AbstractNarcissistic personality disorder, NPD, has been excluded as a diagnostic category and independent personality disorder type in the Personality and Personality Disorder Work Group’s recent proposal for DSM-5 Personality and Personality Disorders. The aim of this paper is to present supporting evidence in favor of keeping NPD as a personality type with a set of separate diagnostic criteria in DSM-5. These include: the prevalence rate, extensive clinical and empirical reports and facts, its psychiatric, social and societal significance especially when associated to functional vocational and interpersonal impairment, social and moral adaptation, and acute suicidality. Proposals for a clinically relevant and empirically based definition of narcissism, a description of the narcissistic personality disorder type, and a set of diagnostic criteria for NPD are outlined.Excerpted from article:"Individuals with the narcissistic personality type can present as overtly arrogant and haughty, with self-enhancing interpersonal behavior—i.e., being actively attention and admiration seeking, self-promoting, boastful, and competitive. They can also show vigorous self-serving interpersonal behavior—i.e., expecting unreasonable and unwarranted rights and services, accepting unreciprocated favors from others, or taking emotional, intellectual and social advantage of others. If expectations are not met, they tend to have intense reactions ranging from rage and retaliation to passive-aggressive rumination, to shame and severe self-criticism. While some readily express their reactions, others tend to exercise rigorous in-ternal control over their emotions, expressed behavior, or interpersonal relationships.
Those with a covert presentation have a more shy appearance and can be self-sufficient, controlled and polite, or avoidant, empty, and indifferent. On the surface they can appear tuned in, modest, or unassuming, hiding or feigning disinterest in self-promotion. However, their avoidance serves to sustain elevated self-esteem and they are still preoccupied with self-enhancing grandiose fantasies and passive aggressive reactions. They also suffer from internal vulnerability, insecurity, inferiority and shame.
A third presentation includes those who are more manifestly aggressive and hostile. Motivated by superiority, envy, vengefulness or sadism, they demonstrate systematic cruel, sadistic or violent interpersonal behavior. Some are charming, deceptive and seductive; others are calculating, exploitive and retaliating. Malignant, criminal or psychopathic behavior can also be present.”
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