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A
psychiatric disorder is a set of behaviours or mental patterns that
can majorly affect a person by causing distress or impairment of
personal functioning. A person affected by such a disorder may be
unable to lead a normal life, due to suffering, impaired functioning
or the stigma attached to them. It is obvious that a psychiatric
disorder can be diagnosed in a young individual, and that such a
diagnosis may lead to a very difficult and disorienting childhood,
and at times, even worse adolescence. All psychiatric disorders
should be diagnosed by a mental health professional, under the
correct circumstances, after an individual or someone in their life
becomes aware of the problem. However, there are cases where
individuals do no realise or believe they have a problem. The focus
of this essay will be on the narcissistic personality disorder, also
known as narcissism, which could affect anyone and tends to not be
commonly diagnosed. Despite that, it is believed that it affects
about one percent of the world’s population. It could be diagnosed
in people of any age, it is, however, more common in young people.

Psychology is the
science that is connected to the mind. The people that work in the
field of psychology seek to find answers about the human behaviour,
the incentives that may affect an individual, as well as the ways in
which a disorder may be treated in order to not cause major negative
effects on a person and their life while simultaneously trying to
minimize the suffering of the individual in question. A psychiatric
disorder is commonly known as an amalgamation of mental patterns
which cause behaviors that may severely affect the individual
suffering from one, the people around them, as well as numerous other
aspects of their life. There are several psychiatric and personality
disorders that could be discussed extensively, the focus of this
paper, however, is the narcissistic personality disorder, also known
as narcissism.

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“Narcissistic
personality disorder (NPD) (formerly
known as megalomania or, colloquially, as egotism) is a form of
pathological narcissism. It is a Cluster B (dramatic, emotional, or
erratic) personality disorder” (Vaknin, 2006). It is an
ego-syntonic disorder, meaning that the person experiencing the
disorder does not necessarily think they have a problem.

“Traditional
psychoanalytic metapsychology defines narcissism as the libidinal
investment of the self.” (Clarkin, 2010). An individual affected by
this personality disorder more often than not displays grandiose
ideas about themselves, and that becomes very evident to anyone
around them. However,
“In patients with narcissistic traits or NPD, it is important to
give attention to the two sides of character functioning, which
include both self-serving and self-enhancing manifestations as well
as hypersensitivity, fluctuations in self-esteem, and internal pain
and fragility.” (Ronningstam, 2011).

On the one hand,
people affected by the narcissistic personality disorder exhibit
different behaviours that may be characterized as bizarre or
abnormal, such as megalomania or immense belief of their
self-importance, an exaggerated focus on achieving success or goals
set by themselves or other figures in their life, an excessive demand
for others’ admiration, as well as a lack of care for other
people’s opinions and beliefs.

On the other hand,
individuals suffering from narcissistic personality disorder display
a fragile ego, an immense lack of understanding of other people and a
tendency to dismiss or belittle other individuals in order to feed
their own need for superiority, as well as an inability to tolerate
others’ views or criticism of their actions. “Individuals with
narcissistic personality disorder appear arrogant and entitled but
suffer from extremely low self-esteem”. ( Murphy & Cowan, 2009)

Thus, it is obvious
that overconfidence cannot be classified as narcissistic personality
disorder. More often than not, narcissism is diagnosed during an
interview between a mental health professional and the person
affected by it. The following are characteristics that individuals
suffering from NPD commonly exhibit, which lead to the diagnosis: “a
sense of superiority, a sense of uniqueness, exaggeration of talents,
boastful and pretentious behavior, grandiose fantasies, self-centered
and self-referential behavior, need for attention and admiration,
arrogant and haughty behavior, and high achievement”. (Ronningstam,
1990) However, in addition to the characteristics above, patients
with narcissistic personality disorder also display
“hypersensitivity, fluctuations in self-esteem and internal pain
and fragility.” (Ronningstam, 2011)

It is a well known
fact that there is not a lot of information about NPD. “Narcissistic
personality disorder is one of the least studied personality
disorders” (Russ, Shedler, Bradley & Westen, 2008) The
disorder’s causes are unknown, thus “experts tend to apply a
biopsychosocial model of causation, meaning that a combination of
environmental, social, genetic and neurobiological factors are likely
to play a role in formulating a narcissistic personality” (Paris,
2014). Evidence suggests that NPD is heritable, and it is not
uncommon for individuals to develop narcissistic personality disorder
if a parent or family member has been affected by it. Despite this,
there is not enough concrete evidence as far as genetic and
physiological processes are concerned; they have yet to be
determined.

