Narcissistic Personality Disorder: A Validity Study and Comparison to Borderline Personality Disorder
Abstract
Seventeen former inpatients with NPD were retrospectively compared to 19 patients with schizophrenia, 26 with MAD and 33 patients with BPD in terms of longitudinal course and outcome, exploring the validity of the NPD diagnosis. Two illustrative cases were presented. Results suggest that NPD is a valid diagnostic entity, more distinct from schizophrenia than MAD. NPD probably differs from BPD in terms of equal sex distribution in NPD; poor social functioning, especially in the low level of satisfaction with heterosexual relationships in NPD at follow-up; more rehospitalization in NPD; probably poorer global functioning in NPD at admission; and probably poorer overall follow-up functioning in NPD.
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Studies have documented the persistence of narcissistic pathology, even among patients who improve symptomatically.
“Overall, studies (Table 2) (76–83) have documented the persistence of narcissistic pathology, even among patients who improve symptomatically.”
From Narcissistic Personality Disorder: Progress in Understanding and Treatment (2022) · cites this paper as [76]
Comorbid conditions are likely contributors to the persistence of functional impairment, especially challenges in interpersonal functioning and romantic relationships.
“These comorbid conditions are likely contributors to the persistence of functional impairment (i.e., unrelenting challenges in interpersonal functioning, especially in the romantic arena) (76).”
From Narcissistic Personality Disorder: Progress in Understanding and Treatment (2022) · cites this paper as [76]
In Plakun (1989), a retrospective 17-year study of patients with narcissistic personality disorder found poor functioning and poor romantic relationships.
“Plakun, 1989 ( 76 ) Mean=24.5, SD=7.7 48:52 Retrospective/17 13.6 Poor functioning, poor romantic relationships”
From Narcissistic Personality Disorder: Progress in Understanding and Treatment (2022) · cites this paper as Plakun, 1989 ( 76 )
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“In his comparison of 17in-patients with NPD and 33 with BPD Plakun (1989) found that the NPD group showed a higher rate of admission at long term follow-up than did the BPD patients, and also a poorer overall level of function and sexual satisfaction.”
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“There is also evidence from a single-subject case study that individuals with significant narcissistic pathology can improve substantially in psychotherapy (Callaghan, Summers, & Weidman, 2003) and mixed evidence of the impact of NPD on functioning from follow-up studies (Plakun, 1989; McGlashan & Heinssen, 1989; Ronn…”
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“…Endicott, Spitzer, Fleiss, & Cohen, 1976) at admission of a comparable Riggs sample that included many of the patients investigated here was 34 (Plakun, 1989), indicating major impairments in work, family relations, judgment, thinking, mood, reality testing, communication, or a serious suicide…”
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- Authors
- Plakun, E. M.
- Affiliations
- Austen Riggs Center (US)
- Corresponding author
- Plakun, Eric M.
- Venue
- Psychiatric Clinics of North America
- Publisher
- Elsevier BV
- Published
- 1989-09
- Volume
- 12
- Issue
- 3
- Pages
- 603-620
- ISSN
- 0193-953X (ISSN-L)
- OpenAlex
- W2131093415
- Cited by
- 39
- References
- 13
- Citations by year
- 2024: 1 · 2022: 1 · 2020: 3 · 2019: 1 · 2018: 1 · 2017: 1 · 2012: 1
- FWCI
- 1.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Keywords
- narcissistic personality disorder, borderline personality disorder, diagnostic validity, schizophrenia, bipolar disorder, longitudinal outcomes, hospital readmission, social functioning, relationship satisfaction, sex distribution
- MeSH terms
- Adult, Borderline Personality Disorder, Female, Follow-Up Studies, Humans, Male, Narcissism, Patient Readmission, Personality Disorders, Psychiatric Status Rating Scales, Psychoanalytic Therapy, Schizophrenia, Schizophrenic Psychology, Suicide, Attempted
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