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Narcissism
G505 Presentation: March 6, 2007
Kelli Brown
Greg Hetrick
Diana Mann
Alexa Yarnelle
The Greek Myth
Narcissus rejected the Nymph Echo
He was cursed to fall in love with his own
reflection.
Narcissus
The Greek Myth (cont.)
He eventually
changed into the
flower,
Narcissus
Narcissistic Personality Disorder
According to the DSM-IV-TR:


“a pervasive pattern of grandiosity, need for
admiration, and lack of empathy that begins by early
adulthood and is present in a variety of contexts.”
A Cluster B disorder that falls under the same cluster
as Antisocial Personality Disorder, Borderline
Personality Disorder, and Histrionic Personality
Disorder (dramatic, emotional, or erratic disorders).
Diagnostic Criteria (Five or more criteria must
be met for a diagnosis)
1) Grandiose sense of self importance


Exaggerates achievements and talents
Expects to be recognized as superior
Counselors—look for:
-boastful, pretentious behavior
-surprise when they don’t receive praise
-minimizing the efforts and contributions of others
Diagnostic Criteria (Five or more criteria must
be met for a diagnosis)
2) Preoccupied with fantasies of unlimited
success, power, brilliance, beauty, or ideal love.
Counselors—look for:
-clients comparing themselves to famous or
prestigious/privileged people
Diagnostic Criteria (Five or more criteria must
be met for a diagnosis)
3) Believe they are special and unique and can
only be understood by, or should associate with,
other special or high-status people (or
institutions).
Counselors—look for:
-clients who exclude others because they are simply not
good enough.
-saying they can only be understood by approved people
-placing a high value on the people chosen to associate with
-insisting on always having the “best” individual provide
services for them (teacher, doctor, etc.)
Diagnostic Criteria (Five or more criteria must
be met for a diagnosis)
4) Requires excessive admiration
Counselors—look for:
-fragile self-esteem
-preoccupation with the opinions others have of them
-expectation of others to covet their belongings and achievements
-fishing for compliments
Diagnostic Criteria (Five or more criteria must
be met for a diagnosis)
5) Has a sense of entitlement (unreasonable
expectations of especially favorable treatment or
automatic compliance with his or her
expectations).
Counselors—look for:
-clients who expect all others to cater to them
-belief that the work they do is “very important” and others should help
them unquestioningly
Diagnostic Criteria (Five or more criteria must
be met for a diagnosis)
6) Is interpersonally exploitative (takes
advantage of others to achieve his or her own
ends
Counselors--look for:
-a lack of sensitivity to the needs and wants of others
-expecting far too much out of other people
-forming relationships that simply enhance their self-esteem
-being greedy with material resources
Diagnostic Criteria (Five or more criteria must
be met for a diagnosis)
7) Lack of Empathy: unwilling to recognize or
identify with the feelings and needs of others.
Counselors—look for:
-trouble understanding the subjective experiences of others
-discussing their own concerns in lengthy detail
-impatience when others talk about their own concerns
-saying hurtful comments (ex: bragging to an ex about a new
relationship; bragging about health to a sick person)
-seeing the problems of others as weaknesses
Diagnostic Criteria (Five or more criteria must
be met for a diagnosis)
8) Often envious of others or believes that
others are envious of him or her.
Counselors—look for:
-thinking they are more deserving than others of positive consequences
-devaluing the admiration given to others
Diagnostic Criteria (Five or more criteria must
be met for a diagnosis)
9) Shows arrogant, haughty behaviors or
attitudes.
Counselors—look for:
-criticizing the work of others
-snobby attitudes, name calling
--DSM-IV-TR
Personality Descriptors
Amoral/conscienceless
Authoritarian
Cares only about appearances
Contemptuous
Critical of others
Cruel
Disappointing gift-givers
Don’t recognize own feelings
Envious and competitive
Feel entitled
Flirtatious or seductive
Gradiose
Hard to have a good time with
Hate to live alone
Hyper-sensitive to criticism
Lacks sense of humor
Naïve
Passive
Pessimistic
Religious
Secretive
Self-Contradictory
Stingy
Strange work habits
Unusual eating habits
Weird sense of time
**http://www.halcyon.com/jmas
hmun/npd/traits.html#contra
Other Characteristics
“Haunted” by criticism
Low threshold for humiliation
Severely impaired relationships
Low functioning due to a fear of defeat
--DSM-IV-TR
NPD is also associated with…
Dysthymic or Major Depressive Disorder
Hypomanic moods
Anorexia Nervosa
Substance-related disorders (especially cocaine)
Other personality disorders such as Histrionic,
Borderline, Antisocial, and Paranoid.
--DSM-IV-TR
Age of Onset/Gender Features
Narcissistic traits common in adolescents
Therefore, NDP is not diagnosed until adulthood
(if these traits have continued beyond
adolescence and caused significant failure in the
interpersonal environment).
Symptoms are intensified by the aging process,
due to physical and occupational limitations.
50-75% diagnosed are male
--DSM-IV-TR
--http://en.wikipedia.org/wiki/Narcissistic_personality_disorder
http://www.mayoclinic.com/health/narcissistic-personalitydisorder/DS00652/DSECTION=5
Prevalence
2-16% in the clinical population
<1% in the general population
--DSM-IV-TR
Differential Diagnosis
NPD is very similar to Histrionic, Antisocial, and
Borderline Personality Disorders, except for one
important characteristic:
GRANDIOSITY
When compared to Borderline PD…
NPD has a stable self-image
NPD has a lack of self-destructiveness,
impulsivity and fear of abandonment
--DSM-IV-TR
When Compared to Histrionic PD…
NPD has excessive pride in achievements
NPD has a lack of emotional display
NPD has lack of concern for others’ sensitivities
--DSM-IV-TR
When compared to Antisocial PD…
NPD is not characteristically impulsive
NPD is not an aggressive disorder
Individuals with NPD are not purposefully
deceitful
NPD requires more admiration from others
Individuals with NPD may lack the conduct
disorder from childhood or criminal behavior in
adulthood
--DSM-IV-TR
When compared to ObsessiveCompulsive Disorder
Both have perfectionistic qualities, and the belief that
only they can do things right
However, people with OCD are more self-criticizing,
while people with NPD think they are perfect.
--DSM-IV-TR
Other Differential Diagnoses
When compared to Schizotypal or Paranoid PD…
--NPD is not socially withdrawn and suspicious (unless
there is fear of defeat or criticism)
When compared to Manic/Hypomanic Episodes…
--both have grandiose characteristics, but NPD does not
have rapid mood change or impaired functioning
Also—be sure that symptoms are not the result of
Substance Use.
--DSM-IV-TR
Possible Causes
Genetics

