Narcissism G505 Presentation: March 6, 2007 Kelli Brown Greg Hetrick Diana Mann Alexa Yarnelle.

NarcissismNarcissismG505 Presentation: March 6, 2007G505 Presentation: March 6, 2007

Kelli BrownKelli Brown

Greg HetrickGreg Hetrick

Diana MannDiana Mann

Alexa YarnelleAlexa Yarnelle

The Greek MythThe Greek Myth

Narcissus rejected the Nymph EchoNarcissus rejected the Nymph Echo

He was cursed to fall in love with his He was cursed to fall in love with his own reflection.own reflection.

NarcissusNarcissus

The Greek Myth The Greek Myth (cont.)(cont.)

He eventually He eventually changed into the changed into the flower, flower,

NarcissusNarcissus

Narcissistic Personality Narcissistic Personality DisorderDisorder

According to the DSM-IV-TR:According to the DSM-IV-TR: ““a pervasive pattern of grandiosity, need for a pervasive pattern of grandiosity, need for

admiration, and lack of empathy that begins admiration, and lack of empathy that begins by early adulthood and is present in a variety by early adulthood and is present in a variety of contexts.” of contexts.”

A A Cluster BCluster B disorder that falls under the same disorder that falls under the same cluster as Antisocial Personality Disorder, cluster as Antisocial Personality Disorder, Borderline Personality Disorder, and Borderline Personality Disorder, and Histrionic Personality Disorder (dramatic, Histrionic Personality Disorder (dramatic, emotional, or erratic disorders).emotional, or erratic disorders).

Diagnostic Criteria Diagnostic Criteria (Five or more (Five or more

criteria must be met for a diagnosis)criteria must be met for a diagnosis)

1) Grandiose sense of self importance1) Grandiose sense of self importance Exaggerates achievements and talentsExaggerates achievements and talents Expects to be recognized as superiorExpects to be recognized as superior

Counselors—look for:Counselors—look for:-boastful, pretentious behavior-boastful, pretentious behavior

-surprise when they don’t receive praise-surprise when they don’t receive praise

-minimizing the efforts and contributions of others-minimizing the efforts and contributions of others



2) Preoccupied with fantasies of 2) Preoccupied with fantasies of unlimited success, power, brilliance, unlimited success, power, brilliance, beauty, or ideal love.beauty, or ideal love.

Counselors—look for:Counselors—look for:-clients comparing themselves to famous or -clients comparing themselves to famous or

prestigious/privileged peopleprestigious/privileged people



3) Believe they are special and unique and 3) Believe they are special and unique and can only be understood by, or should can only be understood by, or should associate with, other special or high-status associate with, other special or high-status people (or institutions).people (or institutions).

Counselors—look for:Counselors—look for:-clients who exclude others because they are simply -clients who exclude others because they are simply

not good enough.not good enough.-saying they can only be understood by approved -saying they can only be understood by approved

peoplepeople-placing a high value on the people chosen to -placing a high value on the people chosen to

associate withassociate with-insisting on always having the “best” individual -insisting on always having the “best” individual

provide services for them (teacher, doctor, etc.)provide services for them (teacher, doctor, etc.)



4) 4) Requires excessive admirationRequires excessive admiration

Counselors—look for:Counselors—look for:-fragile self-esteem-fragile self-esteem

-preoccupation with the opinions others have of them-preoccupation with the opinions others have of them

-expectation of others to covet their belongings and -expectation of others to covet their belongings and achievementsachievements

-fishing for compliments-fishing for compliments



5) 5) Has a sense of entitlement Has a sense of entitlement (unreasonable expectations of especially (unreasonable expectations of especially favorable treatment or automatic favorable treatment or automatic compliance with his or her expectations).compliance with his or her expectations).

