Narcissistic Personality Disorder

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Elsa Ronningstam - One of the best experts on this subject based on the ideXlab platform.

  • perfectionism shame and aggression in depressive patients with Narcissistic Personality Disorder
    Journal of Personality Disorders, 2020
    Co-Authors: Jane Fjermestadnoll, Elsa Ronningstam, Bo S Bach, Bent Rosenbaum, Erik Simonsen
    Abstract:

    Depressive symptoms are known to co-occur in patients with Narcissistic Personality Disorder (NPD). From a psychodynamic perspective, perfectionism, shame, and aggression are regarded as prominent in depressed patients. The authors investigated the occurrence of perfectionism, shame, and aggression in patients with NPD, and whether shame is a mediating or a moderating factor for aggression. Two groups of patients with depression, 61 diagnosed with NPD and no other Personality Disorders (PD) were compared with 56 without any PD, using the SCID screening questionnaire and a semistructured interview. All participants were administered the Multidimensional Perfectionism Scale, the Internalized Shame Scale, and the Buss-Perry Aggression Questionnaire. The NPD group showed significantly higher scores for self-oriented and socially prescribed perfectionism, shame, and aggression (i.e., physical, verbal, anger, and hostility). Shame was found to act as a mediating factor, reducing levels of aggression in patients with perfectionistic traits.

  • Dos and Don'ts in Treatments of Patients With Narcissistic Personality Disorder.
    Journal of personality disorders, 2020
    Co-Authors: Igor Weinberg, Elsa Ronningstam
    Abstract:

    This article identifies guiding principles in effective psychotherapies of patients with Narcissistic Personality Disorder (NPD) and cautions against some common pitfalls. Individual psychotherapies of NPD patients were examined by both authors, who tested whether or not some principles, recommended in the literature, effectively promote these therapies and help these patients in moving forward with their lives and with effective therapy use. The authors identify a number of principles that were associated with more positive therapy development: helping patients identify goals and direction of their therapies, promoting a sense of agency, promoting a shift of focus to sense of vulnerability, and anticipating difficulty in developing and maintaining the treatment alliance. Common mistakes in these treatments are engaging in a power struggle with the patient, overindulging the grandiosity of the patient, directly challenging the grandiosity of the patient, and ignoring treatment-interfering behaviors. Identification of principles of effective therapies with NPD patients can help with the development of more effective treatment approaches for NPD.

  • characterological depression in patients with Narcissistic Personality Disorder
    Nordic Journal of Psychiatry, 2019
    Co-Authors: Jane Fjermestadnoll, Elsa Ronningstam, Bent Rosenbaum, Bo Bach, Erik Simonsen
    Abstract:

    Background: Depressive symptoms often occur in patients with Personality Disorders. Along the lines of the precious concepts of reactive and melancholic forms of depression, two different patterns of depressive symptoms can be identified. Reactive forms of depression is considered to be related to dysfunction of emotional regulation and social functioning, and to Personality Disorders. This study aimed at exploring the pattern of depressive symptoms in patients with Narcissistic Personality Disorder (NPD) compared to a group of depressed patients without Personality Disorder (PD). The Newcastle Diagnostic Depression Scale (NDDS) is a clinical instrument designed to differentiate reactive depression from melancholic depression. Method: The study investigated patterns of depressive symptoms in 117 out-patients, divided into two groups. One group containing 56 patients with depressive symptoms by no PD and the other group comprised of 61 patients with depressive symptoms and NPD. The participants were interviewed using the Newcastle Diagnostic Depression Scale. Results: There was a significant difference between the groups, as the NPD group suffered from reactive forms of depression. The NPD group showed a pattern of depressive symptoms characterized by fluctuation of the depressive state, without time demarcation of depressive episode, ruminations preoccupied with hostility and accusatory feelings towards other, but not self-accusatory feelings, fluctuation suicidal ideation triggered by external events accompanied by parasuicidal behavior, lack of neuro-vegetative symptoms such as insomnia with early wakening, loss of appetite and weight loss. The No PD group showed the opposite pattern. Conclusion: Based on these results NDDS is considered to be an applicable instrument for identifying Personality pathology in patients with depressive symptoms, by recognizing the specific pattern. This is thought to be important for adequate treatment planning.

