Department of Psychiatry, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Eschenallee 3, 14050, Berlin, Germany,
Curr Psychiatry Rep. 2014 May;16(5):445. doi: 10.1007/s11920-014-0445-0.
Although concepts of pathological narcissism are as old as psychology and psychiatry itself, only a small number of clinical studies are based on the criteria for narcissistic personality disorder (NPD), as defined in the Diagnostic and Statistical Manuals of Mental Disorders (DSM). As a result, NPD appears to be one of the most controversially discussed nosological entities in psychiatry. Whereas the majority of empirical studies used self or other ratings of NPD criteria to address issues of reliability and validity of the diagnostic category (i.e., internal consistency, factor structure, discriminant validity), only recent research has applied experimental designs to investigate specific features of NPD (e.g., self-esteem, empathy, shame). The aim of this review is to summarize available empirical data on NPD and relate these findings to current definitions of NPD (according to the DSM-5, [1]). In order to do so, this review follows the five steps to establishing diagnostic validity proposed by Robins and Guze [2], i.e., (1) clinical description, (2) laboratory studies, (3) delimitation from other disorders, (4) family studies, and (5) follow up studies. Finally, this review suggests pathways for future research that may assist further nosological evaluation of NPD and contribute to the overall goal, the improvement of treatment for patients.
尽管病理性自恋的概念与心理学和精神病学本身一样古老，但只有少数临床研究基于《精神障碍诊断与统计手册》（DSM）中定义的自恋型人格障碍（NPD）标准。因此，NPD 似乎是精神病学中最具争议性的讨论分类实体之一。尽管大多数实证研究使用自我或他人对 NPD 标准的评估来解决诊断类别（即内部一致性、因素结构、判别效度）的可靠性和有效性问题，但最近的研究才开始应用实验设计来研究 NPD 的特定特征（例如，自尊、同理心、羞耻感）。本综述的目的是总结关于 NPD 的现有实证数据，并将这些发现与 NPD 的当前定义（根据 DSM-5 [1]）联系起来。为此，本综述遵循了 Robins 和 Guze [2] 提出的建立诊断有效性的五个步骤，即：（1）临床描述，（2）实验室研究，（3）与其他障碍的区分，（4）家族研究，和（5）随访研究。最后，本综述提出了未来研究的途径，这可能有助于进一步对 NPD 进行分类评估，并有助于实现改善患者治疗的总体目标。
