Comparing three systems for diagnosing narcissistic personality disorder

Narcissistic personality disorder (NPD) has been a widely used diagnostic entity. However, opinions about its descriptive validity differ considerably. Hitherto, three diagnostic systems have been developed, those by DSM-III, Akhtar and Thomson, and Kernberg. This paper compares these three systems with respect to concordance among diagnostic criteria, and conceptual themes around which the criteria cluster. The results indicate low concordance among the specific criteria used in these systems but a consensus about the conceptual themes describing self-experience, interpersonal relations and other aspects of NPD. This suggests that NPD is comprised of some core characteristics. However, a reconceptualization of the understanding of NPD must precede further empirical investigations.