Pathological Narcissism and Narcissistic Personality Disorder

The article "Pathological Narcissism and Narcissistic Personality Disorder" by Aaron L. Pincus and Mark R. Lukowitsky provides a comprehensive review of the inconsistencies in the conceptualization, assessment, and diagnosis of narcissism and Narcissistic Personality Disorder (NPD). It highlights the disparity between the clinical prevalence of NPD as per DSM criteria and the higher rates diagnosed by practitioners, often reflecting broader constructs of pathological narcissism. The authors focus on two key phenotypic themes—narcissistic grandiosity and narcissistic vulnerability—which encapsulate maladaptive expressions of self-enhancement and sensitivity to criticism, respectively. The review critiques the current taxonomy and diagnostic frameworks for reifying overt and covert expressions of narcissism as distinct types, calling for an integrated structure that incorporates these dimensions for better clinical and research alignment.

Additionally, the article emphasizes the need to resolve the "criterion problem" in narcissism, which arises from inconsistent definitions and operationalizations across psychology disciplines. It advocates for revising diagnostic criteria to bridge gaps between clinical theory, empirical research, and practical diagnosis. The authors argue for refining assessment tools to capture both normal and pathological expressions of narcissism, ensuring they reflect the interplay of adaptive and maladaptive traits. They propose that future research should focus on synthesizing findings to improve theoretical coherence and practical utility, particularly in light of updates to the DSM and the evolving science of personality disorders.