Narcissism is a highly occurring disorder that presents with impaired functionality and disabilities of psychosocial nature (Caligor et al., 2015). Diagnosis of this disorder is usually confusing due to the huge variations in symptoms presented. These range from positive and negative sides such as captaining industries or inability to maintain employment, impressively loving themselves or hating themselves, popularity in social terms or isolation from social activities and finally they may be role model citizens or bad examples by vulnerability to social evils. Narcicism disorder is depicted by different characteristics that present during conversations and interactions. This paper seeks to discuss an in-depth analysis of narcissism as a personality disorder.
According to the DSM-5 criteria, the key aspects that present in individuals with the narcissism disorder include; a permeating trend of grandiosity, desire to be admired, holding on their rights, and apathy is never manifested in them (Roche et al., 2015). However, this description fails to make mention of crucial aspects presented in clinical pathology of narcissism. These aspects include; unguarded self -esteem, feeling as inferior, bored or empty as well as being emotionally charged in their reactions and discomfort (Wink, 1992)..
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Notably, there are varied subtypes in the narcissism disorder that cover its wide extent in expression (Caligor et al., 2015). The first subtype is the overt that closely corresponds with the DMS-5 criteria. It is characterized by open grandiosity, seeking of attention, arrogant character, entitlement and minute but noticeable anxiety. Individuals in this category depict social charm with oblivion to needs of other people and also depict exploitation in their interpersonal relationships. The second is covert subtype which in a large portion is inadequately covered by the DMS-5 criteria. The individuals in this category are depicted as weak in self-esteem and vulnerable in their interpersonal relationships, show over-reactions to evaluations from other people, maintain their inhibitions, manifest distress in socializing and display envy of other people’s achievements that makes them to continuously compare themselves to others . In their interpersonal relationships, individuals with this subtype depict shyness, self-modesty, overly sensitive to ignorable weaknesses and harbor grandiosity in secrecy (Roche et al., 2015). The covert and overt subtypes are common in that both involve extraordinary levels of self-absorption. Notably, most individuals with the narcissism disorder tend to have a mixture of these two sub-types depending on the life situations. The third is known as the high functioning subtype which is also referred to as autonomous or exhibitionist. Individuals in this sub-type depict grandiosity, competitiveness; they seek attention and are usually provocative in sexual matters (Caligor et al., 2015). In work places, individuals with this subtype often praise themselves of their unmatched abilities at solving problems. Additionally, they utilize their functionality to adapt and employ these characteristics to achieve success. As a result, individuals in this subtype may appear to have no personality disorder and can easily fail to be identified in assessments of diagnostic nature.
Notably, Narcissist disorder incorporates both the optimally functioning and the functionally impaired individuals in the society. As a matter of fact, it is ranked as the disorder with highest coverage of patients among all personality disorders (Caligor et al., 2015). This makes it necessary to differentiate the different subtypes and also consider the severity of the disorder on an individual. Risk factors also need to be considered where individuals who are younger in age especially in college, male and unmarried are at the highest risk of developing the narcissist disorder. Parental control of their children who are in college also increases the risk of developing narcissistic disorder (Wink, 1992).
In assessment of the Narcissism disorder, difficulties present with the major ones being lack of obvious indicators especially among the high functioning group and the fact that it is center on interpersonal relationships (Caligor et al., 2015). Therefore, the best option and also most reliable way of diagnosing the disorder is by employing a clinical interview systematically. Such examples include that of Kernberg that is readily available. However, putting focus on the description given by a patient can add to rapid diagnosis of the disorder. The reason for this is the description of belittling others that is depicted in their statements. They may also describe other people in comparison or in contrast to themselves. All in all, their perception of being superior to everyone still remains (Roche et al., 2015). In addition, the clinician can diagnose the narcissist disorder from the expectations the patient lays on them by expecting rapid cures from the physician. In case the illness recurs, these individuals consider the physicians as failures and often find fun in demeaning the physicians. This is a depiction of lack of apathy that lies deep in the character of most individuals with this disorder.
In differential diagnosis, the clinician looks out for illness of bipolar nature, abuse of drugs and substance, mental depression, disorders from anxiety and other such like symptoms. These symptoms have been proved to be comorbid with this personality disorder of narcissism, often making it worse for inexperienced clinicians to identify the major issue at hand. For instance, depression or anxiety may not necessarily be linked to narcissistic disorder (Roche et al., 2015). However, with keen analysis, proper diagnosis can be made and appropriate treatment administered. In administering treatment, the clinician may opt to use the psychotherapeutic approach where the patient is engaged in intense psychotherapy. Alternatively, the clinician may use the psychopharmacological approach especially to take care of depression and anxiety (Roche et al., 2015). However, a combination of the two approaches can be better than use of only one approach.
In conclusion, the Narcissism disorder present with varied symptoms that differentiates them into various subtypes. Despite being widespread, the disorder remains to be the least studied since the rates of reporting are usually low. As noted, the major risk factors are younger age especially in college, being male as well as being unmarried. Therefore, this disorder is significant as it greatly affects interpersonal relations.
References
Caligor, E., Levy, K. N., & Yeomans, F. E. (2015). Narcissistic personality disorder: diagnostic and clinical challenges. American Journal of Psychiatry . 172(5), 415-422.
Roche, M. J., & Pincus, A. L. (2015). Narcissistic Personality Disorder. The Encyclopedia of Clinical Psychology .
Wink, P. (1992). Three Types of Narcissism in Women from College to Mid‐Life . Journal of Personality , 60(1), 7-30.
