Narcissistic personality disorder ( NPD ) is a personality disorder with long-term abnormal behavior patterns characterized by excessive feelings about self-interest, excessive need for admiration, and lack of empathy. Those exposed often spend a lot of time thinking about achieving strength or success, or on their appearance. They often take advantage of the people around them. Behavior usually begins in early adulthood, and occurs in various social situations.
The cause of the narcissistic personality disorder is unknown. This is a personality disorder belonging to cluster B by the Diagnostic and Statistical Manual of Mental Disorders . The diagnosis is made by a health care professional who interviews the person in question. This condition needs to be distinguished from mania and substance use disorders.
Treatment has not been well studied. Therapy is often difficult because people with disorders often do not consider themselves having problems. About one percent of people are believed to be affected at some point in their lives. It seems to be more common in men than women and affects young people more than older people. Personality was first described in 1925 by Robert Waelder, and the term NPD began to be used in 1968.
Video Narcissistic personality disorder
Signs and symptoms
People with narcissistic personality disorder (NPD) are characterized by their persistent greatness, excessive need for admiration, and personal humiliation and lack of empathy for others. Thus, people with NPD usually display arrogance and distorted feelings of superiority, and they attempt to build up brute force and control over others. Self-confidence (a strong sense of self) is different from a narcissistic personality disorder; people with NPD usually reward themselves for others as long as they openly ignore the feelings and desires of others, and expect to be treated as superiors, regardless of their actual status or achievement. In addition, people with narcissistic personality disorder usually show a fragile ego (self concept), critical intolerance, and a tendency to disparage others to validate their own superiority.
DSM-5 indicates that people with NPD usually display some or all of the following symptoms, usually without equivalent quality or achievement:
- Grandiosity in the hope of superior treatment from others
- Fixed on the fantasy of power, success, intelligence, attractiveness, etc.
- Self perception is unique, superior, and associated with high status persons and institutions
- Needs continuous admiration from others
- The right to special treatment and compliance from others
- Exploit others for personal gain
- Not willing to empathize with the feelings, desires, and needs of others
- Very jealous of others, and the belief that others are jealous of them
- Pompous and arrogant attitude
Narcissistic personality disorder usually develops during adolescence or during early adulthood. It is not uncommon for children and adolescents to show some features similar to NPD, but such events are usually temporary, and do not meet the criteria for NPD diagnosis. The true symptoms of the NPD are pervasive, clear in many situations, and rigid, consistent over time. NPD symptoms should be severe enough to the extent that significantly impairs a person's ability to develop meaningful human relationships. Generally, NPD symptoms also interfere with a person's psychological ability to function, whether at work, or school, or important social arrangements. DSM-5 indicates that the properties manifested by the person must be substantially different from cultural norms, in order to qualify as a NPD symptom.
Related features
People with NPD tend to overestimate their skills and achievements as well as their level of intimacy with people they regard as high status. Their sense of superiority can cause them to monopolize the conversation and become impatient or dismissive when others talk about themselves. In conversation, they can intentionally or unconsciously degrade or humiliate others by overemphasizing their own success. When they realize that their statement has hurt others, they tend to react with humiliation and see it as a sign of weakness. When their own ego is hurt by real or perceived criticism, their anger can be disproportionate with the situation, but usually, their actions and responses are deliberate and calculated. Despite these discomforts, their self-image is particularly stable (ie, overinflated).
To the extent that people are pathologically narcissistic, they can control, blame, selfish, intolerant of others' views, unaware of the needs of others and the effects of their behavior on others, and insist that others see them because they want to be seen. Narcissistic individuals use various strategies to protect themselves at the expense of others. They tend to devalue, humiliate, humiliate and blame others, and they often respond to threatening feedback with anger and hostility. Because the fragile individual ego of the NPD is hypersensitive to perceived criticism or defeat, they are vulnerable to feelings of shame, humiliation and disrespect over small or even imagined incidents. They usually mask these feelings from others by humiliating humility or by isolating themselves socially, or they may react with outbursts of anger, insubordination, or in vengeance. The combination of "self-concept of being pumped" and "the real self" is seen in the inherent indulgence of narcissistic personality disorder. Also inherent in this process is the defense mechanism of denial, idealization and devaluation.
