Narcissistic Personality Disorder inside the DSM V
The DSM V re-defines personality disorders as a result:
at
"The important features of a character disorder are impairments in character (self and interpersonal) functioning and also the presence of pathological character traits."
According to the June 2011 text of the DSM V, the following criteria should be met to diagnose Narcissistic Character Disorder (in parentheses my comments):
Important impairments in character functioning in either identity, or self-direction (ought to be: in both.)
Identity
The narcissist keeps referring to other individuals excessively to be able to regulate his self-esteem (really, sense of self-worth) and for "self-definition" (to define his identity.) His self-appraisal is exaggerated, regardless of whether it truly is inflated, deflated, or fluctuating among these two poles and his emotional regulation reflects these vacillations.
(Finally, the DSM V accepted what I have been saying for decades: that narcissists can have an "inferiority complex" and feel worthless and negative; that they undergo cycles of ups and downs in their self-evaluation; and ththis cycling influences their mood and affect.)
Self-direction
The narcissist sets goals to be able to gain approval from other individuals (narcissistic provide; the DSM V ignores the fact that the narcissist finds disapproval equally rewarding so long as it areas him firmly in the limelight.) The narcissist lacks self-awareness as far as his motivation goes (and as far as every thing else besides.)
The narcissist's individual standards and benchmarks are either too higher (which supports his grandiosity), or too low (buttresses his sense of entitlement, that is incommensurate with his real-life performance.)
Impairments in interpersonal functioning in either empathy or intimacy (should be: in both.)
Empathy
The narcissist finds it tough to recognize with the feelings and requirements of others, but is extremely attuned to their reactions when they are relevant to himself (cold empathy.) Consequently, he overestimates the effect he has on other people or underestimates it (the classic narcissist never ever underestimates the impact he has on other folks - but the inverted narcissist does.)
Intimacy
The narcissist's relationships are self-serving and, therefore shallow and superficial. They're centred around and geared in the regulation of his self-esteem (obtaining narcissistic supply for the regulation of his labile sense of self-worth.)
The narcissist isn't "genuinely" interested in his intimate partner's experiences (implying that he does fake such interest convincingly.) The narcissist emphasizes his need to have for individual gain (by using the word "need", the DSM V acknowledges the compulsive and addictive nature of narcissistic provide). These twin fixtures on the narcissist's relationships render them one-sided: no mutuality or reciprocity (no intimacy).
Pathological character traits
Antagonism characterized by grandiosity and attention-seeking
Grandiosity
The aforementioned feeling of entitlement. The DSM V adds that it can be either overt or covert (which corresponds to my taxonomy of classic and inverted narcissist.)
Grandiosity is characterized by self-centredness; a firmly-held conviction of superiority (arrogance or haughtiness); and condescending or patronizing attitudes.
Attention-seeking
The narcissist puts inordinate work, time, and sources into attracting other people (sources of narcissistic supply) and placing himself in the focus and centre of consideration. He seeks admiration (the DSM V gets it fully incorrect here: the narcissist does prefer to be admired and adulated, but, failing that, any form of focus would do, even when it is negative.)
The diagnostic criteria finish with disclaimers and differential diagnoses, which reflect years of accumulated research and newly-gained understanding:
The above enumerated impairments ought to be "stable across time and consistent across conditions ... not better understood as normative for the individuals developmental stage or socio-cultural atmosphere ... will not be solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a basic medical condition (e.g., serious head trauma)."
Bibliography
Goldman, Howard H., Evaluation of General Psychiatry, fourth edition,1995.Prentice-HallInternational, London.
Gelder, Michael, Gath, Dennis, Mayou, Richard, Cowen, Philip (eds.),Oxford Textbook of Psychiatry, third edition, 1996, reprinted 2000. Oxford University Press, Oxford.
Vaknin, Sam, Malignant Self-love: Narcissism Revisited, eighth revised impression, 1999-2006. Narcissus Publications, Prague and Skopje.
Westen, Drew et al. Refining the Construct of Narcissistic Character Disorder: Diagnostic Criteria and Subtypes (Posted at )
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