Review Article ISSN: 2574 -1241 DOI: 10.26717/BJSTR.2019.22.003686 Malignant Narcissism: Concealed Side of Psychopathy Saeed Shoja Shafti * Professor of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Razi Psychiatric Hospital, Iran *Corresponding author: Saeed Shoja Shafti, Professor of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Razi Psychiatric Hospital, IranProfessor of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Razi Psychiatric Hospital, Iran ARTICLE INFO Abstract Received: September 28, 2019 While in ‘Diagnostic and Statistical Manual of Mental Disorders’, narcissistic person- Published: October 15, 2019 personality illnesses in cluster B of personality disorders, more central similarity than dissimilarityality disorder is and evident antisocial between personality them. Although disorder ‘grandiose have been sense classified of self-importance’ as two distinct and Citation: Saeed Shoja Shafti. Malignant ‘Failure to conform to social norms with respect to lawful behaviors’ have been identi- Narcissism: Concealed Side of Psychopa- thy. Biomed J Sci & Tech Res 22(1)-2019. with antisocial personality disorder and narcissistic personality disorder share a ten- BJSTR. MS.ID.003686. fied as the main feature of first and second personality disorder, respectively, individuals to share in some comparable roots which necessitate a renewed appraisal. In the present Keywords: Narcissistic Personality Dis- article,dency to these be tough-minded, apparently dissimilar glib, superficial, morbid manners exploitative, have and been lack analyzed empathy. from So, a they different look order; Antisocial Personality Disorder; Narcissism; Psychopathy; Sociopathy; Fo- on different Bio-Psycho-Social grounds. rensic Psychiatry; Aggression perspective to find an similar origin which may display diverse modes of behavior, based Introduction The essential feature of Narcissistic Personality Disorder (NPD) and feelings of others. They tend to discuss their own concerns in is a pervasive pattern of grandiosity, need for admiration, and lack and have difficulty recognizing the desires, subjective experiences, inappropriate and lengthy detail, while failing to recognize that of empathy that begins by early adulthood and is present in a others also have feelings and needs. They are often contemptuous variety of contexts. Individuals with this disorder have a grandiose and impatient with others who talk about their own problems sense of self-importance [1] (Table 1). They routinely overestimate and concerns. These individuals may be oblivious to the hurt their their abilities and inflate their accomplishments, often appearing or believe that others are envious of them. Arrogant, haughty of their own accomplishments is an underestimation (devaluation) remarks may inflict. These individuals are often envious of others boastful and pretentious. Often implicit in the inflated judgments behaviors characterize these individuals. On the other hand, of the contributions of others. They may feel that they can only be vulnerability in self-esteem makes individuals with narcissistic understood by, and should only associate with, other people who personality disorder very sensitive to “injury” from criticism or are special or of high status and may attribute “unique,” “perfect,” or “gifted” qualities to those with whom they associate. Individuals [1]. with this disorder believe that their needs are special and beyond defeat. They may react with disdain, rage, or defiant counterattack the ken of ordinary people. Their own self-esteem is enhanced Such experiences often lead to social withdrawal or an appear- (i.e., “mirrored”) by the idealized value that they assign to those ance of humility that may mask and protect the grandiosity. Sus- with whom they associate. While individuals with this disorder tained feelings of shame or humiliation and the attendant self-crit- generally require excessive admiration, their self-esteem is almost icism may be associated with social withdrawal, depressed mood, invariably very fragile. A sense of entitlement, combined with a lack and persistent depressive disorder (dysthymia) or major depres- of sensitivity to the wants and needs of others, may result in the sive disorder. In contrast, sustained periods of grandiosity may be conscious or unwitting exploitation of others [1]. Individuals with associated with a hypomanie mood. Narcissistic personality dis- narcissistic personality disorder generally have a lack of empathy order is also associated with anorexia nervosa and substance use Copyright@ Saeed Shoja Shafti | Biomed J Sci & Tech Res | BJSTR. MS.ID.003686. 