Counselors—look for:Counselors—look for:-clients who expect all others to cater to them-clients who expect all others to cater to them

-belief that the work they do is “very important” and others -belief that the work they do is “very important” and others should help them unquestioninglyshould help them unquestioningly



6) 6) Is interpersonally exploitative (takes Is interpersonally exploitative (takes advantage of others to achieve his or her advantage of others to achieve his or her own endsown ends

Counselors--look for:Counselors--look for:-a lack of sensitivity to the needs and wants of others-a lack of sensitivity to the needs and wants of others

-expecting far too much out of other people-expecting far too much out of other people

-forming relationships that simply enhance their self-esteem-forming relationships that simply enhance their self-esteem

-being greedy with material resources-being greedy with material resources



7) 7) Lack of Empathy: unwilling to Lack of Empathy: unwilling to recognize or identify with the feelings and recognize or identify with the feelings and needs of others.needs of others.

Counselors—look for:Counselors—look for:-trouble understanding the subjective experiences of others-trouble understanding the subjective experiences of others

-discussing their own concerns in lengthy detail-discussing their own concerns in lengthy detail

-impatience when others talk about their own concerns-impatience when others talk about their own concerns

-saying hurtful comments (ex: bragging to an ex about a new -saying hurtful comments (ex: bragging to an ex about a new relationship; bragging about health to a sick person)relationship; bragging about health to a sick person)

-seeing the problems of others as weaknesses -seeing the problems of others as weaknesses



8) 8) Often envious of others or believes Often envious of others or believes that others are envious of him or her.that others are envious of him or her.

Counselors—look for:Counselors—look for:-thinking they are more deserving than others of positive -thinking they are more deserving than others of positive

consequencesconsequences

-devaluing the admiration given to others-devaluing the admiration given to others



9) 9) Shows arrogant, haughty behaviors or Shows arrogant, haughty behaviors or attitudes.attitudes.

Counselors—look for:Counselors—look for:-criticizing the work of others-criticizing the work of others

-snobby attitudes, name calling-snobby attitudes, name calling

--DSM-IV-TR--DSM-IV-TR

Personality DescriptorsPersonality DescriptorsAmoral/consciencelessAmoral/consciencelessAuthoritarianAuthoritarianCares only about appearancesCares only about appearancesContemptuousContemptuousCritical of othersCritical of othersCruelCruelDisappointing gift-giversDisappointing gift-giversDon’t recognize own feelingsDon’t recognize own feelingsEnvious and competitiveEnvious and competitiveFeel entitledFeel entitledFlirtatious or seductiveFlirtatious or seductiveGradioseGradioseHard to have a good time withHard to have a good time withHate to live aloneHate to live alone

Hyper-sensitive to criticismHyper-sensitive to criticismLacks sense of humorLacks sense of humorNaïveNaïvePassivePassivePessimisticPessimisticReligiousReligiousSecretiveSecretiveSelf-ContradictorySelf-ContradictoryStingyStingyStrange work habitsStrange work habitsUnusual eating habitsUnusual eating habitsWeird sense of timeWeird sense of time

****http://www.halcyon.com/jmashttp://www.halcyon.com/jmashmun/npd/traits.html#contrahmun/npd/traits.html#contra

Other CharacteristicsOther Characteristics

““Haunted” by criticismHaunted” by criticism

Low threshold for humiliationLow threshold for humiliation

Severely impaired relationshipsSeverely impaired relationships

Low functioning due to a fear of defeatLow functioning due to a fear of defeat


NPD is also associated NPD is also associated with…with…

Dysthymic or Major Depressive DisorderDysthymic or Major Depressive Disorder

Hypomanic moodsHypomanic moods

Anorexia NervosaAnorexia Nervosa

Substance-related disorders (especially cocaine)Substance-related disorders (especially cocaine)

Other personality disorders such as Histrionic, Other personality disorders such as Histrionic, Borderline, Antisocial, and Paranoid.Borderline, Antisocial, and Paranoid.


