{ "schemaVersion": 2, "eyebrow": "Psychiatry", "title": "Narcissistic Personality Disorder", "summary": "Evaluate narcissistic personality disorder longitudinally, corroborate impairment with collateral history, assess co-occurring mood, substance, and safety syndromes, and use a structured psychotherapy-centered plan. Medication has no established role for core narcissistic pathology but may target a clearly diagnosed comorbidity.", "seoDescription": "Physician guide to evaluating narcissistic personality disorder, distinguishing comorbidity, managing risk, and selecting psychotherapy-centered care.", "clinicalQuestion": "How should physicians diagnose, risk-stratify, and manage narcissistic personality disorder in clinical practice?", "specialty": "Psychiatry", "audience": "U.S. physicians and medical trainees", "tags": [ "narcissistic personality disorder", "pathological narcissism", "personality disorders", "psychotherapy", "transference-focused psychotherapy", "mentalization-based treatment" ], "keyTakeaways": [ "Do not diagnose narcissistic personality disorder from self-described confidence, interpersonal conflict, or a single clinical encounter; establish persistent maladaptive functioning and obtain collateral history when feasible. [19]", "Document functional impairment and dimensional personality features alongside the categorical diagnosis; DSM-5 includes an alternative hybrid trait-and-impairment model in its emerging models section. [8][19]", "Prioritize a longitudinal psychotherapy formulation with explicit, collaborative treatment goals; transference-focused psychotherapy and mentalization-based approaches have been adapted for pathological narcissism, but direct outcome evidence remains limited. [9][13]", "Do not prescribe medication for core narcissistic pathology; there are no FDA-approved medications for narcissistic personality disorder, and pharmacotherapy should target a separately established comorbid disorder or symptom syndrome. [13][19]", "Assess substance use directly because personality pathology and substance use disorders frequently co-occur; avoid attributing substance-related disinhibition, aggression, or mood symptoms solely to personality structure. [18]" ], "sections": [ { "id": "diagnostic-decision", "eyebrow": "Diagnosis", "heading": "Make the diagnosis from enduring impairment, not interpersonal style", "intro": "Anchor the formulation in persistent dysfunction across settings and over time.", "paragraphs": [ "A formal diagnosis requires more than grandiosity, entitlement, admiration seeking, or a difficult therapeutic interaction. Establish whether the pattern is enduring, inflexible, maladaptive, and associated with clinically important interpersonal, occupational, or social impairment. Obtain a longitudinal history across work, intimate relationships, friendships, and prior treatment, then seek collateral information when feasible because self-report alone may incompletely characterize personality functioning. [12][19]", "At the initial assessment, separate a categorical narcissistic personality disorder diagnosis from a dimensional description of the patient’s personality functioning and maladaptive traits. The DSM-5 Section III hybrid model combines impairment in personality functioning with dimensional trait facets and retains categorical types to preserve continuity; use this framework clinically to record the degree of identity, self-direction, empathy, and intimacy impairment even when billing or documentation uses the categorical diagnosis. [8][19]", "Avoid overmedicalizing traits that are not causing clinically significant suffering or dysfunction. Clarify the patient’s own treatment target before confronting narcissistic defenses or assigning a diagnostic label; collaborative goal-setting and inclusion of the patient perspective are emphasized to reduce iatrogenic harm and improve engagement. [19]" ], "bullets": [ "Document developmental course, relationship pattern, occupational consequences, prior psychotherapies, psychiatric admissions, self-harm, aggression, and current substance use. [12][18][19]", "Ask collateral informants about stability of interpersonal exploitation, entitlement, empathy deficits, affective reactivity, and impairment across settings rather than relying on isolated conflicts. [19]", "Record a dimensional formulation when traits are prominent but categorical threshold or durable impairment remains uncertain. [8][19]" ], "subsections": [], "table": { "caption": "Clinical findings that change the next diagnostic step.", "columns": [ "Finding during assessment", "Interpretation", "Next action" ], "rows": [ [ "Traits are situational, recent in onset, or confined to an acute mood, substance-related, or psychotic episode", "Do not presume enduring personality pathology; state-related symptoms may be driving the presentation. [18][19]", "Treat and reassess the acute syndrome longitudinally before finalizing a