Narcissistic Personality Disorder The purpose of this paper is to di

NPD: History, Diagnostic Criteria and Prevalence

According to Pervin (1990), the origins of psychological thought regarding NPD can be found in Freud's early writings on narcissism. In this regard, Pervin states that Freud characterized narcissism in five ways. These were as: (1) a sexual perversion in which one's own body was used as a sexual object; (2) a stage of libido development; (3) a type of object choice in which the sexual object is chosen because of having characteristics similar to one's own; (4) a type of object-relationship in which libidinal cathexis is withdrawn from external objects and redirected toward the self or parts of self; and (5) a constituent of self-esteem related to the ego ideal.

The pivotal role of self in Freud's early thoughts on narcissism is retained in contemporary conceptions of narcissistic personality disorder which the American Psychiatric Association (DSM-IV, 1994) characterizes as a personality marked by a pervasive pattern of grandiosity, need for admiration, and lack of empathy. The APA also states that proper diagno

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Ronningstam (1996) notes that prevalence rates can often vary depending upon the differences in diagnostic criteria. For example, clinicians using the Millon Clinical Multiaxial Inventory I or II will often find higher prevalence rates than will those using the Structural Interview for DSM-IV Personality Disorders. General Information According to Sue, Sue and Sue (1994), people with NPD commonly use denial and devaluation of others to maintain their inflated self-concept. In particular, denial is used to ward off feelings of inferiority that may have developed from early childhood. Most certainly, individuals with NPD will respond to any criticism with one or both of these defense mechanisms. Masterson (1981) provides an example of the kind of thinking of the individual with NPD in a quotation of one narcissistic client who reported: I was denied promotion to chief executive by my board of directors, although my work was good, because they felt I had poor relations with my employees. When I complained to my wife, she agreed with the board, saying my relations with her and the children were equally bad. I don't understand. I know I'm more competent than all these people. (Masterson, 1981, p. ix) Messer (1985) has
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