Age of Onset/Gender Age of Onset/Gender FeaturesFeatures

Narcissistic Narcissistic traits traits common in adolescentscommon in adolescentsTherefore, NDP is Therefore, NDP is not diagnosednot diagnosed until until adulthood (if these traits have continued adulthood (if these traits have continued beyond adolescence and caused significant beyond adolescence and caused significant failure in the interpersonal environment).failure in the interpersonal environment).Symptoms are intensified by the aging Symptoms are intensified by the aging process, due to physical and occupational process, due to physical and occupational limitations.limitations.50-75% diagnosed are male50-75% diagnosed are male

--DSM-IV-TR --DSM-IV-TR --http://en.wikipedia.org/wiki/Narcissistic_personality_disorder--http://en.wikipedia.org/wiki/Narcissistic_personality_disorderhttp://www.mayoclinic.com/health/narcissistic-personality-disorder/DS00652/http://www.mayoclinic.com/health/narcissistic-personality-disorder/DS00652/

DSECTION=5DSECTION=5

PrevalencePrevalence

2-16% in the clinical population2-16% in the clinical population

<1% in the general population<1% in the general population


Differential DiagnosisDifferential Diagnosis

NPD is very similar to Histrionic, NPD is very similar to Histrionic, Antisocial, and Borderline Personality Antisocial, and Borderline Personality Disorders, except for one important Disorders, except for one important characteristic:characteristic:

GRANDIOSITYGRANDIOSITY

When compared to Borderline When compared to Borderline PD…PD…

NPD has a stable self-imageNPD has a stable self-image

NPD has a lack of self-destructiveness, NPD has a lack of self-destructiveness, impulsivity and fear of abandonmentimpulsivity and fear of abandonment


When Compared to Histrionic When Compared to Histrionic PD…PD…

NPD has excessive pride in achievementsNPD has excessive pride in achievements

NPD has a lack of emotional displayNPD has a lack of emotional display

NPD has lack of concern for others’ NPD has lack of concern for others’ sensitivitiessensitivities


When compared to Antisocial When compared to Antisocial PD…PD…

NPD is not characteristically impulsiveNPD is not characteristically impulsive

NPD is not an aggressive disorderNPD is not an aggressive disorder

Individuals with NPD are not purposefully Individuals with NPD are not purposefully deceitfuldeceitful

NPD requires more admiration from othersNPD requires more admiration from others

Individuals with NPD may lack the conduct Individuals with NPD may lack the conduct disorder from childhood or criminal disorder from childhood or criminal behavior in adulthoodbehavior in adulthood


When compared to Obsessive-When compared to Obsessive-Compulsive DisorderCompulsive Disorder

Both have perfectionistic qualities, and the belief Both have perfectionistic qualities, and the belief that only they can do things rightthat only they can do things right

However, people with OCD are more self-However, people with OCD are more self-criticizing, while people with NPD think they are criticizing, while people with NPD think they are perfect.perfect.


Other Differential DiagnosesOther Differential Diagnoses

When compared to Schizotypal or Paranoid PD… When compared to Schizotypal or Paranoid PD…

--NPD is not socially withdrawn and suspicious --NPD is not socially withdrawn and suspicious (unless there is fear of defeat or criticism)(unless there is fear of defeat or criticism)

When compared to Manic/Hypomanic Episodes…When compared to Manic/Hypomanic Episodes…

--both have grandiose characteristics, but NPD does --both have grandiose characteristics, but NPD does not have rapid mood change or impaired not have rapid mood change or impaired functioningfunctioning

Also—be sure that symptoms are not the result of Also—be sure that symptoms are not the result of Substance Use. Substance Use.


Possible CausesPossible Causes

GeneticsGenetics Twin StudyTwin Study

Of the 18 personality characteristic Of the 18 personality characteristic measured, narcissism had the highest measured, narcissism had the highest hertability.hertability.

--Alvarez study--Alvarez study —Assortative mating (“self- —Assortative mating (“self-seeking like” hypothesis**seeking like” hypothesis**

--http://en.wikipedia.org/wiki/Narcissism--http://en.wikipedia.org/wiki/Narcissism

Possible Causes Possible Causes (cont.)(cont.)

Unconscious belief that oneself is “flawed Unconscious belief that oneself is “flawed in a way that makes the person in a way that makes the person fundamentally unacceptable to others” fundamentally unacceptable to others”

Lack of healthy, empathic Lack of healthy, empathic attachments with primary caregivers.attachments with primary caregivers.

