Narcissistic personality disorder. Descriptive features and differential diagnosis

This article brings the scattered literature on narcissistic personality disorder together and synthesizes its various descriptive aspects into a multifaceted profile of the condition. The disorder is viewed as consisting of characteristic "overt" and "covert" findings in six areas of psychosocial functioning: (1) self-concept; (2) interpersonal relations; (3) social adaptation; (4) ethics, standards and ideals; (5) love and sexuality; and (6) cognitive style. Overtly, and individual with narcissistic personality disorder is grandiose, exploitative, moralistic, often successful, seductive, charming, and impressively knowledgeable and articulate. Covertly, however, he is doubt ridden, deeply envious of others, chronically bored, corruptible, unable to love, forgetful of details, and inattentive to objective aspects of events. Such conceptualization is superior to ordinary checklist methods of diagnosis, as it combines descriptive and psychodynamic observations and correlates the behavioral and psychostructural (hence developmental) aspects of the narcissistic character pathology. This profile also helps in more meaningful differential diagnosis of narcissistic from related personality disorders.