Narcissistic Personality Disorder

Beginning with its inception in DSM-III, NPD has been characterized by a pervasive pattern of grandiosity, feeling privileged, entitled, and expecting preferential treatment, as well as displaying an exaggerated sense of self-importance, and showing arrogant and haughty behaviors or attitudes. In contrast to DSM's predominantly grandiose emphasis, other conceptualizations stress the more vulnerable and sensitive aspects of NPD. Increasingly both the overt and covert as well as the grandiose and vulnerable aspects of narcissism have been recognized. Historically research on NPD has been relatively sparse compared to other personality disorders such as borderline and antisocial personality and the sparsity led to the disorder being considered controversial and its validity questioned. As such, there is limited treatment research looking at NPD and in the absence of empirically supported treatments for narcissistic pathology, extrapolating principles from efficacious treatments for near-neighbor disorders with treatment modifications based on theoretical and clinical rationales is warranted.