I am currently taking a course through Wright State University (Fairborn, OH) so that I can complete requirements for licensure as a counselor in the state of Ohio. I have decided to post one of my assignments for the course, which was to examine the different symptoms of a specific personality disorder and describe how they may relate to other problems (e.g., disorders) for the person. I decided to focus on the narcissistic personality disorder, about which you can find out more information here.
Narcissistic Personality Disorder (NPD) falls into Cluster B of the personality disorder categories; persons with a Cluster B disorder tend to be emotional, erratic, and dramatic (Butcher, Mineka, and Hooley 2004). Persons with NPD are often grandiose - they typically inflate their own abilities and accomplishments while deflating those of other persons. They appear to care only for themselves, disregarding the thoughts and emotions of others. Persons with NPD believe they are worthy of special attention and status, and they often prefer to associate only with those whom they perceive to have a high status as well. They may use others to obtain what they want or believe they deserve. Although seemingly impregnable, they greatly dislike criticism and are often preoccupied with others' views of them. Prevalance is estimated at less than 1% of the general population (Ronningstam 1999).
Due to their high regard for their own abilities and an abhorrence of criticism, persons with NPD may experience episodes of depression because of a sense of missed opportunities and a lack of recognition from others (Ronningstam 1999). NPD has a higher prevalence among bipolar patients (11-47%) but no study has shown a consistency of prevalence between NPD and any specific Axis I disorder. "In clinical samples of NPD, the most frequently co-occurring Axis I disorders were major depression or dysthymia (42-50%) followed by substance abuse (25-50%) and bipolar disorder (5-12%)" (p. 680). Treatment may be difficult due to the person's lack of perception that they are in need of treatment.
Cluster B disorders have the highest co-occurrence with substance abuse disorders (Nace 1990). Persons with NPD may turn to substances to cope with the perceived failure of others to adequately acknowledge or support them. They may use substances in an effort to inflate their sense of self and eliminate depressed feelings or low self-esteem. The treatment for substance abuse of a person with NPD may be greatly affected by the person's belief that he or she is above commonly used forms of treatment and therefore deserving of special attention; the person may also believe that he or she is actually in control of the substance abuse (Richards 1993).
Butcher, J.N., Mineka, S., & Hooley, J.M., (2004). Abnormal psychology (12th ed.). Boston, MA: Allyn & Bacon
Nace, Edgar. (1990). "Substance abuse and personality disorder," Managing the Dually Diagnosed Patient, Current Issues and Clinical Approaches, David F. O'Connell, editor. Binghamton, New York: The Haworth Press, Inc.
Richards, Henry Jay. (1993). Therapy of the Substance Abuse Syndromes. Northvale, New Jersey: Jason Aronson Inc.
Ronningstam, Elsa. (1999). Narcissistic Personality Disorder. In T. Millon, P. Blaney, and R. Davis (Eds.), Oxford textbook of psychopathology. New York: Oxford University Press.