Furthermore,
treatments of NPD have not been well studied. It proves difficult to
treat since more often than not, individuals affected by the
narcissistic personality disorder do not consider themselves
affected, and tend to believe that there is no problem as far as they
are concerned. Pursuit of treatment usually follows a major negative
life event, “such as major depressive disorder, substance use
disorders, bipolar disorders or eating disorders” (Ronningstam,
2016)
Treatment
of the narcissistic personality disorder mostly revolves around
psychotherapy.

One severely
significant factor of narcissistic personality disorder is that
“narcissistic personality disorder usually develops in adolescence
or during early adulthood” (American Psychiatric Association,
2013). Additionally, it tends to occur to males more than females.

In childhood and
adolescence, young individuals tend to display behaviors that could
remind one of the characteristics of patients with narcissistic
personality disorder, however they should be differentiated. As
mentioned by the Mayo Clinic Staff, “It
is not uncommon for children and adolescents to display some
traits similar to those of NPD, but such occurrences usually are
transient, and do not meet the criteria for a diagnosis of NPD”.
The true symptoms of this personality disorder tend to be pervasive,
being displayed over a long amount of time consistently, while also
being majorly evident in different situations one may find themselves
in. Something that must be mentioned and kept in mind is that “the
onset of pathological narcissism is in infancy, childhood and early
adolescence and t is commonly attributed to childhood abuse and
trauma inflicted by parents, authority figures, or even peers.”
(Vaknin, 2006)

For
a young individual, suffering from narcissistic personality disorder
could affect their life in ways that overshadow the difficulties that
older individuals diagnosed with NPD face. It is obvious that young
children and adolescents go through different challenges and changes,
since those are the years when one tends to start developing a
personal identity, learn and absorb various life lessons, develop
meaningful human relationship, not to mention the physiological
changes that occur. “Narcissistic Personality Disorder (NPD) is
exacerbated by the onset of äging and the physical, mental, and
occupational restrictions it imposes.” (Vaknin, 2006)

As
far as childhood is concerned, if a child suffers from NPD they could
have trouble forming bonds with individuals other than their parents,
the child may display disruptive or “abnormal” behavior in social
settings, such as deceit, manipulation in order to gain the attention
of others etc. What is worrisome is the fact that numerous children
display such characteristics, thus it is very difficult to
distinguish between the typical behavior of a young child and young
patients that suffer from NPD. Another issue is that “many
clinicians are reluctant to diagnose personality disorders (PDs)
during youth, viewing paediatric personality deviations instead as
reflective of given developmental stages. This is so despite evidence
that certain youth are indeed at risk for the eventual development of
PDs as adults. Unfortunately, late identification of these disorders
prevents timely treatment and potentially increases morbidity.”
(Guilé & Greenfield, 2004)

However,
adolescence is the time where individuals affected by narcissistic
personality disorder tend to have the most significant personal and
social setbacks. NPD’s symptoms tend to impair social and other
functioning. It proves to be a hurdle for an individual’s general
psychological abilities. Based on that, an adolescent suffering from
narcissistic personality disorder is very likely to have an impaired
ability to form meaningful relationships both with their parents and
with their peers, be unable to function properly at school, and have
trouble connecting to other individuals due to their lack of care
about others, while at the same time craving attention and approval
from others. As mentioned before, that is as much a part of
adolescence as of NPD, which leads to a very unbalanced and turbulus
coming of age for the adolescent in question, while also being a
severe issue for parents, teachers and people around them in general.

In
conclusion, narcissistic personality disorder is centered around an
individual’s ego and it tends to impair an individual’s social
and other functioning. It is common for sufferers of NPD to not
realise or believe they have a problem, due to which it is not so
frequently diagnosed or treated. More often than not, it appears
during early adulthood, and is attributed to major trauma or genetics
(family history of NPD). Children and adolescents suffering from
narcissistic personality disorder typically have a severely trying
and disorienting upbringing, which will translate into their adult
lives as an immense setback socially, professionally and
psychologically.

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