The child begins to feel unwanted The child begins to feel unwanted and unconnected to others.and unconnected to others.((http://en.wikipedia.org/wiki/Narcissistic_personality_disorderhttp://en.wikipedia.org/wiki/Narcissistic_personality_disorder))

http://www.mayoclinic.com/health/narcissistic-personality-http://www.mayoclinic.com/health/narcissistic-personality-disorder/DS00652/DSECTION=6disorder/DS00652/DSECTION=6

Possible Causes Possible Causes (cont.)(cont.)

**According to the **According to the Mayo Clinic WebsiteMayo Clinic Website, these , these developmental or parenting factors may contribute developmental or parenting factors may contribute to NPD:to NPD:An oversensitive temperament at birth An oversensitive temperament at birth Overindulgence and overvaluation by parents Overindulgence and overvaluation by parents Valued by parents as a means to regulate their own self-Valued by parents as a means to regulate their own self-esteem esteem Excessive admiration that is never balanced with realistic Excessive admiration that is never balanced with realistic feedback feedback Unpredictable or unreliable caregiving from parents Unpredictable or unreliable caregiving from parents Severe emotional abuse in childhood Severe emotional abuse in childhood Being praised for perceived exceptional looks or talents by Being praised for perceived exceptional looks or talents by adults adults Learning manipulative behaviors from parentsLearning manipulative behaviors from parents

http://www.mayoclinic.com/health/narcissistic-personality-disorder/DS00652/http://www.mayoclinic.com/health/narcissistic-personality-disorder/DS00652/DSECTION=3DSECTION=3

Narcissistic ParentsNarcissistic Parents

See children as “extensions of See children as “extensions of themselves,” and pressure them to themselves,” and pressure them to act according to their unreachable act according to their unreachable standards.standards.

Overly intrusive or neglectfulOverly intrusive or neglectful

Harsh punishments including Harsh punishments including physical abuse, blame, guilt, physical abuse, blame, guilt, criticism, emotional neglect, etc.criticism, emotional neglect, etc.(http://en.wikipedia.org/wiki/Narcissistic_personality_disorder)(http://en.wikipedia.org/wiki/Narcissistic_personality_disorder)

Environmental Factors:Environmental Factors:“Co-Narcissism”“Co-Narcissism”

Narcissists look for this trait in their Narcissists look for this trait in their mates, encourage it in their children.mates, encourage it in their children.Characterized by being passive and Characterized by being passive and compliant to the demands of otherscompliant to the demands of othersEasily accepts blameEasily accepts blameAccept others’ opinionsAccept others’ opinions““Co-Dependent personality style similar to Co-Dependent personality style similar to co-alcoholism and co-dependency.”co-alcoholism and co-dependency.”

(http://en.wikipedia.org/wiki/Narcissistic_personality_disorder)(http://en.wikipedia.org/wiki/Narcissistic_personality_disorder)

Treatment StrategiesTreatment Strategies

Difficult, because most people with Difficult, because most people with NPD will not seek treatment, due to NPD will not seek treatment, due to the characteristics of the disorderthe characteristics of the disorder

Usually directed by others to begin Usually directed by others to begin therapy (unwillingly)therapy (unwillingly)

People with NPD fear that therapy People with NPD fear that therapy will expose their weaknesseswill expose their weaknesses

http://www.mayoclinic.com/health/narcissistic-personality-disorder/http://www.mayoclinic.com/health/narcissistic-personality-disorder/DS00652/DSECTION=6DS00652/DSECTION=6

Treatment Strategies Treatment Strategies (cont.)(cont.)

