Narcissistic Personality Disorder: Diagnostic and Clinical Challenges

Caligor, Eve; Levy, Kenneth N.; Yeomans, Frank E.

doi:10.1176/appi.ajp.2014.14060723

Cited by 187 publications

(159 citation statements)

References 42 publications

Supporting

Mentioning

126

Contrasting

Unclassified

Order By: Relevance

“…Narcissistic personality disorder spans a spectrum, ranging from high-functioning to malignant subtypes, is difficult to treat and requires longer-term treatment such as transference- or schema-focused psychotherapy and dialectical behavioral therapy54 ) . It is unknown whether this also applies to the burned out person with maladaptive narcissism (not narcissistic personality disorder).…”

Section: Resultsmentioning

confidence: 99%

“…It is unknown whether this also applies to the burned out person with maladaptive narcissism (not narcissistic personality disorder). Nonetheless, these persons will probably benefit most from any such oriented therapies if an exhaustive life engagement is discussed as a consequence of trying to maintain a self-perception of being exceptional (in fantasy or behavior) because of a fragile sense of self54 ) . Moreover, therapists may try to uncover maladaptive narcissism as a dysfunctional strategy for keeping up with an illusory self-image as a grandiose person, so to eventually turn maladaptive into adaptive behaviors4 ) .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Association of adaptive and maladaptive narcissism with personal burnout: findings from a cross-sectional study

et al. 2017

View full text Add to dashboard Cite

Burnout is associated with poor mental and physical functioning and high costs for societies. Personality attributes may critically increase the risk of personal burnout. We specifically examined whether narcissism associates with personal burnout in a working population. We studied n=1,461 employees (mean age 41.3 ± 9.4 yr, 52% men) drawn from a random sample of a pharmaceutical company in Germany. All participants completed the personal burnout subscale of the Copenhagen Burnout Inventory and the Narcissistic Personality Inventory to assess maladaptive (entitlement/exploitativeness) and adaptive (leadership/authority) narcissism. In linear regression analysis, when mutually adjusting for the maladaptive and adaptive narcissism scales, higher adaptive narcissism was associated with lower burnout scores (ß=−0.04, p<0.05), whereas higher maladaptive narcissism was associated with higher burnout scores (ß=0.04, p<0.05). Additionally, younger age (ß=−0.07), female gender (ß=0.11), depressive symptoms (ß=0.42), sleep problems (ß=0.30), stress at work (ß=0.23) and at home (ß=0.09) were all independently associated with increased burnout scores (all p-values<0.01). Narcissistic personality attributes may play an important role in personal burnout. While maladaptive narcissism was associated with increased levels of burnout symptoms, adaptive narcissism was associated with fewer burnout symptoms.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Association of adaptive and maladaptive narcissism with personal burnout: findings from a cross-sectional study

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Several researchers have examined the impact of NPD on the psychotherapeutic relationship. 12–14 Tanzilli and colleagues 14 found that individuals treating patients with NPD were more likely to experience negative counter-transference feelings of disengagement as well as feeling criticized or mistreated. These authors highlight the core feature of narcissism—struggle to form intimate relationships—as a significant barrier to positive treatment outcome, due to the patient’s potential inability to form a safe and trusting relationship with the therapist.…”

Section: Introductionmentioning

confidence: 99%

Narcissistic Personality Disorder in Clinical Health Psychology Practice: Case Studies of Comorbid Psychological Distress and Life-Limiting Illness

Kacel

Ennis

Pereira

2017

Behavioral Medicine

View full text Add to dashboard Cite

Narcissistic Personality Disorder (NPD) is characterized by a persistent pattern of grandiosity, fantasies of unlimited power or importance, and the need for admiration or special treatment. Individuals with NPD may experience significant psychological distress related to interpersonal conflict and functional impairment. Research suggests core features of the disorder are associated with poor prognosis in therapy, including slow progress to behavioral change, premature patient-initiated termination, and negative therapeutic alliance. The current manuscript will explore challenges of working with NPD within the context of life-limiting illness for two psychotherapy patients seen in a behavioral health clinic at a large academic health science center. The ways in which their personality disorder affected their illness-experience shared significant overlap characterized by resistance to psychotherapeutic change, inconsistent adherence to medical recommendations, and volatile relationships with providers. In this manuscript we will (1) explore the ways in which aspects of narcissistic personality disorder impacted the patients’ physical health, emotional well-being, and healthcare utilization; (2) describe psychotherapeutic methods that may be useful for optimizing psychosocial, behavioral, and physical well-being in individuals with comorbid NPD and life-limiting disease; and (3) review conceptualizations of NPD from the DSM-5 alternative model for assessing personality function via trait domains.

show abstract

“…An empathic approach acknowledges the patient's intense emotional response to the challenges of hospitalization without frustration and judgment. Maintaining an empathic—or even simply neutral—stance can avoid a power struggle and also improves the therapeutic alliance with the patient …”

Section: Behavioral Interventionsmentioning

confidence: 99%

When personality is the problem: Managing patients with difficult personalities on the acute care unit

Riddle

Meeks

Alvarez

et al. 2016

Journal of Hospital Medicine

View full text Add to dashboard Cite

Personality disorders are pervasive patterns of maladaptive behaviors, thoughts, and emotions that often go unrecognized and can wreak havoc in the patient's interpersonal life. These inflexible patterns of managing the world can be disruptive when an individual is admitted to the hospital, causing distress for both the patient who lacks the skills to deal with the expectations of the hospital environment and the treatment team who can feel ill equipped to manage such behavior. Having a personality disorder has implications for an individual's healthcare outcomes; those with a personality disorder have a life expectancy nearly 2 decades shorter than the general population for a multitude of reasons, among them trouble interacting with the healthcare system. Although a diagnosis of a specific personality disorder may be difficult to make on an acute care unit, identification of dysfunctional personality structures can provide opportunity for better management of an individual patient's medical and psychological needs. This review focuses on the identification of these individuals in the acute care setting and provides an overview of evidence‐based behavioral and pharmacological interventions. Journal of Hospital Medicine 2015;11:873–878. © 2015 Society of Hospital Medicine

show abstract

Narcissistic Personality Disorder: Diagnostic and Clinical Challenges

Abstract: See related features: Clinical Guidance (Table of Contents) and AJP Audio (online).

Cited by 187 publications

References 42 publications

Association of adaptive and maladaptive narcissism with personal burnout: findings from a cross-sectional study

Association of adaptive and maladaptive narcissism with personal burnout: findings from a cross-sectional study

Narcissistic Personality Disorder in Clinical Health Psychology Practice: Case Studies of Comorbid Psychological Distress and Life-Limiting Illness

When personality is the problem: Managing patients with difficult personalities on the acute care unit

Contact Info

Product

Resources

About