According to DSM-5, "Many highly successful individuals display personality traits that may be considered narcissistic, only when these traits are inflexible, maladaptive, and persist and cause significant functional impairment or subjective distress whether they are narcissistic personality disorders. " Due to the high functionality associated with narcissism, some people may not see it as a nuisance in their lives. Although overconfidence tends to make individuals with an ambitious NPD, it does not necessarily lead to professional success and achievement. These people may not want to compete or may refuse to take any risk to avoid failure. In addition, their inability to tolerate decline, disagreement or criticism, along with lack of empathy, makes it difficult for such individuals to work cooperatively with others or to maintain long-term professional relationships with superiors and colleagues.
Maps Narcissistic personality disorder
Cause
The cause of the narcissistic personality disorder is unknown. Experts tend to apply the cause-effect biopsychosocial model, which means that a combination of environmental, social, genetic and neurobiological factors tends to play a role in formulating narcissistic personality.
Genetic
There is evidence that narcissistic personality disorder is inherited, and individuals are much more likely to develop NPD if they have a family history of the disorder. The study of the occurrence of personality disorders in twins determines that there is moderate to high heritability for narcissistic personality disorder.
However, specific genes and gene interactions that contribute to the cause, and how they may affect the developmental and physiological processes underlying this condition, have not been determined.
Environment
Environmental and social factors are also suspected to have a significant influence on early NPD. In some people, pathological narcissism can develop from attachment disruption to their primary caregiver, usually their parent. This can lead to a child's perception of himself as unimportant and unrelated to others. The boy usually comes to believe that they have some personality disability that makes them unappreciated and undesirable. Too many people, permissive parenting and overly sensitive child care and over-controlling, are believed to be contributing factors.
According to Leonard Groopman and Arnold Cooper, the following factors have been identified by various researchers as a possible factor to promote the development of NPD:
- Very sensitive temperament (personality traits) at birth.
- Excessive admiration that is never matched by realistic feedback.
- Excessive praise for good behavior or excessive criticism for bad behavior in childhood.
- Overindulgence and overvaluation by parents, other family members, or peers.
- Praised for seeing exceptional looks or abilities by adults.
- Severe emotional abuse in childhood.
- Unpredictable or unreliable parenting from parents.
- Learn the manipulative behavior of a parent or peer.
- Estimated by parents as a means to regulate their self-esteem.
Cultural elements are believed to affect the prevalence of NPD as well because the nature of NPD has been found to be more common in modern societies than is traditional.
Pathophysiology
There is little research on the neurological basics of narcissistic personality disorder. However, recent studies have identified structural abnormalities in their brains with narcissistic personality disorders, particularly noting less volume of gray matter in the left anterior insula. Other studies have linked conditions with diminished gray matter in the prefrontal cortex.
The areas of the brain identified in the above study are related to empathy, affection, emotional setting, and cognitive function. These findings suggest that narcissistic personality disorder is related to the compromised capacity for emotional empathy and emotional regulation.
Diagnosis
DSM-5
Narcissistic personality disorder formulation at the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorder, 4th Edition, Text Revision (DSM-IV-TR) was criticized for failing to describe the range and complexity of the disorder. Critics say it focuses too on the "interpersonal patterns of the external, the symptomatic, or the individual social narcissist, at the expense of... internal complexity and individual suffering," which they argue reduces its clinical utility.
The Personality and Personality Disorders Working Group initially proposed the elimination of NPD as a distinct disorder in DSM-5 as part of a major revision of the diagnostic criteria for personality disorder, replacing categorically with a dimensional approach based on the severity of dysfunctional personality traits. domain. Some doctors have objected to this, characterizing the new diagnostic system as a "different weight conglomeration of different models that can not co-exist" and may have limited utility in clinical practice. The general step towards viewing the dimensions (personality by nature) of the Personality Disorder has been maintained despite the reintroduction of NPD.
ICD-10
World Health Organization (WHO) International Statistical Classification of Diseases and Related Health Problems , 10th Edition (ICD-10) list of narcissistic personality disorder under other personality disorders . It is an ICD-10 requirement that the diagnosis of a particular personality disorder also meets a set of common personality disorder criteria.
