Clinical theorists across various orientations describe individuals diagnosed with narcissistic personality disorder as those characterized by a pervasive pattern of grandiosity, a sense of privilege or entitlement, an expectation of preferential treatment, an exaggerated sense of self-importance, and arrogant or haughty behaviors or attitudes (Westen & Shedler, 1999). Despite common clinical usage, the concept of narcissistic personality disorder is highly controversial and of uncertain validity. The vast majority of the literature on narcissistic personality disorder has been theoretical and clinical rather than empirical. The research that does exist, with a few important exceptions, has not been carried out programmatically. In this chapter, we will summarize and integrate the best available scientific evidence bearing on the etiology, assessment, diagnosis, course, and treatment of the disorder. We will begin with a brief history of the concept of narcissistic personality disorder, then review and evaluate a number of conceptualizations, and conclude with recommendations for further research on unresolved conceptual and methodological issues as we look toward DSM-V. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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"Some clinical writers have further extended this idea about the non-exclusivity of these dimensions by stressing that grandiose and vulnerable dimensions may not only co-exists within in an individual but narcissistic dynamics actually involve oscillations of grandiose and vulnerable mental states (Kernberg, 1975/1985; 1971; Levy et al., 2007; 2011; Levy, 2012; Pincus & Lukowitsky, 2010; Reich, 1960; Ronningstam, 2011). The co-occurrence of these dimensions can clearly be seen in the three cases Riordan presents, despite his classifying two as distinctly entitled and depleted, respectively. "
"Downloaded from content, the NPI may not be suitable for assessing the full scope of pathological narcissism. Clinical psychologists hoping to assess pathological variants of narcissism have a number of semistructured interviews, observer ratings, and self-report measures to choose from (Hilsenroth, Handler, & Blais, 1996; Levy et al., 2007; Pincus & Lukowitsky, 2010). However, many are based on DSM criteria and thus focus largely on narcissistic grandiosity. "
[Show abstract][Hide abstract] ABSTRACT: The Pathological Narcissism Inventory (PNI) is a recently developed multidimensional inventory for the assessment of pathological narcissism. The authors describe and report the results of two studies that investigate the higher order factor structure and gender invariance of the PNI. The results of the first study indicate that the PNI has a higher order factor structure that conforms to the theoretical structure of pathological narcissism with one factor representing narcissistic grandiosity and the other capturing narcissistic vulnerability. These results uniquely place the PNI as the only measure to broadly assess the two phenotypic themes of pathological narcissism. In the second study, results from tests of measurement invariance indicate that the PNI performs similarly in large samples of men (n = 488) and women (n = 495). These results further establish the psychometric properties of the PNI and suggest that it is well suited for the assessment of pathological narcissism.
[Show abstract][Hide abstract] ABSTRACT: Fifty-two residents in a forensic treatment center for convicted sex offenders were studied using a computer-assisted assessment methodology regarding prior exposure to seven categories of major trauma, the subsequent occurrence of 15 PTSD criterion symptoms, the occurrence of sexual disorders and pathological character traits based on the DSM-III-R Axis II diagnostic criteria. This sample represented 43% of all individuals in such treatment in Florida during the study month. The results in terms of trauma exposure, PTS symptom, sexual disorders, and character traits are reported and discussed in relation to the relevant literature. A theoretical formulation based on object relations theory suggesting a causal link between trauma, narcissistic character pathology, adult PTSD, and sexual deviancy for some sex offenders is presented and related to the findings. The methodological limitations of the research and its implications for future research are explored.