Narcissistic personality disorder: a current review

Area of Science:

• Psychiatry
• Clinical Psychology
• Personality Disorders

Background:

• The current diagnosis of narcissistic personality disorder (NPD) in the DSM-IV is criticized for its narrow focus on external patterns, neglecting internal complexity and patient suffering.
• This diagnostic limitation reduces clinical utility and treatment guidance for individuals with narcissistic pathology.

Purpose of the Study:

• To review studies that enhance the identification, understanding, and treatment of pathological narcissistic functioning and NPD.
• To propose a shift from the current diagnostic approach to a more comprehensive formulation of narcissism.

Main Methods:

• This review synthesizes recent studies and literature concerning narcissistic personality disorder.
• Focuses on features contributing to a deeper understanding and improved clinical management of NPD.
• Integrates findings into a proposed regulatory model of narcissistic functioning.

Main Results:

• The current diagnostic criteria for NPD are insufficient in capturing the full spectrum of narcissistic pathology.
• A new regulatory model incorporating internal control, self-esteem, perfectionism, self-criticism, shame, and empathy is presented.
• This model aims to improve the clinical utility and treatment planning for NPD.

Conclusions:

• The diagnosis of narcissistic personality disorder requires revision to better encompass internal experiences and suffering.
• A regulatory model offers a more nuanced framework for understanding and treating pathological narcissism.
• Future research should focus on validating and applying this integrated model in clinical settings.