Narcissistic Personality Disorder (NPD) is a complex mental health condition that has garnered significant attention in popular culture and psychological discourse. However, amidst the growing discussions, there are various misconceptions surrounding NPD that need to be clarified. In this blog post, we will learn some evidence-based findings on NPD, shedding light on the reality of this condition.

What is narcissistic personality disorder?

NPD is a mental health condition characterized by an enduring pattern of grandiosity, fantasies of immense power or significance, and a craving for admiration or special treatment. Essential cognitive, emotional, interpersonal, and behavioural traits comprise impulsivity, volatility, seeking attention, diminished self-worth, and unstable interpersonal connections, leading to widespread challenges in relationships, occupational issues, and considerable psychological distress (Kacel et al., 2017).

What isn’t narcissistic personality disorder?

Narcissism is a personality trait that everyone has to some degree. This trait allows people to prioritize themselves in some capacity. Without this trait, our survival instincts may be weakened. On the extreme end of the spectrum, we have NPD which is a formal mental health diagnosis which refers to persistent signs and symptoms that impact the quality of life.

Findings

• The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes NPD as one of the Cluster B personality disorders, which are characterized as “dramatic, emotional, and erratic.” This cluster also includes Antisocial, Borderline, and Histrionic Personality Disorders. NPD often has overlapping symptoms with these other Cluster B disorders (APA, 2013).
• NPD is often comorbid with substance abuse, mood, and anxiety disorders.
• Narcissistic Personality Disorder (NPD) can manifest in various presentations, which include:
  • Grandiose or overt narcissism which is characterized by an exaggerated sense of importance and entitlement, along with a belief in their superiority over others.
  • Vulnerable or covert narcissism refers to individuals who exhibit defensive and hypersensitive behaviours due to fragile self-esteem, making them easily hurt by criticism or perceived rejection. They may often portray themselves as victims to their advantage and experience persistent feelings of emptiness and self-doubt.
  • Communal narcissism refers to individuals who project a caring, empathetic, and altruistic image. However, their acts of kindness are driven by a desire for recognition and admiration rather than genuine concern for others.
  • Malignant narcissism, which is a more severe and harmful form of presentation. Those with this type of narcissism use manipulative and controlling tactics to exploit and deceive others for their own needs and desires. It may lead to instances of physical or sexual abuse which is often reported by survivors.

• Individuals with NPD are often reluctant to seek help or undergo formal diagnosis due to their belief in their own perfection and superiority over others. Admitting to flaws may challenge their façade of superiority, which many are unwilling to let go of. As a result, seeking help or acknowledging potential issues becomes less likely for those who might have NPD.
• Individuals with NPD often engage in a cycle of love-bombing, devaluation, and eventually discarding their partners in intimate relationships. Survivors of such abuse often describe initially feeling a strong connection and experiencing “movie-like moments” with their partners, only to later encounter inconsistent affection, attention, and care. This rollercoaster pattern can be emotionally distressing for those involved in relationships with individuals displaying NPD traits.
• Studies show narcissistic abuse can predict posttraumatic stress disorder in survivors (Arabi, 2023).
• Some evidence-based treatments for NPD include psychodynamic therapy, cognitive behavioural therapy, mentalization-based therapy, dialectical behavioural therapy, schema therapy, group therapy, and supportive therapy.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425596

Arabi, S. (2023). Narcissistic and psychopathic traits in romantic partners predict post-traumatic stress disorder symptomology: Evidence for unique impact in a large sample. Personality and Individual Differences, 201, 111942. https://doi.org/10.1016/j.paid.2022.111942

Kacel, E. L., Ennis, N., & Pereira, D. B. (2017). Narcissistic personality disorder in Clinical Health Psychology Practice: Case studies of comorbid psychological distress and life-limiting illness. Behavioral Medicine, 43(3), 156–164. https://doi.org/10.1080/08964289.2017.1301875