Narcissistic+personality+disorder

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=Narcissistic Personality Disorder =


 * Diagnostic Features:**

Narcissistic personality disorder is a condition characterized by an inflated sense of self-importance, need for admiration, extreme self-involvement, and lack of empathy for others. Individuals with this disorder are usually arrogantly self-assured and confident. They expect to be noticed as superior. Many highly successful individuals might be considered narcissistic. However, this disorder is only diagnosed when these behaviors become persistent and very disabling or distressing.


 * Complications:**

Vulnerability in self-esteem makes individuals with this disorder very sensitive to criticism or defeat. Although they may not show it outwardly, criticism may haunt these individuals and may leave them feeling humiliated, degraded, hollow, and empty. They may react with disdain, rage, or defiant counterattack. Their social life is often impaired due to problems derived from entitlement, the need for admiration, and the relative disregard for the sensitivities of others. Though their excessive ambition and confidence may lead to high achievement; performance may be disrupted due to intolerance of criticism or defeat. Sometimes vocational functioning can be very low, reflecting an unwillingness to take a risk in competitive or other situations in which defeat is possible. Individuals with this disorder have special difficulties adjusting to growing old and losing their former ?superiority?.


 * Comorbidity:**

In this disorder, sustained feelings of shame or humiliation and the attendant self-criticism may be associated with social withdrawal, depressed mood, and Dysthymic or Major Depressive Disorder. In contrast, sustained periods of grandiosity may be associated with a hypomanic mood. Anorexia Nervosa, Substance-Related Disorders (especially related to cocaine), and other Personality Disorders (especially Histrionic, Borderline, Antisocial, and Paranoid) frequently co-occur with this disorder.

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NPD is treated in talk therapy (psychodynamic or cognitive behavioural). The prognosis for an adult narcissist is poor, though his adaptation to life and to others can improve with treatment. Medication is applied to side-effects and behaviours (such as mood or affect disorders and obsessive-compulsion) - usually with some success. (Healthy Place 2008)
 * Treatment:**


 * __DSM - IV - TR__**

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: []
 * 1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
 * 2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
 * 3) believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
 * 4) requires excessive admiration
 * 5) has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
 * 6) is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
 * 7) lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
 * 8) is often envious of others or believes that others are envious of him or her
 * 9) shows arrogant, haughty behaviors or attitudes

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