Is he mentally ill?

Cognitive

• Less and less interested in knowing about the world because they are so self-focused; must rely on other people or hunches to get direction in life

Sociocultural

• Society encourages girls to be vain, dramatic and selfish—histrionic is just this to an extreme degree

Biological

• Possible genetic link with APD

Grandiose view of their own uniqueness and abilities

• Grandiose view of their own uniqueness and abilities

• Self-centered is an understatement

• Require constant attention and admiration

• Believe only high status people will understand them

• Lack of empathy

• Envious

• Arrogant; take advantage of others

•  <1% prevalence

• Males>females (up to 75 % male)

Psychodynamic—cold rejecting parents lead to children spending lives defending against feeling unsatisfied, rejected, unworthy

• Psychodynamic—cold rejecting parents lead to children spending lives defending against feeling unsatisfied, rejected, unworthy

• Support for this—research says that kids who are abused or who lost parents through adoption, divorce, or death are at increased risk

• Behavioral and cognitive types say just the opposite—people develop this when they are treated too positively early in life. Admiring doting parents teach them to overvalue self worth.

• Support for this—onlies and firstborns are at increased risk.

• Sociocultural theorists—link between disorder and eras of narcissism in society.

One of the most difficult patterns to treat

• One of the most difficult patterns to treat

• If they seek, it is because of other disorders, generally depression
• May try to manipulate therapist into supporting their sense of superiority

• Psychodynamic—recognize and work through basic insecurities and defenses

• Cognitive—focus on self-centered thinking, try to redirect onto the opinions of others, to interpret criticism more rationally

• No approach has had a lot of success

2% females>males (about 3:1)

• 2% females>males (about 3:1)

• Males with the disorder tend to be more aggressive, disruptive

• Instability in relationships, mood and self-image

• Erratic emotions

• Argumentative, irritable, sarcastic

• Unpredictable, and impulsive behavior—spending sex

• No clear sense of self—values, career, loyalty

• Intense relationships—stormy and transient

• Emptiness

• Manipulative attempts at suicide

• Paranoid ideation and dissociative symptoms (75% show short or transient psychotic-like symptoms)

• This PD affects job performance more than other PDs

High frequency of physical and sexual abuse

• High frequency of physical and sexual abuse

• Comorbidity with other Axis I disorders

• Disorders ranging from mood and anxiety disorde