How Narcissistic Personality Links With BPD

How Narcissistic Personality Links With BPD BPD Related Conditions Print Narcissistic Personality Disorder and Borderline Personality By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. Learn about our editorial policy Kristalyn Salters-Pedneault, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on September 12, 2019 Westend61/Getty More in BPD Related Conditions Diagnosis Treatment Living With BPD Narcissistic personality disorder (or NPD) is a personality disorder that frequently co-occurs with borderline personality disorder (BPD). The addition of NPD into the diagnostic picture may complicate the treatment and course of BPD. 1:24 How to Identify a Malignant Narcissist What Is Narcissistic Personality Disorder? NPD is one of 10 personality disorders recognized in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). NPD is one of the Cluster B, or dramatic/erratic, personality disorders. Narcissistic personality disorder is characterized by the presence of five (or more) of the following symptoms:?? Has an inflated sense of self-importanceIs preoccupied with fantasies of success, power, brilliance, beauty, or ideal loveBelieves that he or she is “special” and can only be understood by other special or high-status peopleRequires excessive admirationPossesses a sense of entitlementTakes advantage of othersLacks empathyIs often envious of others or believes others are envious of him or herBehaves in an arrogant, egotistical, or haughty way In short, people with NPD might be described as being very self-absorbed or egotistical. This self-absorption rises to the level of a clinical disorder because it significantly interferes with relationships, occupation, or other important domains in life. Many experts believe that this egotistical style is actually the NPD individuals attempt to deal with an underlying poor sense of self-worth.?? How Often Do NPD and BPD Co-Occur? While the overlap between NPD and BPD are discussed quite often in the popular psychology literature and online, very few careful studies of the co-occurrence of NPD and BPD have been conducted. One such study found that only about 16% of patients with BPD also meet the diagnostic criteria for NPD. However, another study that drew from a community (rather than a treatment-seeking) sample found that almost 39% of people with BPD also have NPD.?? How Does Narcissistic Personality Disorder Affect BPD? There are a number of theoretical reasons to believe that someone with both NPD and BPD would be less likely to get better over time. People with NPD have been described as very resistant to treatment; people with NPD often have poor insight into the ways that their behaviors are detrimental to themselves or others. Also, people with NPD may in fact cause more emotional pain to others than they cause themselves. So, their motivation to change their behavior may be very low. Research does suggest that people with both NPD and BPD are less likely to have their BPD symptoms get better over time. One study that followed BPD patients over six years found that rates of co-occurring NPD were fairly low (about 6%) in patients whose BPD eventually went away (remitted). However, rates of co-occurring NPD were higher (around 19%) in patients whose BPD did not remit after six years.?? So, there is a subset of individuals with non-remitting BPD and higher rates of NPD. Relationships and People with NPD and BPD The relationships of individuals with BPD are often quite dysfunctional. However, adding NPD into the mix can create even more disordered conditions. In addition to the chaotic emotional life and fears of abandonment associated with BPD, a person with co-occurring NPD may also take advantage of or manipulate others while having little empathy for others concerns. This combination can be incredibly destructive in relationships. Treatment for Narcissistic Personality Disorder and BPD There are currently no empirically supported treatments for NPD and no published clinical trials of treatments for NPD alone or co-occurring with BPD. Published research on the treatment of NPD is limited to some case studies or anecdotal accounts, but these types of studies tend to be unreliable and subject to bias. The case study literature on the treatment of NPD has primarily centered around the use of modified psychoanalytic techniques and has recognized the challenges of successfully treating this disorder. The clinical literature, in general, tends to regard NPD as a largely untreatable condition, particularly in its most severe forms. Some people believe that because there is some overlap between NPD and BPD symptoms (such as impulsivity and destructive behaviors) treatments designed for BPD like Dialectical Behavior Therapy  may also work with NPD. However, this remains to be seen; more research on the topic is sorely needed.