The Etiology and Treatments of Narcissistic Personality Disorder: A Systematic Review

Jun Li

doi:10.54097/3pw3ev97

Authors

Jun Li

DOI:

https://doi.org/10.54097/3pw3ev97

Keywords:

Narcissistic personality disorder, etiology, treatments, psychodynamic therapy, transference-focused psychotherapy.

Abstract

Narcissistic personality disorder (NPD) is considered a very complex mental health disorder influenced by different genetic, neurobiological, and environmental factors. Neurobiologically, abnormalities in brain regions within the prefrontal cortex and limbic system contribute to difficulties in emotional regulation and empathy. The environmental factor easily predisposing them to it comes in the form of childhood trauma or over-spoiling by parents. NPD is often comorbid with other personality disorders, such as borderline personality disorder and antisocial personality disorder, which makes the diagnosis even more complex. The treatments of NPD include psychodynamic therapy, in particular, transference-focused psychotherapy, cognitive-behavior techniques such as schema therapy, and the newest, which includes mentalization-based treatment. There also is the enormous challenge of engaging patients with NPD in therapy, given the typical features of resistance, such as grandiosity and ignorance of the true self. Because of this, future research on NPD, especially early intervention and elaboration, has become the expected and focused direction.

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References

[1] American Psychiatric Association, DSM-5 Task Force. Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). American Psychiatric Publishing, Inc. 2013. DOI: https://doi.org/10.1176/appi.books.9780890425596

[2] Campbell, W. K., & Miller, J. D. (2011). The handbook of narcissism and narcissistic personality disorder (pp. 309-318). Hoboken, NJ: John Wiley & Sons. 2011. DOI: https://doi.org/10.1002/9781118093108

[3] Fossati, A., Somma, A., Borroni, S., Maffei, C., Markon, K. E., & Krueger, R. F. Borderline Personality Disorder and Narcissistic Personality Disorder Diagnoses from the Perspective of the DSM-5 Personality Traits: A Study on Italian Clinical Participants. The Journal of Nervous and Mental Disease 204 (12), 939 – 949 (2016). DOI: https://doi.org/10.1097/NMD.0000000000000587

[4] Miller, J. D., Campbell, W. K., & Pilkonis, P. A. Narcissistic personality disorder: relations with distress and functional impairment. Comprehensive Psychiatry 48 (2), 170 – 177 (2007). DOI: https://doi.org/10.1016/j.comppsych.2006.10.003

[5] Kernberg, O. F. Borderline Conditions and Pathological Narcissism. United Kingdom: J. Aronson. 1985.

[6] Ronningstam, E., & Weinberg, I. Narcissistic personality disorder: Patterns, process, and indicators of change in long-term psychotherapy. Journal of Personality Disorders 37 (3), 337 – 357 (2023). DOI: https://doi.org/10.1521/pedi.2023.37.3.337

[7] Pincus, A. L., & Roche, M. J. Narcissistic grandiosity and narcissistic vulnerability. In W. K. Campbell & J. D. Miller (Eds.), The handbook of narcissism and narcissistic personality disorder: Theoretical approaches, empirical findings, and treatments (pp. 31 – 40). John Wiley & Sons, Inc. 2011. DOI: https://doi.org/10.1002/9781118093108.ch4

[8] Caligor, E., Levy, K. N., & Yeomans, F. E. Narcissistic Personality Disorder: Diagnostic and Clinical Challenges. The American Journal of Psychiatry 172 (5), 415 – 422 (2015). DOI: https://doi.org/10.1176/appi.ajp.2014.14060723

[9] Livesley, W. J., Jang, K. L., & Vernon, P. A. Phenotypic and Genetic Structure of Traits Delineating Personality Disorder. Archives of General Psychiatry 55 (10), 941 (1998). DOI: https://doi.org/10.1001/archpsyc.55.10.941

[10] Schulze, L., Dziobek, I., Vater, A., Heekeren, H. R., Bajbouj, M., Renneberg, B., Heuser, I., & Roepke, S. Gray matter abnormalities in patients with narcissistic personality disorder. Journal of Psychiatric Research 47 (10), 1363 – 1369 (2013). DOI: https://doi.org/10.1016/j.jpsychires.2013.05.017

[11] Twenge, J. M., Campbell, W. K. The Narcissism Epidemic: Living in the Age of Entitlement. United States: Atria Books. 2009.

[12] Otani, K., Suzuki, A., Matsumoto, Y., & Shirata, T. Marked differences in core beliefs about self and others, between sociotropy and autonomy: personality vulnerabilities in the cognitive model of depression. Neuropsychiatric disease and treatment 14, 863 – 866 (2018). DOI: https://doi.org/10.2147/NDT.S161541

[13] Bateman, A., & Fonagy, P. Mentalization-Based Treatment. Psychoanalytic inquiry 33 (6), 595 – 613 (2013). DOI: https://doi.org/10.1080/07351690.2013.835170