Antisocial & Narcissistic Personality Disorders

Antisocial PD

• pervasive disregard for rights of others

• pattern of irresponsible behavior (breaking laws, being irritable and physically aggressive, defaulting on debts)

• little regard for truth and little remorse for misdeeds

DSM-5 Criteria

pervasive pattern of disregard for rights of others since the age of 15 as shown by at least 3 of the following

• repeated law breaking

• deceitfulness, lying

• impulsivity

• irritability and aggressiveness

• reckless disregard for own safety and that of others

• lack of remorse

• irresponsibility as seen in unreliable employment or financial history

Etiology– Antisocial

• Genes and environment (social environment–poverty, exposure to violence, polymorphism that predicts psychopathy)

• psychological: insensitivity to fear and threat, unable to learn from experience to avoid trouble, lack of fear or anxiety

Treatment

• often enter treatment for a condition other than the PD

• psychotherapy is treatment of choice

• medication to treat symptoms rather than causes

Narcissistic Personality Disorder

• grandiose view of self

• self-centered (demands constant attention, lacks empathy, feelings of arrogance, envy, entitlement, view themselves as superior to others)

• primary goal of interaction with others is to bolster own self-esteem

• likely to be vindictive and aggressive when faced with a competitive threat or a put-down

DSM-5 Criteria

presence of 5 or more of the following signs of grandiosity, need for admiration, and lack of empathy from early adulthood across many contexts

• grandiose view of one’s importance

• belief that one is special and can be understood only by other high-status people

• tendency to exploit others

• envious of others

• preoccupation with one’s success, brilliance, beauty

• extreme need for admiration

• strong sense of entitlement

• lack of empathy

• arrogant behavior or attitude

Etiology–Narcissistic PD

• parenting

  • overly indulgent parents foster children’s belief that they are special

  • parental tendencies to see their children as highly superior to others predicts children’s narcissistic traits

• fragile self-esteem

  • inflated self-worth and denigration of others defend against feelings of shame

  • sensitivity to negative social interactions

  • associated with higher levels of neuroticism and depression