Narcissism

Question 1

Explain the development of the construct of narcissism.

Answer 1

1. use in psychiatry: sexual feelings and self-admiration
2. disorder of sexual interest
3. Freudic theories
4. psychological construct

Question 2

What constitutes healthy narcissism?

Answer 2

1. self-preservation
2. different, but realistic self-appraisal and affect regulation
3. healthy interpersonal relationships

Question 3

What constitutes exaggerated narcissism?

Answer 3

• increased self-regard and confidence
• increased sense of indestructibility
• increased risk-taking
• strong feelings
• increased entitlement
• increased ideals and standards
• conflict in interpersonal relationships
• infringing rights of others

Question 4

What constitutes pathological narcissism?

Answer 4

• decreased self-esteem regulation
• decreased affect regulation
• dysfunctional interpersonal relationships
• severity depends on the consequences of the disorder

Question 5

Explain the arrogant NPD type.

Answer 5

overt narcissism // grandiosity exhibitionist type

• grandiose fantasies to protect self-esteem
• self-centred and pretentious
• feelings are accurate but reactions are extreme and violent
• others are used to enhance self-esteem and demand admiration

Question 6

Explain the shy, hypervigilant NPD type.

Answer 6

covert narcissism // vulnerability-sensitivity type

• shame limits overt expression
• belief of superiority but lack of confidence
• criticism is accurately felt, emotions are dysphoric
• limited intimacy due to fear of rejection
• interpersonal conflicts and rejections

in practice difficult to identify and assess.

Question 7

Explain the psychopathic NPD type.

Answer 7

grandiose, exploitative, envy, low commitment & low empathy

• irritability and rage
• callous affect
• deceitful interpersonal style
• decreased remorse
• violence and criminality
• malignant narcissism

different from overt or just severity?

Question 8

Explain the development of pathological narcissism.

Answer 8

1. genetics and heritability.
2. disruption neurobiological origins of affect regulation: attachment patterns
3. parenting behaviour: mentalization

Question 9

Explain the resting narcissistic state.

Answer 9

1. injury to self-esteem
2. intolerable emotional response
3. self-righteous action to restore self-esteem: restorative fantasy or restorative violence
4. vulnerable narcissistic state

Question 10

Explain narcissism and sexual offending.

Answer 10

pathological narcissism is not related to sexual offending.

• perceives sexual availability regardless of cues
• rejected sexual advances lead to reactance theory of rape and goal rape

majority of sex offenders do not have psychiatric disorders

Question 11

What are the options for risk management or NPD?

Answer 11

1. treatment
2. supervision
3. monitoring
4. victim safety planning