Narcissistic personality disorder in DSM-5 Section II and Section III: The study of alternative model

Abstract Narcissistic personality disorder (NPD) is a pervasive pattern of grandiosity, need for admiration and lack of empathy that people because of belief to being special and unique, interpersonal problems and empathy are faced. The present paper is studying the conceptualization and diagnosis of narcissistic personality disorder in DSM-5 main Section (Section II) and Alternative model (Section III) and tried to base on five components including in nature (healthy, pathological), phenotype (grandiosity, vulnerability), expression (overt, covert), structure (category, dimension), comorbidity, validity, and clinical benefit was compared the NPD in two DSM-5 sections. The conceptualization and diagnosis of NPD in DSM-5 Section II, has weaknesses and limitations such as; the lack of attention to the natural and pathological nature of narcissism, the emphasis on the grandiosity phenotype of this structure and the disregard of its vulnerability, Neglecting overt and covert expressions of clinical symptoms, the categorical approach to diagnosis, the defect in specify this disorder of other personality disorders and the underestimate of prevalence rate. In contrast, the alternative model in section III has a more comprehensive theoretical, dimensional, and diagnostic conceptualization than the central part, and provides appropriate criteria consider to the function and personality pathology in A and B criteria and has better diagnostic benefits. The alternative model in DSM-5 Section III seems to be a suitable substitute for diagnosis of narcissistic personality disorder in the later versions of DSM, after gaining the validity and integrity with experiences of clinical experts and with care in various types and dimensions of narcissism, can be effective on the diagnostic challenges of clinicians.