personality-disorder diagnosis. [19]" ], [ "Pervasive dysfunction is corroborated across relationships, work, and prior history", "Supports a personality-disorder formulation when the pattern is enduring and inflexible. [12][19]", "Document impairment and trait pattern; develop a psychotherapy-centered treatment plan. [8][19]" ], [ "Patient seeks care for depression, anxiety, aggression, impulsivity, or substance use rather than personality concerns", "The presenting syndrome may be comorbid and immediately treatable even when narcissistic pathology contributes to treatment engagement problems. [13][18][19]", "Perform syndrome-specific assessment and treat the comorbid condition without using medication as treatment for core narcissistic traits. [13][19]" ] ] } }, { "id": "risk-and-comorbidity", "eyebrow": "Safety", "heading": "Assess acute risk and treatable comorbidity before personality-focused work", "intro": "Current danger, intoxication, and major syndromes determine the immediate setting and sequence of care.", "paragraphs": [ "Perform a direct suicide, self-harm, violence, and victimization assessment whenever the presentation includes acute humiliation, loss, rage, severe dysphoria, impulsivity, intoxication, or escalating interpersonal conflict. Determine current intent, plan, access to lethal means, recent behavior, intoxication or withdrawal, psychosis, and capacity to participate in outpatient safety planning; these findings determine whether emergency psychiatric evaluation or a higher level of care is required.", "Screen directly for alcohol, nonmedical drug, and tobacco use rather than inferring that impulsive behavior is personality-based. Substance use disorders are common among patients with personality pathology; one review reports lifetime substance use disorder in approximately 78% of patients with borderline personality disorder, illustrating the need to evaluate co-occurring substance syndromes carefully in patients presenting with affective instability or impulsive behavior. [18]", "Evaluate mood instability, depressive symptoms, anxiety, trauma-related symptoms, attention-deficit/hyperactivity disorder, psychosis, and other personality pathology as separate diagnostic questions. Narcissistic and borderline personality pathology can overlap clinically, and transference-focused psychotherapy has been adapted across personality disorders; however, treatment selection should follow the dominant risk behaviors, functional impairment, and comorbid syndromes rather than a single trait label. [9][13]" ], "bullets": [ "If intoxication, withdrawal, or ongoing substance use plausibly accounts for aggression, disinhibition, mood lability, or relationship disruption, address the substance-use disorder and reassess baseline personality functioning after stabilization. [18]", "When recurrent self-harm, suicidal behavior, or severe emotional dysregulation is present, select a treatment program with structured crisis management and explicit behavioral targets rather than unstructured supportive contact alone. Structured clinical management and mentalization-based programs incorporate protocolized crisis and medication review. [14]", "Use the least restrictive setting compatible with immediate safety, capacity, and ability to engage in a reliable crisis plan; personality diagnosis alone does not establish an indication for hospitalization." ], "subsections": [], "table": null }, { "id": "psychotherapy-selection", "eyebrow": "Treatment", "heading": "Use structured psychotherapy as the core intervention", "intro": "Match treatment structure to the dominant impairment and the patient’s capacity to sustain treatment.", "paragraphs": [ "Psychotherapy is the primary treatment modality for narcissistic personality disorder. Establish a written or clearly documented frame covering treatment goals, session structure, attendance expectations, crisis contacts, boundaries, and how treatment ruptures will be discussed. This frame is especially important when idealization, devaluation, withdrawal, anger, or treatment-interfering behavior threatens continuity.", "Transference-focused psychotherapy is an individual psychodynamic treatment developed for personality disorders and adapted for narcissistic personality disorder. Consider it when identity integration, unstable self-esteem regulation, polarized views of self and others, and recurrent relational enactments dominate the presentation; its specific adaptation for narcissistic personality disorder is supported principally by clinical and theoretical work, including a recent case report rather than definitive comparative efficacy evidence. [9]", "Mentalization-based treatment may be useful when impaired reflection on one’s own and others’ mental states, interpersonal misreading, affective escalation, and unstable attachment responses drive repeated relational crises. It has been adapted conceptually for pathological narcissism, with