Subtype
While the DSM-5 considers narcissistic personality disorder as a homogeneous syndrome, there is evidence for variation in its expression. In a 2015 paper, two main presentations of narcissism are usually suggested, "plain" or "grandiose" subtypes, characterized by greatness, arrogance, and courage, and "hidden" or "vulnerable" subtypes characterized by self-defense and hypersensitivity. Those who have "narcissistic sensibilities" express behavior "through interpersonal exploitative actions, lack of empathy, envy, aggression, and exhibitionism." Psychiatrist Glen Gabbard describes the subtype, which he calls the "unconscious" subtype as a grandiose, arrogant, and thick-skinned person. The subtype "narcissistic vulnerability" requires (at the conscious level) "helplessness, emptiness, low self-esteem, and shame, which can be expressed in behavior as social avoidance in situations where their self-presentation is impossible so that they attract, or the consent they require/expect not to be fulfilled. "Gabbard describes this subtype, which he calls the" hypervigilant "subtype as vulnerable, sensitive, and embarrassed. In addition, the presentation "works high", where there is less damage in the sphere of life where people with more severe expression of the disorder usually have difficulties in, suggested.
Theodore Millon suggests five subtypes of narcissism. However, there are some pure variants of any subtype, and subtypes are not recognized in DSM or ICD.
Additional categories that may not be cited by Millon's current theory may include:
Will Titshaw also suggested three subtypes of narcissistic personality disorder not officially recognized in the DSM or ICD edition.
Comorbidity
NPD has a high rate of comorbidity with other mental disorders. Individuals with NPD are susceptible to depression attacks, often meeting the criteria for concomitant depression disorder. In addition, NPD is associated with bipolar disorder, anorexia, and impaired use of substances, especially cocaine. As far as other personality disorders, NPD may be associated with histrionic, border, antisocial, and paranoid personality disorders.
Treatment
Narcissistic personality disorder is rarely the main reason for people seeking mental health care. When people with NPD enter care, it is usually demanded by life's difficulties or seek help from other disorders, such as major depressive disorders, substance use disorders, bipolar disorder, or eating disorders, or at the urging of relatives and friends. This is partly because individuals with NPD generally have poor insight and fail to recognize their perceptions and behaviors as inappropriate and problematic because of their very positive self-image.
Treatment for NPD centers around psychotherapy. In the 1960s, Heinz Kohut and Otto Kernberg challenged conventional wisdom at the time by outlining a clinical strategy for using psychoanalytic psychotherapy with clients with NPD that they claim to be effective in treating the disorder. The modality of contemporary medicine generally involves therapy that focuses on transference, metacognitive, and schema-focused. Some improvements may be observed through the treatment of symptoms associated with comorbid disorders with psychopharmacy, but by 2016, according to Elsa Ronningstam, a psychologist at Harvard Medical School, "Building alliances and involving agency feelings and patient reflective abilities is essential for change in pathological narcissism. "
A pattern change strategy conducted over a long period of time is used to enhance the ability of those with NPD to become more empathic in everyday relationships. To help modify their sense of entitlement and self-centered schemes, the strategy is to help them identify how to harness their unique talents and to help others for reasons other than their own personal benefits. It's not so much to change their self-perception of their "right" feelings but rather to help them empathize with others. Another type of treatment is temperament change. Psychoanalytic psychotherapy may be effective in treating NPD, but the therapist must recognize the patient's nature and be careful in destroying narcissistic defenses too quickly. Anger, anger, impulsivity, and impatience can be done with skills training. Treatment may be ineffective because the patient may receive feedback poorly and defensively. Anxiety disorders and somatoform dysfunction are common but the most common are depression.
Group care has benefits because the effectiveness of receiving peer feedback rather than physicians may be more acceptable, but group therapy may also conflict with itself as patients may exhibit "demands, egocentrism, social isolation and withdrawal, and social deviant behavior". The researchers initially thought that group therapy among patients with NPD would fail because it was believed that group therapy required empathy that NPD patients were deprived. However, research shows group therapy does hold value for patients with NPD because it allows them to explore boundaries, develop trust, increase self-awareness, and receive feedback. Relationship therapy emphasizes the importance of learning and implements four basic interpersonal skills: "... effective expression, empathy, discussion and problem resolution/conflict resolution". Marital/relationship therapy is the most beneficial when both partners participate.
No drug is indicated to treat NPD, but may be used to treat concurrent mental or symptomatic conditions that may be associated with it such as depression, anxiety, and impulsivity if present.
Prognosis
The effectiveness of psychotherapy and pharmacological interventions in the treatment of narcissistic personality disorder has not been systematically and empirically investigated. Clinical practice guidelines for disorders have not been created, and current treatment recommendations are largely based on theoretical psychodynamic models of NPD and physician experience with individuals suffering in clinical settings.
