Lecture 7: NPD, ASPD and psychopathy Flashcards
- Learn the diagnostic features of ASPD, NPD and psychopathy - Think critically on the overlap between cluster B personality disorders and how they are diagnosed - Reflect on the potential consequences of these PDs - Learn about potential treatment and effectiveness
What are the DSM-5 symptoms for narcissistic personality disorder?
Grandiose sense of self
Need for admiration
Arrogant
Entitled
Fantasies of success, power etc.
Envious of others
Feels “special”
Lack of empathy
Exploitative
What is the prevalence of narcissistic PD?
Community: 0% - 6.2%1
Forensic studies: higher prevalence (e.g., 27.7%2)
Higher prevalence of diagnosis in men than in women (50-75%1)
But understudied due to low prevalence
Grandiose narcissism characteristics (DSM-5 NPD)
- Dominance
- Self-assurance
- Immodesty
- Exhibitionism (center of
attention) - Aggression
Vulnerable narcissism characteristics (similar to DSM-5 BPD)
- Introversion
- Negative emotions
- Interpersonal coldness
- Hostility
- Need for recognition
- Entitlement
- Egocentricity
How does narcissism affect identity?
- Uses others for self-definition and
self-esteem regulation - Exaggerated self-appraisal
- Emotion regulation fluctuates with
self-esteem
How does narcissism affect self-direction?
- Goal setting based on gaining
approval - High/low personal standards
- Unaware of own motivations
How does narcissism affect empathy?
- Impaired ability to recognise/identify
- Excessively attentive to
reactions of others(on the self) - Over- or underestimating
own effect on others
How does narcissism affect intimacy?
- Superficial relationships
- Restrained mutuality (little
genuine interest)
What are the pathways of social interaction outcomes?
Self-enhancement leads to self-admiration which results in striving for uniqueness, grandiose features and charmingness which results in social potency.
There is antagonistic self-protection which leads to rivalry. There is devaluation, striving for supremacy and aggressiveness which leads to social conflict.
What are the characteristics of ASPD?
Disregard for and violation of the rights of others starting since age 15
* Not conforming to social norms → repeated unlawful behavior
* Deceitfulness (lying, conning)
* Impulsivity
* Irritability and aggressiveness
* Reckless disregard for safety of self and others
* Consistent irresponsibility
* Lack of remorse
What is the prevalence of ASPD?
Community: 0.2% - 3.3%1
Forensic studies: higher prevalence (e.g., 30%2)
Higher prevalence of diagnosis in men than in women
How do psychopaths provide a mask of sanity?
Superficial charm and good “intelligence”
Absence of delusions and other signs of irrational thinking
Unreliability
Untruthfulness and insincerity
Lack of remorse or shame
Inadequately motivated antisocial behavior
Poor judgement and failure to learn by experience
Pathological egocentricity and incapacity for love
General poverty in major affective reactions
Specific loss of insight
Unresponsiveness in general interpersonal relations
Fantastic and uninviting behavior with drink and sometimes without
What are the factors which shape psychopathy?
Factor 1: affective/interpersonal
* Affective: lack of guilt/remorse, emotionally shallow, callous (lack of empathy), failure to accept
responsibility for actions
* Interpersonal: glibness/superficial charm, grandiose, pathological lying, conning/manipulative
Factor 2: antisocial/lifestyle
* Antisocial: poor behavioral control, early behavioral problems, juvenile delinquency, revocation
of conditional release, criminal versatility
* Lifestyle: need for stimulation, lack of realistic long term goals, parasitic lifestyle, impulsivity,
irresponsibility
Other
* Promiscuous sexual behavior
* Many short-term relationships
How can you gain a secondary source of information?
- File information from a criminal investigation
- Information from clinical/criminal records
- Information from family or other sources
How does the psychopathy checklist work?
- 20 items scored from 0 (not present) to 2 (clearly present)
- Score > 26 or >30 = psychopathy
- Need for training
