Diagnosis, Classification, and Assessment of Narcissistic Personality Disorder Within the Framework of Object Relations Theory
Abstract
Narcissistic personality disorder (NPD) remains a controversial diagnosis, with lack of consensus on essential features of the disorder and its boundaries. Within the framework of object relations theory (ORT), core organizing, structural features define NPD and provide a coherent conceptual framework for understanding clinical features of the disorder. In the ORT model, both grandiose and vulnerable presentations of NPD are characterized by a specific form of self-pathology, reflecting the impact of a grandiose self-structure in the setting of borderline personality organization. The grandiose self-structure provides some stability of self-functioning but does not confer the self-regulatory capacities provided by normal identity formation and is reliant on maintaining a sense of the self as exceptional. We compare the ORT model of NPD to diagnostic criteria in the Alternative Model for Personality Disorders (AMPD) of the DSM-5, highlighting significant correspondence between the two models as well as conceptual differences.
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Living with pathological narcissism: a qualitative study
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- Authors
- Caligor, E., & Stern, B. L.
- Affiliations
- Columbia University (US)
- Columbia University Irving Medical Center (US)
- ORCID
- Caligor, Eve
- Venue
- Journal of Personality Disorders
- Publisher
- Guilford Publications
- Published
- 2020-03
- Volume
- 34
- Issue
- Supplement
- Pages
- 104-121
- ISSN
- 0885-579X (ISSN-L)
- OpenAlex
- W3011444507
- Cited by
- 27
- References
- 14
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 5 · 2023: 5 · 2022: 6 · 2021: 1 · 2020: 2 · 2013: 1
- FWCI
- 1.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Personality Disorders (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 › Psychoanalysis and Psychopathology Research
- Keywords
- narcissistic personality disorder, object relations theory, vulnerable narcissism, borderline personality organization, identity construction, self-regulation, Alternative Model for Personality Disorders, DSM-5 diagnostic criteria, personality disorder classification
- MeSH terms
- Borderline Personality Disorder, Humans, Object Attachment, Personality, Personality Disorders, Diagnostic and Statistical Manual of Mental Disorders
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