Which the interactive styles are coquettish, callous, and needy, respectively, is the grandi- osity characteristic of narcissistic personality disorder. The relative stability of self-image as well as the relative lack of self—destructiveness, impulsivity, and abandonment concerns der. Excessive pride in achievements, a relative lack of emotional display, and disdain for personality disorder. Although individuals with borderline, histrionic, and narcissistic personality disorders may require much attention, those with narcissistic personality dis- order specifically need that attention to be admiring. Individuals with antisocial and nar- cissistic personality disorders share a tendency to be tough-minded, glib, superficial, exploitative, and unempathic. However, narcissistic personality disorder does not neces- sarily include characteristics of impulsivity, aggression, and deceit. In addition, individu- als with antisocial personality disorder may not be as needy of the admiration and envy of others, and persons with narcissistic personality disorder usually lack the history of con- duct disorder in childhood or criminal behavior in adulthood. In both narcissistic person- ality disorder and obsessive-compulsive personality disorder, the individual may profess a commitment to perfectionism and believe that others cannot do things as well. In con- trast to the accompanying self—criticism of those with obsessive-compulsive personality disorder, individuals with narcissistic personality disorder are more likely to believe that they have achieved perfection. Suspiciousness and social withdrawal usually distinguish those with schizotypal or paranoid personality disorder from those with narcissistic per- sonality disorder. When these qualities are present in individuals with narcissistic person- ality disorder, they derive primarily from fears of having imperfections or ﬂaws revealed.
narcissistic. Only when these traits are inﬂexible, maladaptive, and persisting and cause sonality disorder.
Mania or hypomania. Grandiosity may emerge as part of manic or hypomanic episodes, but the association with mood change or functional impairments helps distinguish these episodes from narcissistic personality disorder.
Substance use disorders. Narcissistic personality disorder must also be distinguished from symptoms that may develop in association with persistent substance use.
Diagnostic Criteria 301.82 (F60.6)
A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to neg- ative evaluation, beginning by early adulthood and present in a variety of contexts, as in- dicated by four (or more) of the following: 1. Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection.
2. Is unwilling to get involved with people unless certain of being liked.
Shows restraint within intimate relationships because of the fear of being shamed or ridiculed. ‘ ls preoccupied with being criticized or rejected in social situations.
ls inhibited in new interpersonal situations because of feelings of inadequacy.
Views self as socially inept, personally unappealing, or inferior to others.
ls unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.
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The essential feature of avoidant personality disorder is a pervasive pattern of social inhi- bition, feelings of inadequacy, and hypersensitivity to negative evaluation that begins by early adulthood and is present in a variety of contexts.