Twin Study
Of the 18 personality characteristic measured,
narcissism had the highest hertability.
--Alvarez study —Assortative mating (“selfseeking like” hypothesis**
--http://en.wikipedia.org/wiki/Narcissism
Possible Causes (cont.)
Unconscious belief that oneself is “flawed in a
way that makes the person fundamentally
unacceptable to others”
Lack of healthy, empathic attachments
with primary caregivers.
The child begins to feel unwanted and
unconnected to others.
(http://en.wikipedia.org/wiki/Narcissistic_personality_disorder)
http://www.mayoclinic.com/health/narcissistic-personalitydisorder/DS00652/DSECTION=6
Possible Causes (cont.)
**According to the Mayo Clinic Website, these
developmental or parenting factors may contribute to
NPD:
An oversensitive temperament at birth
Overindulgence and overvaluation by parents
Valued by parents as a means to regulate their own self-esteem
Excessive admiration that is never balanced with realistic feedback
Unpredictable or unreliable caregiving from parents
Severe emotional abuse in childhood
Being praised for perceived exceptional looks or talents by adults
Learning manipulative behaviors from parents
http://www.mayoclinic.com/health/narcissistic-personality-disorder/DS00652/DSECTION=3
Narcissistic Parents
See children as “extensions of themselves,”
and pressure them to act according to
their unreachable standards.
Overly intrusive or neglectful
Harsh punishments including physical
abuse, blame, guilt, criticism, emotional
neglect, etc.
(http://en.wikipedia.org/wiki/Narcissistic_personality_disorder)
Environmental Factors:
“Co-Narcissism”
Narcissists look for this trait in their mates,
encourage it in their children.
Characterized by being passive and compliant to
the demands of others
Easily accepts blame
Accept others’ opinions
“Co-Dependent personality style similar to coalcoholism and co-dependency.”
(http://en.wikipedia.org/wiki/Narcissistic_personality_disorder)
Treatment Strategies
Difficult, because most people with NPD
will not seek treatment, due to the
characteristics of the disorder
Usually directed by others to begin therapy
(unwillingly)
People with NPD fear that therapy will
expose their weaknesses
http://www.mayoclinic.com/health/narcissistic-personalitydisorder/DS00652/DSECTION=6
Treatment Strategies (cont.)
Individual psychotherapy is the most
common form of treatment (sometimes
group and family counseling is
incorporated)
Pharmacotheraphy is rarely used to treat
NPD itself, but meds may be suggested to
treat other symptoms such as depression
or anxiety.
http://www.mayoclinic.com/health/narcissistic-personalitydisorder/DS00652/DSECTION=6
Prognosis
Success of psychotherapy depends on the
severity of the case
Other related problems that may arise as a
result of NPD:
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Relationship and family problems
Substance abuse and dependence
http://www.nlm.nih.gov/medlineplus/ency/article/000934.htm
A Side Note…
Many people display Narcissistic-type
personality characteristics, especially
people who are successful and competitive
NPD is only a Disorder when the
characteristics are inflexible, maladaptive,
and cause significant impairment or
distress.
--DSM-IV-TR
Assessment Strategies
Personality Disorder Test

Handed out in class
References
DSM-IV-TR
Wikipedia.com:
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
http://en.wikipedia.org/wiki/Narcissistic_personality_disorder
http://en.wikipedia.org/wiki/Narcissism
Mayo Clinic Online:
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http://www.mayoclinic.com/health/narcissistic-personalitydisorder/DS00652/DSECTION=5
http://www.mayoclinic.com/health/narcissistic-personalitydisorder/DS00652/DSECTION=6
http://www.mayoclinic.com/health/narcissistic-personalitydisorder/DS00652/DSECTION=3
MedicinePlus Medical Encyclopedia:

http://www.nlm.nih.gov/medlineplus/ency/article/000934.htm
References (cont.)
Personalilty Disorder Test Sources:
http://www.nightingalecenter.com/archive/narcissist.html
http://www.wellesley.edu/Psychology/Cheek/se
nsitive.html
http://npatest.homestead.com/files/NPAtest.ht
m
References (cont.)
1) L.L. (Subject A). Personal Interview. 27 Feb.
2007.
2) L.L. (Subject A). E-mail communications. April
2005-February 2007.
3) L.L. (Subject A). Personal Narrative. April 2005.
3) Rayment, W.J. Jean Piaget and Child Development.
25 Jan. 2007. 28 Feb. 2007
http://www.indepthinfo.com/articles/piagetdevelopmental-psychology.shtml.
4) Girl, Interrupted, Dir. James Mangold, Columbia
Pictures, 1999.
5) Monster-in-Law, Dir. Robert Luketic, New Line
Cinema, 2005.