Narcissistic Personality Disorder : Facing DSM

Psychoanalytic theories and clinical case studies of patients with narcissistic character pathology were most infl uential in outlining the conceptualization and description of the narcissistic personality disorder (NPD) when it was fi rst included as a diagnostic category in the Diagnostic and Statistic Manual of Mental Disorders, third edition, (DSM-III) in 1980. This was eloquently summarized by Salman Akhtar.1 Infl uences from other disciplines, (ie, psychiatric and psychosocial research on epidemiology and prototypical features), as well as academic social psychological inventory and laboratory studies of human behavior, have contributed additional perspectives on pathological narcissism and NPD. More recently, cognitive neuropsychology and studies of infant and child development have also added valuable information to our understanding of the origins of pathological narcissism and specifi c areas of narcissistic personality functioning. Three recent reviews2-4 have Elsa Ronningstam, PhD