The presence of NPD in patients undergoing psychotherapy for the treatment of other mental disorders is associated with slower treatment progression and higher dropout rates.
Epidemiology
The lifetime prevalence of NPD is estimated to be 1% in the general population and 2% to 16% in the clinical population. A systematic review of 2010 found a prevalence of NPDs ranging from 0% to 6% in community samples. There is a small gender difference, with men having a slightly higher incidence than women.
According to a 2015 meta-analysis that discerns gender differences in NPD, there has recently been a debate about increasing the prevalence of NPD among the younger generation and among women. However, the authors found that this was not reflected in the data and that the prevalence remained relatively stable for both sexes over the past 30 years (when data on the disorder was first collected).
History
The use of the term "narcissism" to describe the excessive vanity and egoism preceded by many years of modern medical classification of narcissistic personality disorder. This condition was named after Narcissus, a mythological Greek youth who became infatuated with his own shadow in a lake. He did not realize at first that it was his own shadow, but when he did, he died of grief for falling in love with someone who was not outside him.
The term "structure of narcissistic personality" was introduced by Kernberg in 1967 and the "narcissistic personality disorder" was first proposed by Heinz Kohut in 1968.
Initial Freudianism
Sigmund Freud commented, regarding the neurotic beliefs of adults, that "this belief is an honest recognition of the old megalomania relic of infancy". He also concluded that "we can detect the megalomaniac element in most other forms of paranoic disorder, we are justified in the assumption that this megalomania is essentially childish and that, as a result of development, it is sacrificed for social consideration".
Edmund Bergler also considers megalomania to be normal in children, and for it can be reactivated later in the gambling. Otto Fenichel states that, for those who react later in the illness to narcissism by denial, similar regression to childhood megalomania is occurring.
Object relation
While Freud saw megalomania as an obstacle to psychoanalysis, in the second half of the 20th century the theory of object relations, both in the United States and among the British Kleinians, governed the revaluation of megalomania as a defense mechanism that offered potential access to therapy. Such an approach builds on Heinz Kohut's view of narcissistic megalomania as a normal aspect of development, on the contrary by Kernberg's consideration of such splendor as the distortion of pathological development.
Society and culture
In popular culture, narcissistic personality disorder has been called megalomania.
Fiction
An article on the Web Victoria argues that Rosamond Vincy, at George Eliot's Middlemarch (1871-72), is a complete narcissist as defined by DSM.
In the movie To Die For, Nicole Kidman's character wants to appear on television in every way, even if this involves killing her husband. The psychiatric assessment of his character notes that he is "seen as a prototypical narcissistic person by the appraiser: on average, he satisfied 8 out of 9 criteria for a narcissistic personality disorder... has he evaluated for personality disorder, he will receive a diagnosis of narcissistic personality disorder".
Other examples of popular fiction include the Adam Demamp television character (played by Adam DeVine at Workaholics) and Dennis Reynolds (played by Glenn Howerton at It's Always Sunny in Philadelphia).
Criticism
A study in Norway concluded that narcissism should be understood as a personality dimension related to the entire range of PDs, not as distinct diagnostic categories. AlarcÃÆ'³n and Sarabia in examining past literature on disorders conclude that narcissistic personality disorder "denotes nosologis inconsistency and that its consideration as a domain of nature with further research is needed will be of great benefit to the field".
See also
References
Further reading
- Masterson, James F (June 1, 1981). Narcissistic and Borderline Disorder: Integrated Development Approach (First Edition). London: Routledge. ISBN: 978-0876302927.
- Brown, Nina W (April 1, 2008). Children from Self-Absorbed (Second ed.). Oakland: New Harbinger Publication. ISBN: 978-0743214285.
- Behary, Wendy (July 1, 2013). Disarming Narcissists (second edition). Oakland: New Harbinger Publication. ISBN: 978-1608827602.
- Hotchkiss, Sandy (August 7, 2003). Why Always About About You? (Reprinted.). Florence: Free Press. ISBN: 978-1572245617.
- Jean M. Twenge, Ph.D. and W. Keith Campbell, Ph.D., The Narcissism Epidemic , New York, Free Press 2009 ISBNÃ, 978-1-4165-7625-9
External links
- Narcissistic personality disorder
- Narcissistic personality disorder Mayo Clinic
- Narcissistic Personality Disorder Cleveland Clinic
- Narcissistic personality disorder: research is summarized PubMed
Source of the article : Wikipedia
0 Comments