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Personality pathology refers to enduring patterns of cognition, emotion, and behavior that negatively affect a person's adaptation. In psychiatry and clinical psychology , it is characterized by adaptive inflexibility, vicious cycles of maladaptive behavior, and emotional instability under stress.
The DSM-5 indicates that: "Many highly successful individuals display personality traits that might be considered narcissistic. Only when these traits are inflexible, maladaptive, and persisting, and cause significant functional impairment or subjective distress, do they constitute narcissistic personality disorder."
Additionally, the DSM-5 introduced the diagnosis Personality disorder - trait specified (PD-TS) as an alternative to let clinicians define the presentation in detail in terms of "impairment of personality functioning" and "pathological personality traits".
Narcissistic defenses are among the earliest defense mechanisms to emerge, and include denial, distortion, and projection. [4] Splitting is another defense mechanism prevalent among individuals with narcissistic personality disorder, borderline personality disorder, and antisocial personality disorder—seeing people and situations in black and white terms, either as all bad or all good.
Diagnosis of personality disorders will be based on levels of personality dysfunction and assessment of pathological levels of one or more of the personality domains, [31] resulting in classification into one of six personality disorder "types" or Personality Disorder Trait Specified (depending on the levels of traits present), in contrast to ...
Dr. Lyons believes that these traits grow from a strategy one needed at some point, in order to get their needs met or to feel safe. Related: How to Spot the 5 Tell-Tale Signs of a Toxic Friendship
It has also been shown that there is a continuum or spectrum of narcissistic traits ranging from normal to a pathological personality. [39] [40] Furthermore, evidence suggests that individual elements of narcissism have their own heritability score.
The Pathological Narcissism Inventory (PNI), Narcissistic Grandiosity Scale (NGS), Interpersonal Exploitativeness Scale (IES) and Psychological Entitlement Scale (PES) are among those tests that have been researched to replace the NPI, though some don't directly measure narcissism and instead measure a subcategory of narcissism like Entitlement.