Individual psychotherapy is the most Individual psychotherapy is the most common form of treatment common form of treatment (sometimes group and family (sometimes group and family counseling is incorporated)counseling is incorporated)Pharmacotheraphy is rarely used to Pharmacotheraphy is rarely used to treat NPD itself, but meds may be treat NPD itself, but meds may be suggested to treat other symptoms suggested to treat other symptoms such as depression or anxiety.such as depression or anxiety.

http://www.mayoclinic.com/health/narcissistic-personality-disorder/http://www.mayoclinic.com/health/narcissistic-personality-disorder/DS00652/DSECTION=6DS00652/DSECTION=6

PrognosisPrognosis

Success of psychotherapy depends Success of psychotherapy depends on the severity of the caseon the severity of the case

Other related problems that may Other related problems that may arise as a result of NPD:arise as a result of NPD: Relationship and family problemsRelationship and family problems Substance abuse and dependenceSubstance abuse and dependence

http://www.nlm.nih.gov/medlineplus/ency/article/000934.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000934.htm

A Side Note…A Side Note…

Many people display Narcissistic-Many people display Narcissistic-type personality characteristics, type personality characteristics, especially people who are successful especially people who are successful and competitiveand competitive

NPD is only a NPD is only a DisorderDisorder when the when the characteristics are inflexible, characteristics are inflexible, maladaptive, and cause significant maladaptive, and cause significant impairment or distress.impairment or distress.


Assessment StrategiesAssessment Strategies

Personality Disorder TestPersonality Disorder Test Handed out in classHanded out in class

ReferencesReferences

DSM-IV-TRDSM-IV-TR

Wikipedia.com:Wikipedia.com: http://en.wikipedia.org/wiki/Narcissistic_personality_disorderhttp://en.wikipedia.org/wiki/Narcissistic_personality_disorder http://en.wikipedia.org/wiki/Narcissismhttp://en.wikipedia.org/wiki/Narcissism

Mayo Clinic Online:Mayo Clinic Online: http://www.mayoclinic.com/health/narcissistic-personality-disohttp://www.mayoclinic.com/health/narcissistic-personality-diso

rder/DS00652/DSECTION=5rder/DS00652/DSECTION=5 http://www.mayoclinic.com/health/narcissistic-personality-disohttp://www.mayoclinic.com/health/narcissistic-personality-diso

rder/DS00652/DSECTION=6rder/DS00652/DSECTION=6 http://www.mayoclinic.com/health/narcissistic-personality-disohttp://www.mayoclinic.com/health/narcissistic-personality-diso

rder/DS00652/DSECTION=3rder/DS00652/DSECTION=3

MedicinePlus Medical Encyclopedia:MedicinePlus Medical Encyclopedia: http://www.nlm.nih.gov/medlineplus/ency/article/000934.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000934.htm

References (cont.)References (cont.)

Personalilty Disorder Test Sources:Personalilty Disorder Test Sources:

http://http://www.nightingale-center.com/archive/narcwww.nightingale-center.com/archive/narcissist.htmlissist.html

http://http://www.wellesley.edu/Psychology/Cheek/senwww.wellesley.edu/Psychology/Cheek/sensitive.htmlsitive.html

http://npatest.homestead.com/files/NPAtehttp://npatest.homestead.com/files/NPAtest.htmst.htm

References (cont.)References (cont.)

1) L.L. (Subject A). Personal Interview. 27 Feb. 1) L.L. (Subject A). Personal Interview. 27 Feb. 2007.2007.

2) L.L. (Subject A). E-mail communications. 2) L.L. (Subject A). E-mail communications. April April 2005-February 2007.2005-February 2007.3) L.L. (Subject A). Personal Narrative. April 3) L.L. (Subject A). Personal Narrative. April 2005. 2005. 3) Rayment, W.J. 3) Rayment, W.J. Jean Piaget and Child Jean Piaget and Child DevelopmentDevelopment. . 25 Jan. 2007. 28 Feb. 2007 25 Jan. 2007. 28 Feb. 2007 http://www.indepthinfo.com/articles/piaget-http://www.indepthinfo.com/articles/piaget-developmental-psychology.shtml. developmental-psychology.shtml. 4) Girl, Interrupted, Dir. James Mangold, 4) Girl, Interrupted, Dir. James Mangold, Columbia Columbia Pictures, 1999.Pictures, 1999.5) Monster-in-Law, Dir. Robert Luketic, New 5) Monster-in-Law, Dir. Robert Luketic, New Line Line Cinema, 2005.Cinema, 2005.

Narcissism G505 Presentation: March 6, 2007 Kelli Brown Greg Hetrick Diana Mann Alexa Yarnelle.

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