the proposed therapeutic aim of increasing emotional awareness, perspective-taking, and reflective capacity; direct evidence in narcissistic personality disorder remains limited. [13]", "When the clinical picture includes borderline personality disorder or prominent self-harm and emotional dysregulation, refer to an established personality-disorder treatment with demonstrated benefit in that population. Dialectical behavior therapy, mentalization-based therapy, transference-focused psychotherapy, and schema therapy are among empirically supported specialized treatments for borderline personality disorder; disorder-specific psychotherapies show small-to-moderate improvements versus nonspecific control treatments for severity, self-harm, suicide-related outcomes, and psychosocial function. [15][16][17]" ], "bullets": [ "Choose a therapist or program able to manage alliance ruptures without retaliatory confrontation, collusion with grandiosity, or abandonment after conflict.", "Define observable targets at baseline: sustained work or school participation, reduction in aggressive or exploitative behavior, fewer relationship crises, improved reflective capacity, and adherence to treatment agreements.", "If a specialist modality is unavailable, provide structured psychiatric management focused on psychoeducation, crisis planning, comorbidity treatment, and consistent boundaries while arranging longitudinal psychotherapy. Structured clinical management has been used as an active comparator in mentalization-based treatment studies. [14][15]" ], "subsections": [ { "heading": "Treatment selection by dominant problem", "paragraphs": [ "Use the dominant functional problem to select the initial psychotherapy emphasis. A patient whose crises follow perceived rejection or humiliation may need a treatment that repeatedly links affective escalation to assumptions about others’ intentions. A patient whose treatment repeatedly destabilizes through idealization and devaluation may benefit from a consistent, interpretive relational frame. Co-occurring self-harm, suicidality, or severe impulsivity should shift early treatment toward a program with explicit behavioral hierarchy and crisis-management capacity. [9][14][17]" ], "bullets": [] } ], "table": { "caption": "Psychotherapy selection for narcissistic pathology and important overlap syndromes.", "columns": [ "Clinical priority", "Reasonable treatment emphasis", "Evidence boundary" ], "rows": [ [ "Identity disturbance, polarized self-other representations, recurrent relational enactments", "Consider transference-focused psychotherapy adapted for narcissistic personality disorder. [9]", "Adaptation to narcissistic personality disorder is described, but direct comparative outcome evidence is limited. [9]" ], [ "Poor perspective-taking, affective misinterpretation, interpersonal escalation", "Consider mentalization-focused work to strengthen reflective function and emotional awareness. [13]", "The rationale and adaptation for pathological narcissism are stronger than direct trial evidence. [13]" ], [ "Borderline personality disorder with self-harm, suicidality, or marked emotional dysregulation", "Refer for a structured, evidence-based borderline personality disorder psychotherapy such as DBT, MBT, TFP, or schema therapy. [15][16][17]", "Evidence pertains to borderline personality disorder and should not be extrapolated as proof of efficacy for core narcissistic pathology. [15][17]" ], [ "Limited access to specialty psychotherapy", "Use experienced, structured clinical management with crisis planning, medication review, and clear treatment boundaries while pursuing referral. [14][15]", "This is a practical bridge, not a substitute for sustained specialty psychotherapy when indicated. [14][15]" ] ] } }, { "id": "medication-and-medical-management", "eyebrow": "Pharmacotherapy", "heading": "Do not medicate narcissistic traits; target a diagnosed comorbid syndrome", "intro": "Medication decisions should remain diagnosis-specific and outcome-measurable.", "paragraphs": [ "There are no FDA-approved medications for narcissistic personality disorder, and pharmacotherapy has not shown strong evidence for changing core narcissistic pathology. Do not use an antidepressant, antipsychotic, mood stabilizer, benzodiazepine, or stimulant solely to treat grandiosity, entitlement, impaired empathy, or need for admiration. [13][19]", "When medication is considered, identify the specific target diagnosis and define the measurable symptom outcome before prescribing: for example, a major depressive episode, bipolar-spectrum episode, anxiety disorder, attention-deficit/hyperactivity disorder, substance-use disorder, psychotic disorder, or another established comorbidity. Reassess whether apparent treatment failure reflects untreated substance use, inconsistent attendance, adverse effects, or a mismatch between the medication target and the patient’s actual