Narcissistic Personality Disorder: A Current Review

Abstract

The diagnosis of narcissistic personality disorder in the DSM-IV has been criticized foremost for its limitations in capturing the range and complexity of narcissistic pathology. The attention to the narcissistic individual's external, symptomatic, or social interpersonal patterns--at the expense of his or her internal complexity and individual suffering--has also added to the diagnosis' low clinical utility and limited guidance for treatment. Recent studies and reviews have pointed to the need for change in the diagnostic approach to and formulation of narcissism. This review focuses specifically on studies of features that add to the identification, understanding, and treatment of patients with pathological narcissistic functioning and narcissistic personality disorder. They have been integrated into a regulatory model that includes the functions and fluctuations of internal control, self-esteem, perfectionism with accompanying self-criticism, shame, and empathic ability and functioning.

Perfectionism and narcissism: A meta-analytic review

“…Morf and Rhodewalt's (2001) self-regulatory model describes perfectionism as an interpersonal strategy used as a means of protecting and enhancing narcissistic individuals' self-esteem. Similarly, Ronningstam (2010) theorized that narcissistic individual's grandiose self-concept is driven by a sustained sense of worthlessness, which prompts exhibition of an image of perfect capability in pursuit of others' respect and admiration. And Pincus, Cain, and Wright (2014) noted perfectionism in narcissism is particularly problematic as perfectionism contributes to a lack of positive reinforcement from occupational, social, and recreational activities as well as social withdrawal as a means "to hide an imperfect self" (p. 4).…”

“…More than a century of case histories and theoretical accounts suggest perfectionism is a central feature of the grandiose and the vulnerable aspects of narcissist's style of thinking, behaving, and relating (e.g., Beck, Freeman, & Davis, 2004;Freud, 1957;Horney, 1950;Ronningstam, 2010Ronningstam, , 2011Rothstein, 1999;Sorotzkin, 1985). Millon, for instance, noted that "narcissists cannot tolerate any flaw, however small, in the perfection of the self" (Millon & Davis, 2000, p. 284).…”

Self-reported depression and sense of disease in cosmetic patients

“…It is also characterized by showing arrogant behavior and attitudes, reacting strongly to criticism and by lack of empathy [19].…”

Réflexions sur le traitement basé sur la mentalisation ainsi que son adaptation pour des hommes présentant des troubles de la personnalité mixte ou narcissique

“…Pour Ronningstam (2010), le « contrôle interne » est une fonction psychologique qui sert à maintenir un sens interne de maîtrise, de cohésion, de pouvoir, d'unicité et de suffisance (Ronningstam, 2010, p. 71), ce qui s'apparente au concept de cohésion du self tel que compris par Kohut. Pour ce dernier, la cohésion du self est centrale au fonctionnement narcissique, ce qui implique de tenter de garder une impression de contrôle sur une peur sous-jacente de perte de contrôle interne (Kohut, 1971, p. 118-119, 128).…”

“…Pour ce dernier, la cohésion du self est centrale au fonctionnement narcissique, ce qui implique de tenter de garder une impression de contrôle sur une peur sous-jacente de perte de contrôle interne (Kohut, 1971, p. 118-119, 128). Pour Ronningstam (2010), la peur de perdre le contrôle peut être déclenchée par des expériences internes ou externes, et ce, surtout en ce qui a trait au besoin d'être suffisant et lorsque le patient devient envahi par la honte et la peur engendrer par la menace perçue de l'estime de soi (Ronningstam, 2010, p. 71). Ainsi, il nous faut être attentif à ce type d'expérience subjective qui s'avère fréquente en processus thérapeutique et régulière en groupe.…”