what are the 2 types of narcissism
- Grandiose narcissism (comperable to the DSM 5 NPD)
o Dominance
o Self assurance
o Immodesty
o Exhibitionism
o Aggression - Vulnerable narcissism (more simmilar to DSM BPD)
o Introversion
o Negative emotions
o Interpersonal coldness
o Hostility
o Need 4 recognition
o Entitlement
o Egocentrity - Both are narcissistic but different in their exhibition
- Mostly separate
DIMENSIONAL approach to NPD (4 aspects)
- Identity - they identify themselves based on how others think of them
- Self-direction – goal setting based on approval
- Empathy – low, difficulty recognizing emotions in others, focus on their own emotions
- Intimacy – superficial relationships bcs low empathy, demand a lot give little
what are the 2 PATHWAYS of NAPD
- Admiration – trying to get positive attention through self-promotion, admiration from others, can feed into grandiose fantasies, leads to having admirers (usually grandiose, only when they feel threatened)
- Rivalry – pushes others down, devaluate others, strive for supremacy in a bad way, leads to social conflict, but can inflate your ego (usually vulnerable, but less aggressive)
- Ppl tend to have a preference, but they use them interchangeably.
2 FACTOR model of psychopathy
1) Affective/interpersonal – lack of gilt, shallow emotionality, callous, nota ccepting responsibility for actions, superficial charm, grandiose, lying, manipulation
2) Antisocial/lifestyleyle - poor behavioral control, early behavioral problems, juvenile delinquency, revocation of conditional release, criminality, need fro stimulation, lack of long tearm goals, parasitic lifestyle, impulsivity, irresponsibility
Other (promiscupis sexual behavior, many serious short term relationships)
what is the male to female ratio of having ASPD
4:1
what is the difference between malignant narcisists and true psychopaths
malignant narcisists have more empathy and loyalty
psychopaths rarely have mood or anxiety disorders likely due to structural deficits in the amygdala
what are the 2 common countertransference reactions when dealing with patients with ASPD
disbelief - staff deny the patients true nature
collusion - staff is manipulated into “helping” the patients, often through unethical and ilegal actions
tratment of ASPD
long-term treatment with clearly defined structures and cosequences for breaking rules is necessary
14 established principles for treating ppl with ASPD
- outpatient caution - consider hospital settings due to lack of oversight
- consultation - second opinion
- safety
- realistic expectations
- therapist integrity
- countertransference management
- confront denial
- internal state awareness - help patients understand it
- here and now focus
- promote mentalization and empathy
- non neutrality - express shock
- espect resistance
- empathize honesty
what are the core psychological features of NPD
defecits in self definition, self esteem and affect regulation
T/F
structured assesment is better in idagnosing NPD than a skilful clinicians interwiev
false
T/F
patients with malignant narcissism or antisocial traits particularly those with comorbid depression, anxiety or treatable psychosis may have a better diagnosis than those without
T
T/F
the severity of comorbidity is linked to the severity of NPD
T
T/F
because there are no empiricaly supported treatments for NPD, treatments for BPD are recomended
T