  • Narcissistic Personality Disorder with Borderline Features
    Borderline Personality Disorder, 2018
    Co-Authors: Elsa Ronningstam
    Abstract:

    Patients with a primary Narcissistic Personality Disorder with accompanying borderline features present with specific challenges in psychotherapy. Their initial provocations and dismissiveness can significantly mask their internal struggle. A neutral and validating therapeutic approach can help patients feeling seen and recognized, and invite their description and reflective ability of their subjective experiences. Exploration of emotional functioning and capability is important as emotional disengagement can represent both a self-enhancing defense strategy or a neuropsychological deficits in emotional processing. Attention to external life experiences outside of treatment is also important as they can contribute to corrective emotional experiences and realizations promoting change.

  • Mini Quiz: Narcissistic Personality Disorder
    2016
    Co-Authors: Elsa Ronningstam
    Abstract:

    What is the clinical approach to pathological narcissism and Narcissistic Personality Disorder?

Joshua D. Miller - One of the best experts on this subject based on the ideXlab platform.

  • The narcissism epidemic: Commentary on Modernity and Narcissistic Personality Disorder.
    Personality disorders, 2014
    Co-Authors: Jean M. Twenge, Joshua D. Miller, W. Keith Campbell
    Abstract:

    Comments on the original article by Paris (see record 2012-18549-001) regarding Narcissistic Personality Disorder. The current authors agree with Paris that modern life is making people more Narcissistic. In fact, the authors demonstrate with this commentary, the case for increasing narcissism is even stronger than presented in his article. An explain that expressing individualism and lack of social support play key roles in this increase. However, the current authors question the idea that therapy is building narcissism.

  • Narcissistic Personality Disorder and the DSM-V.
    Journal of abnormal psychology, 2010
    Co-Authors: Joshua D. Miller, Thomas A. Widiger, W. Keith Campbell
    Abstract:

    We address 3 issues relevant to Narcissistic Personality Disorder (NPD) and the DSM-V. First, we argue that excluding NPD while retaining other traditional Personality Disorder constructs (e.g., avoidant) makes little sense given the research literature on NPD and trait narcissism and their association with clinically relevant consequences such as aggression, self-enhancement, distorted self-presentation, failed relationships, cognitive biases, and internalizing and externalizing dysregulation. Second, we argue that the DSM-V must include content (in diagnostic form or within a dimensional trait model) that allows for the assessment of both grandiose and vulnerable variants of narcissism. Finally, we suggest that any dimensional classification of Personality Disorder should recover all of the important component traits of narcissism and be provided with official recognition in the coding system.

  • Corrigendum to “Is research using the Narcissistic Personality inventory relevant for understanding Narcissistic Personality Disorder?” [Journal of Research in Personality 43 (2009) 482–488]
    Journal of Research in Personality, 2009
    Co-Authors: Joshua D. Miller, Eric T Gaughan, Charles Kamen, Lauren R. Pryor, W.k. Campbell
    Abstract:

    Abstract A correction is made to a previously published paper in Table 2 [Miller, J.D., Gaughan, E.T., Pryor, L.R., Kamen, C. (2008). Is research using the Narcissistic Personality inventory relevant for understanding Narcissistic Personality Disorder? [Journal of Research in Personality 43 (2009) 482–488].

  • is research using the Narcissistic Personality inventory relevant for understanding Narcissistic Personality Disorder
    Journal of Research in Personality, 2009
    Co-Authors: Joshua D. Miller, Eric T Gaughan, Charles Kamen, Lauren R. Pryor, W.k. Campbell
    Abstract:

    Abstract Most research on narcissism has been conducted using the Narcissistic Personality inventory (NPI). However, the generalizability of findings from the NPI to Narcissistic Personality Disorder (NPD) is unknown. The current study uses two samples (48 clinical outpatients; 49 undergraduates) to address this question by examining the correlations between the NPI and interview ratings of NPD. The profiles generated by both assessments in relation to measures of general Personality traits are compared to expert and meta-analytically derived profiles of NPD. The NPI and NPD assess overlapping constructs as they are significantly correlated and generate similar Personality profiles. The measures diverge primarily in that NPI narcissism includes traits related to certain facets of Extraversion, which is consistent with expert conceptualizations of NPD.

