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date: 26 February 2021

Abstract and Keywords

The diagnosis of narcissistic personality disorder (NPD) evolving over the past 40 years within several fields of inquiry—clinical and psychoanalytic as well as psychiatric and empirical—is discussed in this chapter. The inclusion of NPD as a separate personality disorder in the latest proposal of DSM-5 has warranted continuing studies and development of the diagnosis and treatment of pathological narcissism and NPD. Specific focus is on capturing the complexity of narcissistic pathology, identifying narcissistic core traits in the context of regulatory and dynamic variability, and incorporating the functional and phenotypic range of NPD. The diagnostic process, that is, identifying narcissistic traits in a collaborative alliance-building context between patient and clinician, aims at establishing a meaningful diagnosis that can inform patient and relatives and serve to guide treatment. Concluding guidelines for enhancing accuracy and meaningfulness of the NPD diagnosis are proposed.

Keywords: narcissistic personality disorder, pathological narcissism, self-esteem, emotional regulation, aggression, shame, perfectionism, self-disclosure

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