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Cited by 30Personality Disorders and PsychopathologyPersonality Traits and PsychologyPsychoanalysis and Psychopathology Research

Narcissistic Personality Disorder: Are Psychodynamic Theories and the Alternative DSM-5 Model for Personality Disorders Finally Going to Meet?

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Schalkwijk, Frans, Luyten, Patrick, Ingenhoven, Theo, Dekker, Jack·2021·Frontiers in Psychology
DOI 10.3389/fpsyg.2021.676733PMC PMC8321510
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Abstract

Narcissistic Personality Disorder is the new borderline personality disorder of our current era. There have been recent developments on narcissism that are certainly worthwhile examining. Firstly, relational and intersubjective psychoanalysts have been rethinking the underlying concepts of narcissism, focusing on the development of self and relations to others. Secondly, in the DSM-5, the Alternative DSM-5 Model for Personality Disorders (AMPD) was presented for a dimensional evaluation of the severity of personality disorder pathology. The combined dimensional and trait conceptualization of NPD opened the door to new integrated diagnostic perspectives, including both internal and interpersonal functioning. Finally, Pincus and Lukowitsky encourage clinicians to use a hierarchical model of pathological narcissism, as it opens up opportunities for shared points of interest in empirical research from different scholarly perspectives. As for most non-psychodynamic clinicians and researchers the DSM-5 clearly bears dominant weight in their work, we will take the AMPD model for NPD as our point of reference. We will discuss the narcissist's unique pattern of self-impairments in identity and self-direction, and of interpersonal disfunctioning (evaluated by assessing empathy and intimacy). Subsequently, we will examine how contemporary psychodynamic theories and the hierarchical model of Pincus and Lukowitsky additionally inform or contradict the AMPD. For us, one of the big advantages of the AMPD is the use of structured clinical evaluations of disturbances of the self and interpersonal functioning and the dimensional evaluation of severity. As psychodynamically oriented therapists, we are enthusiastic about the opportunities for inclusion of psychodynamic concepts, but we also discuss a number of sticking points.

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  • The overt versus covert dimension of pathological narcissism is independent of the vulnerability versus grandiose dimension.

    “The overt versus covert dimension is independent of the vulnerability versus grandiose dimension (11, 28), although unlike the latter, it is relatively invariable over time and across domains.”

    From Narcissistic Personality Disorder: Progress in Understanding and Treatment (2022) · cites this paper as [11]

  • The overt versus covert dimension is relatively invariable over time and across domains.

    “The overt versus covert dimension is independent of the vulnerability versus grandiose dimension (11, 28), although unlike the latter, it is relatively invariable over time and across domains.”

    From Narcissistic Personality Disorder: Progress in Understanding and Treatment (2022) · cites this paper as [11]

    The Hierarchical Model of Narcissism section says grandiose and vulnerable narcissism can each be expressed overtly or covertly, but does not say whether overt or covert expression remains stable over time or across domains. Searches for stability, time, and domains found no passage addressing that claim. (LLM, conf=0.72)

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Research works printed but not linked: 12

  1. Caligor E. (2013). Narcissism in the psychodynamic diagnostic manual,” in Understanding and Treating Pathological Narcissism, ed Ogrodniczuk J. S. (Washington, DC: American Psychological Association), 63– 79. 10.1037/14041-004 · DOI
  2. Freud S. (1914). Outline of Psychoanalysis, Standard Edn., Vol. 23. London: Hogarth Press.
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  5. Lachmann F. M. (2007). Transforming Narcissism. Reflections on Empathy, Humor and Expectations. New York, NY; London: The Analytic Press.
  6. Lingiardi V. McWilliams N.(eds.). (2017). Psychodynamic Diagnostic Manual, 2nd Edn. New York, NY; London: The Guilford Press.
  7. Modell A. H. (1993). The Private Self. Cambridge, MA: Harvard University Press.
  8. Morrison A. P. Lansky M. R. (2008). Shame and envy, in Jealousy and Envy. New Views About Two Powerful Feelings, eds Wurmser L. Jarass H. (New York, NY; London: Routledge), p. 179– 187.
  9. Pincus A. L. (2013). The pathological narcissism inventory, in Understanding and Treating Pathological Narcissism, ed Ogrodniczuk J. S. (Washington, DC: American Psychological Association), 93– 110. 10.1037/14041-006 · DOI · Paper page
  10. Schalkwijk F. (2015). Self-Conscious Emotions and the Conscience in Adolescence. Theory and Diagnostics. Hove; New York, NY: Routledge.
  11. Skodol A. E. Bender D. S. Oldham J. M. (2014b). An alternative model for personality disorders. DSM-5 Section III and beyond, in The American Psychiatric Publishing Textbook of Personality Disorders, 2nd Edn., Oldham J. M. Skodol A. E. Bender D. S. (Washington DC: American Psychiatric Publishing), 511– 544. 10.1176/appi.books.9781585625031.rh25 · DOI
  12. Wurmser L. Jarass H. (eds.). (2008). Jealousy and Envy. New Views About to Powerful Feelings. New York. NY; London: Routledge.

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Authors
Schalkwijk, F., Luyten, P., Ingenhoven, T., & Dekker, J.
Affiliations
  • University of Amsterdam (NL)
  • University College London (GB)
  • Arkin (NL)
Corresponding author
Schalkwijk, Frans
ORCID
Venue
Frontiers in Psychology
Publisher
Frontiers Media SA
Published
2021-07-15
Volume
12
Pages
676733-676733
ISSN
1664-1078 (ISSN-L)
DOI
10.3389/fpsyg.2021.676733
PMC
PMC8321510
OpenAlex
W3184269566
Cited by
30
References
73
Citations by year
2026: 2 · 2025: 6 · 2024: 6 · 2023: 7 · 2022: 7 · 2021: 1 · 2013: 1
FWCI
0.70
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • VU Research Portal (publishedVersion, other-oa)
  • Lirias (acceptedVersion, cc-by)
  • UvA-DARE (University of Amsterdam) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
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, interpersonal problems, empathy, intimacy, relational psychoanalysis, intersubjectivity

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