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Narcissistic personality disorder has been little researched. These investigators asked experienced psychiatrists and clinical psychologists (mean practice experience, 20 years) to describe current long-term patients with longstanding “personality problems . . . that cause distress or dysfunction.” Respondents provided 1201 patient descriptions (mean contact with assessed patients, 17 months).
The authors comprehensively studied the 101 patients who met both DSM-IV checklist criteria for narcissistic personality disorder and more-precise clinician ratings for closely fitting the disorder “construct.” They identified several core features not currently listed in the DSM, including interpersonal vulnerability, underlying emotional distress, an…