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Diagnosing Narcissism

 

ICD 10 Personality Disorder Criteria:

  • A diverse category of psychiatric disorders characterized by behavior that deviates markedly from the expectations of the individual's culture; this pattern of deviation is pervasive and inflexible and is stable over time. The behavioral pattern negatively interferes with relationships and work.
  • A major deviation from normal patterns of behavior.
  • Personality disorders are long-term patterns of thoughts and behaviors that cause serious problems with relationships and work. People with personality disorders have difficulty dealing with everyday stresses and problems. They often have stormy relationships with other people. The exact cause of personality disorders is unknown. However, genes and childhood experiences may play a role. Symptoms vary widely depending on the specific type of personality disorder. Treatment usually includes talk therapy and sometimes medicine.
  • When normal personality traits become inflexible and maladaptive, causing subjective distress or impaired social functioning, they can be considered disorders.

ICD 10 Narcissistic Personality Disorder

  • A disorder characterized by an enduring pattern of grandiose beliefs and arrogant behavior together with an overwhelming need for admiration and a lack of empathy for (and even exploitation of) others.
  • Personality disorder characterized by excessive self-love, egocentrism, grandiosity, exhibitionism, excessive needs for attention, and sensitivity to criticism.

DSM V Diagnostic Criteria:

To diagnose narcissistic personality disorder, the following criteria must be met: 

  1. Significant impairments in personality functioning manifest by: 
  2. Impairments in self functioning (a or b): 
  3. Identity: Excessive reference to others for self-definition and self-esteem regulation; exaggerated self-appraisal may be inflated or deflated, or vacillate between extremes; emotional regulation mirrors fluctuations in self-esteem. 
  4. Self-direction: Goal-setting is based on gaining approval from others; personal standards are unreasonably high in order to see oneself as exceptional, or too low based on a sense of entitlement; often unaware of own motivations.

AND

  1. Impairments in interpersonal functioning (a or b): 
  2. Empathy: Impaired ability to recognize or identify with the feelings and needs of others; excessively attuned to reactions of others, but only if perceived as relevant to self; over- or underestimate of own effect on others. 
  3. Intimacy: Relationships largely superficial and exist to serve self-esteem regulation; mutuality constrained by little genuine interest in others‟ experiences and predominance of a need for personal gain 
  4. Pathological personality traits in the following domain: 
  5. Antagonism, characterized by: 
  6. Grandiosity: Feelings of entitlement, either overt or covert; self-centeredness; firmly holding to the belief that one is better than others; condescending toward others. 
  7. Attention seeking: Excessive attempts to attract and be the focus of the attention of others; admiration seeking. 
  8. The impairments in personality functioning and the individual's personality trait expression are relatively stable across time and consistent across situations. 
  9. The impairments in personality functioning and the individual's personality trait expression are not better understood as normative for the individual's developmental stage or socio-cultural environment. 
  10. The impairments in personality functioning and the individual's personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma)