be improved through treatment so that their life can adapt to social relationships. There are two approaches to treatment.

The psychodynamic approach focuses on the unconscious conflicts that exists inside the diagnosed individual. The cognitive-behavioral approach focuses on the way a person will act and think on their actions. Most of the time it will focus primarily on prior learning to explain how the difference in personality results.

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