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Cited by 77Personality Disorders and PsychopathologyPersonality Traits and PsychologyPsychoanalysis and Psychopathology Research

Current understanding of narcissism and narcissistic personality disorder

Open access
Yakeley, Jessica·2018·BJPsych Advances
DOI 10.1192/bja.2018.20
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Abstract

SUMMARY This article reviews historical contributions to the conceptualisation of narcissism and narcissistic personality disorder (NPD), including its evolution as a clinical diagnosis within the DSM classification of mental disorders. It discusses the epidemiology and aetiology of NPD, noting that empirical studies of both are limited. The challenges of managing patients with prominent narcissistic traits are presented, and the psychological therapies specifically designed for the treatment of patients with NPD are summarised. LEARNING OBJECTIVES • Understand different models of narcissism • Understand the epidemiology, comorbidity and theories of aetiology of NPD • Know how to manage and treat patients with pathological narcissism and NPD DECLARATION OF INTEREST None.

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  • Vulnerable narcissism includes depressed mood, insecurity, hypersensitivity, shame and identification with victimhood.

    “Vulnerable narcissism, in marked contrast to the overt grandiose features listed in DSM-5 criteria, includes instances of depressed mood, insecurity, hypersensitivity, shame and identification with victimhood [8–12].”

    From Living with pathological narcissism: a qualitative study (2020) · cites this paper as [10]

    The Diagnosis section (page unavailable) contrasts DSM-5’s grandiose criteria with vulnerable narcissism and describes the latter as overly sensitive, insecure, and anxious about shame and inadequacy. The Challenges section mentions victimhood, dysphoria, and depressive disorder in people with NPD generally, but does not identify depressed mood or victimhood as features of the vulnerable subtype. (LLM, conf=0.86)

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  • PN remains significantly underdiagnosed and undertreated, largely due to stigmatization and limited research focus, with few high-quality population studies and most existing knowledge derived from small sample-size investigations, case reports, and case series.

    “PN remains significantly underdiagnosed and undertreated. This is largely due to stigmatization and limited research focus respectively, with few high-quality population studies and most existing knowledge derived from small sample-size investigations, case reports, and case series (61).”

    From Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach (2025) · cites this paper as [61]

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Research works printed but not linked: 8

  1. c Narcissism and narcissistic personality disorder BJPsych Advances (2018), vol. 24, 305-315 doi: 10.1192/bja.2018.20 not otherwise specified personality disorder. Santé Mentale au Québec, 38: 243-58. · DOI
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  3. Hare R (2003) Hare Psychopathy Checklist-Revised (PCL-R): 2nd edition Technical Manual. Multi Health Systems.
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  5. Lee T, Mach E, Grove P (2013) Complexities in narcissistic personality dis- order assessment, engagement and treatment. Presentation at the Royal College of Psychiatrists' Faculty of Medical Psychotherapy Annual Conference, 17-19 April 2013 (https://www.rcpsych.ac.uk/pdf/calcmp- con2013tennysonleeewamach.pdf).
  6. Millon T (1981) Disorders of Personality. John Wiley & Sons.
  7. Rosenstein DS, Horowitz HA (1996) Adolescent attachment and psycho- pathology. Journal of Consulting and Clinical Psychology, 64: 244-53.
  8. Widiger TA, Trull TJ (1994) (1998) Performance characteristics of the DSM-III-R personality disorder criteria sets. In DSM-IV Sourcebook (vol 4) (eds A Widiger, AJ Francis, HA Pincus, et al): 357-73). American Psychiatric Press.

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Authors
Yakeley, J.
Affiliations
British Psychoanalytical Society (GB)
Corresponding author
Yakeley, Jessica
ORCID
Yakeley, Jessica
Venue
BJPsych Advances
Publisher
Royal College of Psychiatrists
Published
2018-07-05
Volume
24
Issue
5
Pages
305-315
ISSN
  • 2056-4678 (ISSN-L)
  • 2056-4686
DOI
10.1192/bja.2018.20
OpenAlex
W2872220689
Cited by
77
References
68
Citations by year
2026: 8 · 2025: 12 · 2024: 23 · 2023: 12 · 2022: 8 · 2021: 7 · 2020: 5 · 2019: 2
FWCI
4.12
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified)
Locations
BJPsych Advances (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
narcissism, narcissistic personality disorder, pathological narcissism, DSM classification, etiology, comorbidities, psychotherapy

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