  • Narcissistic Personality Disorder relations with distress and functional impairment
    Comprehensive Psychiatry, 2007
    Co-Authors: Joshua D. Miller, Keith W Campbell, Paul A. Pilkonis
    Abstract:

    This study examined the construct validity of Narcissistic Personality Disorder (NPD) by examining the relations between NPD and measures of psychological distress and functional impairment both concurrently and prospectively across two samples. In particular, the goal was to address whether NPD typically “meets” Criterion C of the DSM-IV definition of Personality Disorder, which requires that the symptoms lead to clinically significant distress or impairment in functioning. Sample 1 (N =152) was composed of individuals receiving psychiatric treatment, while Sample 2 (N=151) was composed of both psychiatric patients (46%) and individuals from the community. NPD was linked to ratings of depression, anxiety, and several measures of impairment both concurrently and at 6month follow-up. However, the relations between NPD and psychological distress were (a) small, especially in concurrent measurements, and (b) largely mediated by impaired functioning. NPD was most strongly related to causing pain and suffering to others, and this relationship was significant even when other Cluster B Personality Disorders were controlled. These findings suggest that NPD is a maladaptive Personality style which primarily causes dysfunction and distress in interpersonal domains. The behavior of Narcissistic individuals ultimately leads to problems and distress for the Narcissistic individuals and for those with whom they interact.

W.k. Campbell - One of the best experts on this subject based on the ideXlab platform.

Giancarlo Dimaggio - One of the best experts on this subject based on the ideXlab platform.

  • 10 Things to Know About Narcissistic Personality Disorder
    2015
    Co-Authors: Giancarlo Dimaggio
    Abstract:

    Lack of empathy is a commonly known feature of Narcissistic Personality Disorder. Romantic relationships are typically shallow and difficult for to maintain. What are some other features of NPD? More in this case presentation.

  • adopting metacognitive interpersonal therapy to treat Narcissistic Personality Disorder with somatization
    Journal of Contemporary Psychotherapy, 2014
    Co-Authors: Giancarlo Dimaggio, Sara Valeri, Giampaolo Salvatore, Raffaele Popolo, Antonella Montano, Paolo Ottavi
    Abstract:

    Narcissistic Personality Disorder (NPD) is characterized by an intellectualizing narrative style, poor metacognition, maladaptive interpersonal schemas, a restricted set of states of mind, impaired agency and perfectionism. Metacognitive Interpersonal therapy targets these dysfunctions with a series of formalized procedures aimed at first forming a shared formulation of functioning which patients and therapists can then use to plan change. We describe here the core NPD pathology and illustrate the therapy process of a patient with NPD and a somatization Disorder. Implications for treatment of NPD are discussed together with a call for empirical testing of therapies for this severe condition.

  • Psychotherapy Tips: Working With Persons With Narcissistic Personality Disorder
    2012
    Co-Authors: Giancarlo Dimaggio
    Abstract:

    Narcissistic Personality Disorder is largely understudied, in spite of clinicians' warnings that this is the most frequent presentation in patients.

  • metacognitive interpersonal therapy for Narcissistic Personality Disorder and associated perfectionism
    Journal of Clinical Psychology, 2012
    Co-Authors: Giancarlo Dimaggio, Giovanna Attina
    Abstract:

    Treating Narcissistic Personality Disorder (NPD) successfully is possible but requires a thorough understanding of the pathology and appropriate clinical procedures. Perfectionism is one prominent feature often associated with Narcissistic difficulties. Metacognitive Interpersonal Therapy (MIT) for NPD adopts manualized step-by-step procedures aimed at progressively dismantling Narcissistic processes by first stimulating an autobiographical mode of thinking and then improving access to inner states and awareness of dysfunctional patterns. Finally, adaptive patterns of thinking, feeling, and acting are promoted, together with a sense of autonomy and agency and a reduction of perfectionistic regulatory strategies. Throughout, there needs to be constant attention to regulation of the therapy relationship to avoid ruptures and maximize cooperation. We describe here a successful case of MIT applied to a man in his early 20's with narcissism, perfectionism, and significant co-occurrence of Axis I and Axis II Disorders.

  • Narcissistic Personality Disorder: Rethinking What We Know
    2012
    Co-Authors: Giancarlo Dimaggio
    Abstract:

    DSM-5 better captures the essence of Narcissistic Personality Disorder (NPD) than previous versions did. The hypervigilant NPD subtype is the least understood but seen the most often in patients.

