An update on narcissistic personality disorder

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Purpose of review

This article will discuss the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 proposal for narcissistic personality disorder (NPD), and highlight some of the advantages of introducing a dual diagnostic approach that includes a dimensional conceptualization for identifying and diagnosing pathological narcissism and NPD, in addition to specific traits.

Recent findings

Reviews and studies have specifically highlighted how people with NPD behave and are observed by others, and the negative consequences of their behavior. Accounts on the subjective perspectives of pathological narcissism stem foremost from psychoanalytic and psychodynamic accounts, but they have remained relatively separated from diagnostic and empirical studies.


The new diagnostic approach to NPD can encourage a better integration of the clinicians’ observations of indicators of pathological narcissism from an external perspective and the patients’ formulations of their own subjective experiences and understanding of their problems.

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