syndrome. [18][19]", "Avoid using medication as a substitute for a treatment frame when anger, interpersonal conflict, or therapy rupture is the primary problem. Pharmacologic treatment may be appropriate for mood instability, impulsivity, or aggression only when those symptoms are linked to a diagnosable comorbidity and monitored as distinct treatment targets; it should not be presented as treatment of narcissistic personality disorder itself. [13][19]" ], "bullets": [ "At each medication visit, document the target syndrome, baseline symptom burden, adherence, adverse effects, substance use, and functional change.", "Coordinate prescribing with the psychotherapist so medication changes do not inadvertently reinforce crisis-driven treatment patterns or undermine agreed treatment boundaries.", "Use evidence-based treatment for co-occurring substance-use disorder rather than framing abstinence or relapse prevention as personality treatment. [18]" ], "subsections": [], "table": null }, { "id": "monitoring-and-therapeutic-alliance", "eyebrow": "Follow-up", "heading": "Monitor function, alliance rupture, and risk rather than trait severity alone", "intro": "Sustained engagement and functional improvement are more actionable than debating diagnostic labels at every visit.", "paragraphs": [ "At follow-up, monitor concrete outcomes: attendance, treatment-interfering behavior, occupational or educational participation, relationship stability, aggression or self-harm events, substance use, emergency utilization, and progress toward patient-defined goals. Review safety at every clinically meaningful change in humiliation, separation, mood state, intoxication, or interpersonal conflict.", "Treat alliance rupture as clinical data. When the patient experiences the clinician as dismissive, admiring, controlling, or abandoning, name the observable interaction, ask for the patient’s interpretation, and reconnect the episode to agreed treatment goals. Mentalization-based approaches specifically use reflection on the therapeutic relationship, while transference-focused approaches work directly with relational patterns emerging in treatment. [9][13][14]", "Avoid punitive discharge for predictable interpersonal conflict when outpatient safety permits. Instead, distinguish nonnegotiable safety and boundary violations from therapy-interfering behavior that can be formulated and addressed within treatment. Escalate to specialty personality-disorder care when repeated rupture, aggression, self-harm, or severe functional decline exceeds the practice’s capacity for structured management." ], "bullets": [ "Revisit the diagnostic formulation after stabilization of acute mood, psychotic, or substance-related syndromes. [18][19]", "Use collateral reports, with appropriate consent, to track real-world relationship and occupational functioning rather than relying only on in-session presentation. [19]", "Measure whether psychotherapy is improving behavior and functioning; insight without reduction in recurrent crises or impairment should prompt reassessment of treatment structure and comorbidity." ], "subsections": [], "table": null } ], "faq": [], "references": [ { "number": 1, "title": "Metacognitive interventions for adolescents with mental disorders: a scoping review | Pediatric Research", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41390-026-05115-z", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 2, "title": "Neurobiological correlates of personality dimensions in ...", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-025-85989-x.pdf", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 3, "title": "Dietary patterns and emotion dysregulation in borderline ...", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-026-36068-2", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 4, "title": "Divalproex in the Treatment of Impulsive Aggression: Efficacy in Cluster B Personality Disorders | Neuropsychopharmacology", "detail": "www.nature.com", "url": "https://www.nature.com/articles/1300153", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 5, "title": "DSM-III - 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However, the previously described alternative model in section III of the DSM-5 addresses some of the aforementioned critiques by formulating personality disorders in a d", "score": 0.42076674 }, { "number": 6, "title": "DSM-5 - an overview | ScienceDirect Topics", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/dsm-5", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### Abstract\n\nThe purpose of this article is to provide an overview of the DSM-5 personality disorders (PDs). Included herein is a discussion of the paranoid, schizoid, schizotypal, antisocial, borderline, narcissistic, histrionic, avoidant, dependent, and obsessive–compulsive PDs. Also discussed is", "score": 0.4191967 }, { "number": 7, "title": "Histrionic Personality Disorder - an