Narcissism; as a personality disorder,its symptoms,cause,prevention and management

Definition

Narcissism is a personality disorder in which a person has an inflated sense of self-importance or grandiosity. A personality disorder is an enduring pattern of inner experience and behavior that deviates from the norm of the individual’s culture. The pattern is seen in two or more of the following areas: cognition; affect; interpersonal functioning; or impulse control. The enduring pattern is inflexibility and pervasiveness cut across a broad range of personal and social situations. It typically leads to significant distress or impairment in the social life of an individual, it’s attitude to  work and  other areas of functioning. The pattern is stable and of long duration, and its onset can be traced back to early adulthood or adolescence.

 

Symptoms

In order for a person to be diagnosed with narcissistic personality disorder (NPD) they must meet five or more of the following symptoms:

  • Exaggerated sense of self-importance (grandiosity).
  •  Excessive attention and admiration.
  • Expect to be recognized as superior even without achievements that warrant it.
  • Exaggerate achievements and talents.
  • Being preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate.
  • Believe they are superior and can only associate with equally special people.
  • Monopolize conversations and belittle or look down on people they perceive as inferior.
  • Expect special favors and unquestioning compliance with their expectations.
  • Insist on having the best of everything.
  • Troubled relationships and a lack of empathy for others. But behind this mask of extreme confidence lies a fragile self-esteem that’s vulnerable to the slightest criticism.
  • Has a very strong sense of entitlement, e.g., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
  • Is exploitative or  takes advantage of others to achieve his or her own ends
  • Lacks empathy and willingness to recognize or identify with the feelings and needs of others
  • Is often envious of others or believes that others are envious of him or her
  • Regularly shows arrogant, haughty behaviors or attitudes
  • A narcissistic personality disorder causes problems in many areas of life, such as relationships, work, school or financial affairs. People with narcissistic personality disorder may be generally unhappy and disappointed when they’re not given the special favors or admiration they believe they deserve. They may find their relationships unfulfilling, and others may not enjoy being around them.

Causes

The cause of   narcissistic personality disorder is still unknown. As with personality development and with other mental health disorders, the cause of narcissistic personality disorder is likely complex. Many theories and professionals subscribe to a bio-psycho-social model of causation.  Narcissistic personality disorder may be linked to:

  • Genetics ― This refers to inherited characteristics from the parents. If the parents of the person has this personality disorder, research suggests that there is a slightly increased risk for this disorder to be passed down  to their children
  • Neurobiology — the connection between the brain and behavior and thinking
  • Social Factor: This refers how a person interacts in their early development with their family (If the family members excessively adores or criticize the child, are over protective or neglectful), friends (who are narcissist) and other children which go a long way to influence them. Recently Researchers have identify the social cause of narcissism to be linked with excessive posting of visuals in the social media platforms such as facebook, instagram etc
  • Psychological factors: This refers to the individual’s personality and temperament shaped by their environment and learned coping skills to deal with stress

This suggests that no single factor is responsible rather; it is the complex and likely intertwined nature of all three factors that are important.

RISK FACTORS

  • Males are more at risk than females
  • Addicted social media usage.
  • Adolescents or early adults , this may simply be typical of their age and doesn’t mean they’ll go on to develop narcissistic personality disorder.
  • Sanguine or Choleric temperament.
  • First Class Family.

 

OCCURRENCES

  • Rare
  • More prevalent in males than females
  • Occur in around 6 percent of the general population, according to research.
  • Decreases in intensity with age, just like most personality disorders, with many people experience few of the most extreme symptoms by the time they are in their 40s or 50s.
  • Fewer than 100 thousand cases per year (Nigeria)

Prognosis

Chronic, it can last for years or lingers for a lifetime.

 

DIAGNOSIS

The disorder needs to be diagnosed by a professional. Because personality disorders give long-standing and enduring patterns of behavior, they are most often diagnosed in adulthood. It is uncommon for them to be diagnosed in childhood or adolescence, because a child or teen is under constant development, personality changes, and maturation. However, if it is diagnosed in a child or teen, the features must have been present for at least 1 year.

Personality disorders such as NPD are typically diagnosed by a trained mental health professional, such as a Psychologist, Psychiatric Nurse Practitioner and Psychiatrist. Family physicians and general practitioners are generally not trained or well-equipped to make this type of psychological diagnosis. So while you can initially consult a family physician about this problem, they should refer you to a mental health professional for diagnosis and treatment. There is no laboratory, blood, or genetic tests that are used to diagnose personality disorder.

Many people with this disorder don’t seek out treatment. People with personality disorders, in general, do not often seek out treatment until the disorder starts to significantly interfere or otherwise impact a person’s life. This most often happens when a person’s coping resources are stretched too thin to deal with stress or other life events.

A diagnosis is made by a mental health professional comparing your symptoms and life history with those listed here. They will make a determination whether your symptoms meet the criteria necessary for a personality disorder diagnosis.

 

Complications

Complications of narcissistic personality disorder, and other conditions that can occur along with it, can include:

  • Relationship difficulties
  • Problems at work or school
  • Depression and anxiety
  • Physical health problems
  • Drug or alcohol misuse
  • Suicidal thoughts or behavior

Prevention

It must always be emphasized that no one chooses to have a personality disorder or high-conflict personality, so it’s good to have empathy and compassion for them and treat them with respect, regardless of whether you distance yourself from them or manage a relationship with them.           Because the cause of narcissistic personality disorder is unknown, there’s no known way to prevent the condition. However, the following can help:

  • Visit the mental health institution  as soon as possible for childhood mental health problems.
  • Participate in family therapy to learn healthy ways to communicate or to cope with conflicts or emotional distress.
  • Attend parenting classes and seek guidance from therapists or social workers if needed.
  • Avoid being in the company of a group of narcissist especially if you can easily be influenced.
  • Avoid persistence visual post on social media.

Treatment of Narcissistic Personality Disorder

This involves inter-disciplinary teams like Clinical Psychologist, Psychiatrist, Psychiatric Nurse, Social workers, Therapist etc

The Treatment Measures Includes

  • Psychotherapy or Talk Therapy. It should be a long-term Treatment with a therapist who has an experience  in treating this kind of disorder.
  • Supportive groups therapy: A forum for counseling and sharing experiences among people with a similar condition.
  • Family Therapy
  • Psychological counseling that helps families resolve conflicts and communicate more effectively.
  • Group Psychotherapy
  • Regular follow-up to evaluate for improvement. Regular follow-up to evaluate for improvement.
  • Medications may also be prescribed to help with specific troubling and debilitating symptoms.
  • Other Supportive care

 

References

  1. Bressert, S. (2018). Narcissistic Personality Disorder. Psych Central. Retrieved on November 6, 2018, from https://psychcentral.com/disorders/narcissistic-personality-disorder/
  2. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.

 

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