Texas A&M University, College Station, TX 77845, USA.
J Clin Psychol. 2012 Aug;68(8):908-21. doi: 10.1002/jclp.21895. Epub 2012 Jun 21.
Narcissistic personality disorder and related concepts have a complex history and have been subject to extensive theoretical discourse but relatively little empirical research. An initial proposal for the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) that suggested eliminating this disorder as a discrete personality disorder type met with considerable controversy that ultimately led to its reinstatement in subsequent proposals. Nonetheless, the DSM-5 proposal for personality disorders as a whole would involve a significantly different formulation of narcissistic personality from that described in DSM-IV-one that places a greater emphasis on shared deficits among all personality disorders that tap elements thought to fall on the narcissistic spectrum, such as deficits in empathic capacity. This article describes this revised formulation, and presents a case study that illustrates the similarities and differences in the DSM-IV and proposed DSM-5 portrayal of narcissistic issues and related clinical problems over the course of a particular treatment.
自恋型人格障碍及相关概念有着复杂的历史，它们一直是理论探讨的焦点，但实证研究却相对较少。最初，《精神疾病诊断与统计手册》第五版（DSM-5）提出将自恋型人格障碍从离散的人格障碍类型中剔除，这一提议引起了广泛争议，最终导致该障碍在后续提案中被重新纳入。尽管如此，DSM-5 对人格障碍的整体建议将涉及对自恋型人格的一种明显不同的表述，与 DSM-IV 中的描述相比，这种表述更加注重所有人格障碍共有的缺陷，这些缺陷涉及到被认为属于自恋谱系的元素，例如共情能力的缺陷。本文描述了这种修订后的表述，并通过一个案例研究说明了在特定治疗过程中，DSM-IV 和拟议的 DSM-5 对自恋问题和相关临床问题的描述的异同。
