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Cited by 50Personality Disorders and PsychopathologyPersonality Traits and PsychologyPsychoanalysis and Psychopathology Research

Narcissistic Personality Disorder: Progress in Recognition and Treatment

Ronningstam, Elsa, Weinberg, Igor·2013·Focus
DOI 10.1176/appi.focus.11.2.167
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Abstract

This review will address pathological narcissism and narcissistic personality disorder (NPD)—the clinical presentation, the challenges involved in diagnosing NPD, and significant areas of co-occurring psychopathology (i.e., affective disorder, substance usage, and suicide). Major depressive disorder is the most common comorbid disorder in patients with pathological narcissism or NPD. Need for self-enhancement and chronic disillusionment with self make these individuals particularly susceptible to substance use. Suicidal preoccupation in these patients is characterized by the absence of depression, lack of communication, self-esteem dysregulation, and life events that decrease self-esteem. The diagnostic focus on patients’ external characteristics and interpersonal behavior tends to dismiss the importance of their internal distress and painful experiences of self-esteem fluctuations, self-criticism, and emotional dysregulation. A collaborative and exploratory diagnostic approach to pathological narcissism ...

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  • Motivation for coming to treatment in narcissistic personality disorder appears to be influenced by numerous factors, such as ultimatums from work, family, or friends; dissatisfaction with life or inability to accomplish important goals; acute life crisis; worsening of another comorbid condition; and suicidality.

    “Motivation for coming to treatment appears to be influenced by numerous factors, such as ultimatums from work, family, or friends; dissatisfaction with life or inability to accomplish important goals; acute life crisis; worsening of another comorbid condition; and suicidality (3).”

    From Narcissistic Personality Disorder: Progress in Understanding and Treatment (2022) · cites this paper as [3]

  • Treatment dropout is particularly high for individuals with pathological narcissism.

    “This is particularly salient as treatment dropout is particularly high for individuals with pathological narcissism [4], and as typical reason for attending treatment is for interpersonal difficulties [79].”

    From Living with pathological narcissism: a qualitative study (2020) · cites this paper as [79]

  • Many patients with narcissistic personality disorder have comorbid conditions, including mood disorder, anxiety disorder, or substance use disorder.

    “Many patients with the disorder have comorbid conditions (mood disorder, anxiety disorder, or substance use disorder) (3).”

    From Narcissistic Personality Disorder: Progress in Understanding and Treatment (2022) · cites this paper as [3]

  • Grandiose narcissists typically show an inflated self image and lack of depressive symptoms and subjective distress.

    “Although every subtype of narcissism is characterized by emotional dysregulation and unstable self esteem instability [8–11], grandiose narcissists typically show an inflated self image and lack of depressive symptoms and subjective distress.”

    From Symptom severity and mindreading in narcissistic personality disorder. (2018) · cites this paper as [11]

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Authors
Ronningstam, E., & Weinberg, I.
ORCID
Venue
Focus
Publisher
American Psychiatric Association Publishing
Published
2013-04
Volume
11
Issue
2
Pages
167-177
ISSN
  • 1541-4094 (ISSN-L)
  • 1541-4108
DOI
10.1176/appi.focus.11.2.167
OpenAlex
W2151427954
Cited by
50
References
91
Citations by year
2026: 3 · 2025: 4 · 2024: 7 · 2023: 6 · 2022: 5 · 2021: 5 · 2020: 4 · 2019: 1 · 2018: 2 · 2017: 4 · 2016: 3 · 2015: 4 · 2014: 2
FWCI
3.33
Type
journal article
Language
en
Open access
closed
Locations
FOCUS The Journal of Lifelong Learning in Psychiatry (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 › Psychoanalysis and Psychopathology Research
Keywords
narcissistic personality disorder, pathological narcissism, diagnosis, comorbidities, major depressive disorder, substance use, suicide, emotional dysregulation, self-criticism, self-enhancement, interpersonal behavior

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