overview", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/topics/social-sciences/histrionic-personality-disorder", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Scoring of Assessment—To obtain a continuous score, simply sum the item scores per disorder. For categorical scores, one must create dichotomous variables using a threshold cutoff score per item. Subthreshold item responses (0 or 1) are assigned a value of 0, and responses of 2 or higher are assigne", "score": 0.40853685 }, { "number": 8, "title": "A comparison of the DSM-5 Section II and Section III personality disorder structures", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0165178114000432", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Deriving ICD-11 personality disorder domains from dsm-5 traits: initial attempt to harmonize two diagnostic systems Bach B., …, Mulder R.Acta Psychiatrica Scandinavica • Volume 136 • 2017 \n The Alternative DSM-5 Personality Disorder Traits Criterion: A Comparative Examination of Three Self-Report", "score": 0.39445806 }, { "number": 9, "title": "A case report of the treatment of narcissistic personality disorder with transference focused psychotherapy - Bird - 2024 - Journal of Clinical Psychology - Wiley Online Library", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1002/jclp.23637", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "# A case report of the treatment of narcissistic personality disorder with transference focused psychotherapy. The following case study provides a description of the transference-focused psychotherapy (TFP) treatment of a young man diagnosed with narcissistic personality disorder (NPD). TFP is an in", "score": 0.6551821 }, { "number": 10, "title": "“Labeled, Criticized, Looked Down On”: Characterizing the Stigma of Narcissistic Personality Disorder - Finch - 2025 - Personality and Mental Health - Wiley Online Library", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1002/pmh.70015", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "# “Labeled, Criticized, Looked Down On”: Characterizing the Stigma of Narcissistic Personality Disorder. Narcissistic personality disorder (NPD) is widely thought to be highly stigmatized; however, little empirical research has characterized this stigma. “Countertransference Phenomena and Personalit", "score": 0.48264915 }, { "number": 11, "title": "Personality Disorders | Continuum", "detail": "journals.lww.com", "url": "https://journals.lww.com/continuum/fulltext/2015/06000/personality_disorders.21.aspx", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "Google Scholar\n\n42.\n\nLevy KN, Wassennan RH, Seott LN, et al. Empirical evidence for transference-focused psychotherapy and other psychodynamic psychotherapy for borderline personality disorder. In: Levy RA, Albon JS, Rosenbaum JF, eds. Handbook of evidence-based psychodynamic psychotherapy: bridging", "score": 0.19219075 }, { "number": 12, "title": "The ICD-10 Classification of Mental and Behavioural ...", "detail": "cdn.who.int", "url": "https://cdn.who.int/media/docs/default-source/classification/other-classifications/9241544228_eng.pdf", "authors": "cdn.who.int", "host": "cdn.who.int", "snippet": "Personality disorders are therefore subdivided according to clusters of traits that correspond to the most frequent or conspicuous behavioural manifesta-tions. The subtypes so described are widely recognized as major forms of 200 F60-F69 DISORDERS OF ADULT PERSONALITY AND BEHAVIOUR personality devia", "score": 0.48264915 }, { "number": 13, "title": "Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12006724", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "personality disorder have emerged as adaptations for PN, such as dialectical behavior therapy (DBT) (72), transference-focused psychotherapy (TFP) (73), mentalization-based therapy (MBT) (74, 75), and schema therapy (76). To date, there is no strong empirical evidence supporting pharmacotherapy for ", "score": 0.71687365 }, { "number": 14, "title": "Mentalization-Based Treatment", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4467231", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "A larger trial comparing outpatient therapy with structured clinical management showed more compelling outcomes. Patients with BPD who were consecutive referrals were randomly allocated (minimization for age, gender, antisocial personality disorder) to intensive outpatient and structured clinical ma", "score": 0.60498303 }, { "number": 15, "title": "Borderline personality disorder: a comprehensive review of ...", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10786009", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "### Psychotherapy\n\nPsychotherapy is regarded as the first‐line treatment for BPD22, 54, 198. Guidelines do not recommend brief forms of psychotherapy lasting less than three months22. However, although a number of specialist treatments – i.e., dialectical behavioral therapy (DBT), mentalization‐base", "score": 0.5951402 }, { "number": 16, "title": "Schema therapy for borderline personality disorder - PMC - NIH", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6248917", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "## is a pervasive, debilitating psychological condition found in 28.5% of clinical populations and between 0.8% and 1.6% among community samples [1][2]. BPD is often regarded as the most lethal form of mental illness and the most severe personality disorder , where completed suicides are estimated ", "score": 0.52670854 }, { "number": 17, "title": "Perspectives on Dialectical Behavior Therapy and Mentalization-Based Therapy for Borderline Personality Disorder: Same, Different, Complementary?", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9624210", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "Though there is some variation regarding the availability of individual treatments in different countries, the most common and most intensively studied treatments for BPD are dialectical-behavioral therapy (DBT),11 mentalization-based therapy (MBT),12 schema-focused therapy (SFT),13 transference-foc", "score": 0.47387698 }, { "number": 18, "title": "Comorbidity of Personality Disorder among Substance Use Disorder Patients: A Narrative Review - PMC", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6241194?term=%22Indian+J+Psychol+Med%22%5Bjour%5D", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "Title: Comorbidity of Personality Disorder among Substance Use Disorder Patients: A Narrative Review - PMC\nFor example, studies suggest SUDs to be one of the most common psychiatric comorbidities among patients with BPD, with a lifetime prevalence of around 78%.[25] Another study reported that almos", "score": 0.43727133 }, { "number": 19, "title": "Narcissistic Personality Disorder - StatPearls - NCBI Bookshelf", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK556001#article-27055.s1", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "Experts in personality disorders have suggested switching to a dimensional model of personality rather than a cluster model. The proposed dimensional models describe temperament, utilization of defense mechanisms, and identification of pathological personality traits.(#article-27055.r47) Although th", "score": 0.42005292 }, { "number": 20, "title": "Emotional dysregulation subgroups in patients with adult Attention-Deficit/Hyperactivity Disorder (ADHD): a cluster analytic approach | Scientific Reports", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-019-42018-y", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "found by the SCID screen questionnaire or the interview was almost the same with 58% and 54%, respectively; the overall kappa was 0.7876.\"). We only used the questionnaire data in the present study which does not allow formal diagnoses. The self-defeating personality disorder is represented by 7 ite", "score": 0.0924337 }, { "number": 21, "title": "Neural correlates of aggression in personality disorders ...", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41398-023-02612-1", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "by NJ Kolla · 2023 · Cited by 27 — A mechanism-based approach to anti-aggression psychotherapy in borderline personality disorder: group treatment affects amygdala activation and", "score": 0.06947242 }, { "number": 22, "title": "Cluster B Personality Disorders are Associated with Allelic ...", "detail": "www.nature.com", "url": "https://www.nature.com/articles/1300737", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "by CP Jacob · 2005 · Cited by 129 — Here, we investigated the influence of allelic variation of MAOA activity on aggression-related personality traits and disease risk in patients", "score": 0.045901228 }, { "number": 23, "title": "Exploring concept creep in narcissistic personality disorder", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S0001691826004051", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "by MP Hengartner · 2026 — DSM-5 criteria of narcissistic personality disorder, including grandiosity, need for admiration, extraordinariness, entitlement, interpersonal exploitation,", "score": 0.36881536 }, { "number": 24, "title": "DSM-IV - an overview | ScienceDirect Topics", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/topics/immunology-and-microbiology/dsm-iv", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "The consolidation of separate diagnoses into one single diagnosis, the collapse of the three domains into two, the increase in the criteria for repetitive behaviors, and the inclusion of specifiers of severity level collectively reflect changes that were made as part of the shift from a categorical ", "score": 0.35837606 } ], "publishedAt": "2026-08-24T18:49:23.732040+00:00", "updatedAt": "2026-08-24T18:49:23.732040+00:00", "readingMinutes": 7, "slug": "narcissistic-personality-disorder" }