ABSTRACTThe Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition appears likely to eliminate the diagnosis of narcissistic personality disorder. There are significant problems with the discriminant validity of the current narcissistic personality disorder critiera set; furthermore, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition’s narrow focus on “grandiosity” probably contributes to the wide disparity between low narcissistic personality disorder prevalence rates in epidemiological studies and high rates of narcissistic personality disorder in clinical practice. Nevertheless, the best course of action may be to refine the narcissistic personality disorder criteria, followed by careful field testing and a search for biomarkers, rather than wholesale elimination of the narcissistic personality disorder category. The construct of “malignant narcissism” is also worthy of more intense empirical investigation.Excerpted from article"...Peter Abelard, demonstrates in the epigram quoted at the beginning of this article. Indeed, Abelard might well fit the category of individuals Twenge and Campbell call the “socially savvy narcissists who have the most influence on the culture.” These high-fliers may be the sort one of my colleagues had in mind when he defined a narcissist as, “somebody who, at the moment of peak sexual bliss, cries out his own name!”
These celebrity narcissists are not, for the most part, the kind of individuals I used to see in my own psychiatric practice. My patients tended to fall into the group Twenge and Campbell call “vulnerable narcissists.” These unfortunate souls seem to cloak themselves in a mantle of gold, while feeling on the inside that they are nothing but rags. They suffer, to be sure—but they also induce suffering in others by acting out their insecurities in a thousand provocative ways. And, like some of their celebrity counterparts, these vulnerable narcissists are prone to outbursts of anger, verbal abuse, or obnoxious behavior—usually when they feel rejected, thwarted, or frustrated. They remind one of philosopher Eric Hoffer’s observation that, “Rudeness is the weak man’s imitation of strength...”
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