S Roepke - One of the best experts on this subject based on the ideXlab platform.

  • Structural and Functional Brain Imaging in Borderline, Antisocial, and Narcissistic Personality Disorder
    MRI in Psychiatry, 2014
    Co-Authors: Lars Schulze, S Roepke
    Abstract:

    The aim of this chapter is to present main functional and structural brain findings from the neuroscientific study of Personality Disorder. In particular, this chapter will focus on borderline, antisocial, and Narcissistic Personality Disorders. First, findings from individuals with borderline Personality Disorder (BPD) will be reviewed to highlight neural underpinnings of major psychopathological domains in BPD, i.e., processing and regulation of emotions, self-injurious behavior and pain processing, as well as interpersonal disturbances. Second, abnormalities of specific brain structures and functional networks of individuals with antisocial behavior and traits of psychopathy will be presented. Finally, we will discuss the few studies available from the neurobiological study of Narcissistic Personality Disorder.

  • Shame in patients with Narcissistic Personality Disorder.
    Psychiatry research, 2013
    Co-Authors: Kathrin Ritter, C-h Lammers, A Vater, Nicolas Rüsch, Michela Schröder-abé, Astrid Schütz, Thomas Fydrich, S Roepke
    Abstract:

    Shame has been described as a central emotion in Narcissistic Personality Disorder (NPD). However, there is a dearth of empirical data on shame in NPD. Patients with NPD (N=28), non-clinical controls (N=34) and individuals with borderline Personality Disorder (BPD, N=31) completed self-report measures of state shame, shame-proneness, and guilt-proneness. Furthermore, the Implicit Association Test (IAT) was included as a measure of implicit shame, assessing implicit shame-self associations relative to anxiety-self associations. Participants with NPD reported higher levels of explicit shame than non-clinical controls, but lower levels than patients with BPD. Levels of guilt-proneness did not differ among the three study groups. The implicit shame-self associations (relative to anxiety-self associations) were significantly stronger among patients with NPD compared to nonclinical controls and BPD patients. Our findings indicate that shame is a prominent feature of NPD. Implications for diagnosis and treatment are discussed.

  • Narcissistic Personality Disorder
    Der Nervenarzt, 2013
    Co-Authors: C-h Lammers, A Vater, S Roepke
    Abstract:

    Narcissism is a multifaceted term which encompasses traits of normal Personality as well as a specific Personality Disorder. While much research has been concerned with narcissism as a trait there are only few empirical studies available on Narcissistic Personality Disorder (NPS). The current diagnostic of NPS according to DSM-IV-TR focuses on grandiose type narcissism whereas vulnerable narcissism, which has been described by clinicians and researchers has not yet been recognised. Psychotherapy of Narcissistic patients through different psychotherapeutic schools focuses mainly on processes in the therapeutic relationship, the analysis and change of grandiose and vulnerable schemas, emotion regulation techniques and correction of Narcissistic behavior in favor of prosocial interactions.

  • lack of empathy in patients with Narcissistic Personality Disorder
    Psychiatry Research-neuroimaging, 2011
    Co-Authors: Kathrin Ritter, C-h Lammers, A Vater, S Roepke, Thomas Fydrich, Isabel Dziobek, Sandra Preisler, Anke Ruter, Hauke R Heekeren
    Abstract:

    Abstract The study's objective was to empirically assess cognitive and emotional empathy in patients with Narcissistic Personality Disorder (NPD). To date, “lack of empathy” is a core feature of NPD solely based on clinical observation. The study's method was that forty-seven patients with NPD, 53 healthy controls, and 27 clinical controls with borderline Personality Disorder (BPD) were included in the study. Emotional and cognitive empathy were assessed with traditional questionnaire measures, the newly developed Multifaceted Empathy Test (MET), and the Movie for the Assessment of Social Cognition (MASC). The study's results were that individuals with NPD displayed significant impairments in emotional empathy on the MET. Furthermore, relative to BPD patients and healthy controls, NPD patients did not show deficits in cognitive empathy on the MET or MASC. Crucially, this empathic profile of NPD is not captured by the Structured Clinical Interview for DSM-IV for Axis II Disorders (SCID-II). The study's conclusions were that while NPD involves deficits in emotional empathy, cognitive empathy seems grossly unaffected.

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