16310 Volume 22- Issue 1 DOI: 10.26717/BJSTR.2019.22.003686 disorders (especially related to cocaine) [2]. Histrionic, borderline, They may engage in sexual behavior or substance use that has antisocial, and paranoid personality disorders may be associated a high risk for harmful consequences. Individuals with antisocial with narcissistic personality disorder [1]. personality disorder also tend to be consistently and extremely On the other hand, the essential feature of antisocial personality remorse for the consequences of their acts. Psychopaths frequently disorder (APD) is a pervasive pattern of disregard for, and violation irresponsible, including financial irresponsibility and show little lack empathy and tend to be callous, cynical, and contemptuous of, the rights of others that begins in childhood or early adolescence of the feelings, rights, and sufferings of others. They may have and continues into adulthood. This pattern has also been referred to as psychopathy, sociopathy, or dyssocial personality disorder. Individuals with antisocial personality disorder fail to conform an inflated and arrogant self-appraisal and may be excessively to social norms with respect to lawful behavior [3]. They may opinionated, self-assured, or cocky. Lack of empathy, inflated commonly included in traditional conceptions of psychopathy repeatedly perform acts that are grounds for arrest (whether self-appraisal, and superficial charm are features that have been that may be particularly distinguishing of the disorder [3]. These they are arrested or not), such as destroying property, harassing individuals are more likely than people in the general population others, stealing, or pursuing illegal occupations. Persons with this to die prematurely by violent means (e.g., suicide, accidents, and disorder disregard the wishes, rights, or feelings of others. They homicides). Individuals with antisocial personality disorder are frequently deceitful and manipulative in order to gain personal may also experience dysphoria, including complaints of tension, inability to tolerate boredom, and depressed mood. They may or malinger [3]. A pattern of impulsivity may be manifested by profit or pleasure. They may repeatedly lie, use an alias, con others, have associated anxiety disorders, depressive disorders, substance a failure to plan ahead. Individuals with antisocial personality use disorders, somatic symptom disorder, gambling disorder, and disorder tend to be irritable and aggressive and may repeatedly other disorders of impulse control [3]. Individuals with antisocial personality disorder also often have personality features that meet individuals also display a reckless disregard for the safety of get into physical fights or commit acts of physical assault. These criteria for other personality disorders, particularly borderline, themselves or others. histrionic, and narcissistic personality disorders [3] (Table 1). Table 1: Diagnostic criteria of narcissistic and antisocial personality disorders, plus there, relatively, common features. Criteria Antisocial Personality Disorder (≥3) Diagnostic Criteria of Narcissistic Personality Disorder (≥5) Overall Shared Features Failure to conform to social norms with Has a grandiose sense of self-importance (e.g., exaggerates respect to lawful behaviors, as indicated by 1 achievements and talents, expects to be recognized as superior Criminality repeatedly performing acts that are grounds without commensurate achievements). for arrest. Deceitfulness, as indicated by repeated Is preoccupied with fantasies of unlimited success, power, 2 lying, use of aliases, or conning others for Lying brilliance, beauty, or ideal love. personal profit or pleasure. Believes that he or she is “special” and unique and can only be 3 Impulsivity or failure to plan ahead understood by, or should associate with, other special or high- status people (or institutions Selfishness Irritability and aggressiveness, as indicated 4 Requires excessive admiration Aggressiveness Has a sense of entitlement (i.e., unreasonable expectations of byReckless repeated disregard physical for fights safety or ofassaults. self or 5 especially favorable treatment or automatic compliance with his Abusiveness others. or her expectations). Consistent irresponsibility, as indicated by Is interpersonally exploitative (i.e., takes advantage of others to 6 repeated failure to sustain consistent work Exploitation achieve his or her own ends). Lack of remorse, as indicated by being behavior or honor financial obligations. Lacks empathy is unwilling to recognize or identify with the 7 indifferent to or rationalizing having hurt, Cruelty feelings and needs of others. mistreated, or stolen from another. Is often envious of others or believes that others are envious of 8 - Suspiciousness him or her. 9 - Shows arrogant, haughty behaviors