Narcissistic Personality Disorder: Facing DSM-V

Empathy accounts for the naturally occurring subjective experience of similarity between the feelings expressed by self and others without loosing sight of whose feelings belong to whom. Empathy involves not only the affective experience of the other person's actual or inferred emotional state but also some minimal recognition and understanding of another's emotional state. In light of multiple levels of analysis ranging from developmental psychology, social psychology, cognitive neuroscience, and clinical neuropsychology, this article proposes a model of empathy that involves parallel and distributed processing in a number of dissociable computational mechanisms. Shared neural representations, self-awareness, mental flexibility, and emotion regulation constitute the basic macrocomponents of empathy, which are underpinned by specific neural systems. This functional model may be used to make specific predictions about the various empathy deficits that can be encountered in different forms of social and neurological disorders.

The present study examines the lack of strong correlations among existing self-report measures of narcissism. A principal-components analysis of 6 MMPI narcissism scales resulted in 2 orthogonal factors, 1 implying Vulnerability-Sensitivity and the other Grandiosity-Exhibitionism. Although unrelated to each other, these 2 factors were associated with such core features of narcissism as conceit, self-indulgence, and disregard of others. Despite this common core, however, Vulnerability-Sensitivity was associated with introversion, defensiveness, anxiety, and vulnerability to life's traumas, whereas Grandiosity-Exhibitionism was related to extraversion, self-assurance, exhibitionism, and aggression. Three alternative interpretations of these results are considered, and an argument for the distinction between covert and overt narcissism is made.