Narcissistic Personality Disorder: Progress in Recognition and Treatment (original) (raw)
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Depression and Narcissistic Pathologies of the Self
Clinical Schizophrenia and Related Psychoses, 2021
The manic phase of Bipolar I Disorder is often misdiagnosed as Narcissistic Personality Disorder (NPD).Narcissists mourn the loss of narcissistic supply; they grieve over vanished sources of supply; they bemoan the injustice and discrimination that they suffer at the hands of their inferiors. Narcissists are often in a bad mood, anhedonic, dysphoric, and outright depressed. The narcissist's mood swings are self-destructive and self-defeating.
DEPRESSION AND NARCISSISTIC DISORDER — Case report and clinical considerations
Archiv Euromedica, 2021
The evolution of research in the field of psychotherapy is not definitive, but always flexible when new therapeutic and/or pharmacological procedures are established. Aim: To show evidence for the importance of psychotherapy in the treatment of depression. Case description: As a method of therapy that is used successfully, there is cognitive behavioural therapy (CBT). The reported case study confirms by the results obtained and the objectives achieved, that CBT prevents much better recurrences in psychiatric disorders. Conclusion: Our case confirms that psychotherapy increases the quality of the patient's life in the fight against depression, modulation of one's own affect (narcissistic disorder), time management, development of communication and acceptance skills. It decreased anxiety and cardiovascular symptoms. The role of psychotherapy in the treatment of mental illness is beneficial and effective and facilitates compliance with antidepressant and anxiolytic treatment.
Narcissistic Personality Disorder in DSM-V—In Support of Retaining a Significant Diagnosis
Journal of Personality Disorders, 2011
Narcissistic personality disorder, NPD, has been excluded as a diagnostic category and independent personality disorder type in the Personality and Personality Disorder Work Group's recent proposal for DSM-5 Personality and Personality Disorders. The aim of this paper is to present supporting evidence in favor of keeping NPD as a personality type with a set of separate diagnostic criteria in DSM-5. These include: the prevalence rate, extensive clinical and empirical reports and facts, its psychiatric, social and societal significance especially when associated to functional vocational and interpersonal impairment, social and moral adaptation, and acute suicidality. Proposals for a clinically relevant and empirically based definition of narcissism, a description of the narcissistic personality disorder type, and a set of diagnostic criteria for NPD are outlined.
Psychological testing that matters: Creating a road map for effective treatment
2014
Clinically, we observe that patients whose self-esteem is especially brittle require certain considerations in formulating a treatment plan (e.g., Gold & Stricker, 2011). We refer to such patients as narcissistically vulnerable, but we are not using the term narcissistic pejoratively or as an equivalent to the Diagnostic and Statistical Manual of Mental Disorders (DSM) category of Narcissistic Personality Disorder. In contemporary psychoanalysis, as informed by self psychology (Kohut, 1977, 1984) and relational theory (e.g., Mitchell, 1986), narcissism is appreciated as a normal part of being human, and healthy self-love has its own developmental course intertwined with that of developing love for others. Regulating self-love and self-worth-that is, self-esteem-through life's inevitable failures, successes, losses, accomplishments, disapproval, and praise is a universal challenge requiring multiple adjustments, calibrations, and stabilizations daily. Some people, however, because of developmental setbacks and insufficiencies, struggle significantly with restoring a realistic, positive, and integrated sense of themselves through the upturns and downturns of fortune and misfortune. 7 EXPERIENCE OF SELF AND OTHER: NARCISSISTIC VULNERABILITIES
Characterological depression in patients with narcissistic personality disorder
Nordic Journal of Psychiatry, 2019
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 outpatients , 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.
Journal of Contemporary Psychotherapy, 2019
This review sought to outline the common complicating and facilitating factors during treatment of depressive symptoms in patients with narcissistic pathology, including various specific treatment approaches. A systematic literature search was performed to identify literature describing the co-occurrence of depressive symptoms and narcissistic pathology along with psychotherapeutic considerations and methods used to treat depressive symptoms in such patients. Theory and research suggest that depressive symptoms often co-occur with narcissistic disturbances because depression may emerge when narcissistic defenses fail. Narcissistic disturbances are thought to oscillate between grandiose and vulnerable features, and patients often seek treatment when they are in the vulnerable state. Psychological factors that are frequently dysregulated in these patients are shame, perfectionism and aggression. These factors must therefore be recognized as a part of the narcissistic pathology, and should particularly be considered in order to build a psychotherapeutic alliance with the patient, to avoid premature termination of treatment, and to achieve a positive treatment response. Psychotherapy must primarily target the underlying narcissistic disturbance, and not the depressive symptoms per se. The review aims at outlining treatment approaches that may be useful for clinicians.
Narcissistic Pathology: Empirical Approaches
Psychiatric Annals, 2009
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