Sunday, March 02, 2008

Narcissistic Personality Disorder: Relations with distress and functional impairment

Ooh, something that looks like a legitimate scienfitic basis for asserting something about narcissistic personality disorder.

Narcissistic Personality Disorder: Relations with distress and functional impairment

by Joshua D. Miller, Ph.D. and W. Keith Campbell, Ph.D., University of Georgia and Paul A. Pilkonis, Ph.D., Western Psychiatric Institute and Clinic University of Pittsburgh Medical Center

Narcissistic personality disorder (NPD), despite substantial interest from a theoretical perspective, has received very little empirical attention (1). In fact, some have concluded that “most of the literature regarding patients suffering with narcissistic personality disorder is based on clinical experience and theoretical formulations, rather than empirical evidence” (2; p. 303).

So? What else is new?

In particular, there is a striking lack of data regarding the impairment and distress associated with NPD.

What impairment or distress? I could have saved you the trouble and told you that you won't acquire empirical data of any impairment or distress.

Because there isn't any - except for some unwanted moments of self-awareness that attempt to rise from the dead now and then. (But they are quickly reburied with a few shovel-fulls of dirt on somebody else.) Jeez, we all should wish we had so little trouble from within.

These are often very successful people. They rise to the top in corporations, politics, gangs, congregations, institutions, and just about any other field you care to mention. They dominate others. They think they're the greatest. It's wonderful to be them! So, what on earth makes you think you're going to find any distress or impairment in them?

As with psychopaths, the only time that happens is if they get caught and punished for something they do. Maybe they go to jail, get fired, or their whipping boy abandons them, leaving them no one to suck the blood of. THEN they have a problem. Then they get depressed.

Until they land a new gig.

Central to the issue of validity for any DSM disorder is whether it is actually associated with distress or impairment – in fact criterion C for PD from the DSM-IV (9, p. 689) mandates that one of the two be present in order to make a PD diagnosis.

Woops. No distress, no impairment = no personality disorder - in fact, no mental illness at all. Hmm. For once the DSM makes sense.

Now I see why Dr. Robert Hare and others say they are not convinced that psychopathy is a mental illness. He thinks it may well be just a certain "strategy" in the game of life, a way of life.

After all, if psychopthay doesn't impair or distress the psychopath in daily life, what else can you call it?

Importantly, the strongest impairment associated with NPD is the distress or “pain and suffering” experienced not by the narcissist but by his or her significant others. In fact, the suffering experienced by others is uniquely predicted by NPD when controlling for other PDs.

Woah! Then NPD makes OTHER PEOPLE sick, not the narcissist, eh?

But I could have told you THAT too. Anyone who has lived with a narcissist can.

It appears that there are traits specific to NPD that are especially difficult to tolerate when faced regularly.

No kidding. What was your first clue?

Then if there's any disease here, the malignant narcissist is it. Right?

I mean, they have no mental illness, they just always cause OTHERS mental pain and suffering, causing OTHERS impairement and distress.

Duh. If that isn't just the definition of a bad person (to be around), I don't know what is.


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