What is the Difference Between Pathological Narcissism and Narcissistic Personality Disorder?

This video answers the question: What is the difference between pathological narcissism and narcissistic personality disorder. When we talk about narcissistic personality disorder and compare it to pathological narcissism, it's important to understand that narcissistic personality disorder (NPD) is a diagnosis listed in the Diagnostic and Statistical Manual (DSM). It's a diagnosis a client could receive if they demonstrated certain symptoms and, of course, this diagnosis can only be given by a licensed and qualified clinician. Pathological narcissism is a construct and we use pathological narcissism in research, but it's not a diagnosis, rather it's on a continuum. NPD as it's described in the DSM, has nine symptom criteria: grandiose sense of self-importance, fantasies of unlimited power or success (a lot of times I just think of this really as exaggerated fantasies as they're not always unlimited), this idea of being special or unique and that only certain special or unique people would understand somebody, a need for excessive admiration, a sense of entitlement, exploiting other individuals interpersonally, having a lack of empathy, having envy for other people and believing other people envy you, and being arrogant, haughty, pretentious, or supercilious. The symptom criteria for NPD differ from the definition of pathological narcissism. With pathological narcissism, we see a number of qualities that aren't captured in the symptom criteria for NPD and also with pathological narcissism two types of narcissism are appreciated at the same time: grandiose and vulnerable. With grandiose narcissism, we see a lot of overlap with the symptom criteria of NPD. There are characteristics like being arrogant or exploiting others interpersonally. We don't see hardly any over at all with vulnerable narcissism. We see characteristics like mood lability, being shy, being self-critical, having fragile self-esteem, having feelings of inadequacy, perfectionism, and hypersensitivity. As we compare NPD with pathological narcissism, we see that NPD does focus on grandiose narcissism and pathological narcissism covers both grandiose and vulnerable narcissism. If we look at the associated features for NPD in the DSM, we do see a discussion of this idea of being self-critical and of having social withdrawal, so some of the elements of vulnerable narcissism are captured there in the associated features. If you consider the dimensional model in the DSM, this is listed as the alternative model for personality disorders, we do see that some of the other characteristics associated with vulnerable narcissism are captured, but it's still not complete.

Dawood, S., & Pincus, A. L. (2018). Pathological narcissism and the severity, variability, and instability of depressive symptoms. Personality Disorders: Theory, Research, And Treatment, 9(2), 144-154. doi:10.1037/per0000239

[johnharrisjr]

I thought it was interesting that a person with Pathological Narcissism could have both the grandiose and vulnerable constructs that alternate back and forth.

[tsbcmhc]

There is a lot going on in this video and I'm still fairly confused on the difference between pathological narcissism and narcissistic personality disorder. I am definitely going to have to research these disorders more in order to gain a better grasp.

[kimandres]

I just completed a case study on incels (Elliot Rodger, specifically) for a class and wish I had known more about pathological narcissism before writing it lol. This actually sounds spot on to describe Rodger; he exhibited both grandiose and vulnerable narcissism and as you said, when his grandiose expectations and/or needs were not met, the emotional dysregulation resulted in vulnerability - almost seems like the vulnerability is contingent upon the grandiosity. However, his vulnerability evolved into resentment, anger, hatred, a slew of other feelings that became dangerous until he ultimately carried out his attacks. Certainly, he had at least one other disorder going on; I wonder what the comorbidity rate of pathological narcissism is with antisocial personality disorder.

[MJ-tlvp]

Vulnerable or covert narcissists are not shy. They tend to have the aloof behavior either because they are not interested in situations where they are not the topic or they are just in their space coz outside world is complicated and or stupid. Vulnerable can adapt the grandiose attitude and vice-versa. I know coz I'm related to a covert.

[amirhosseinazad]

I love it that you start the video as soon as possible without wasting anytime. Simple and short yet consistent and in an at least relatively good depth of the subject 👌🏻👏🏻

[SK_TorON]

Thank you, Dr. Grande! The increasing interest that we all seem to have in unhealthy manifestations of narcissism is probably driven not only by personal experiences of being on receiving ends of narcissistic personalities, but it is also a reflection of societal trends. Sometimes I wonder what will happen when the current teenagers- of the social media generation-grow up and begin acting in the real world: making decisions and influencing others. How much damage should we expect as a society in a near future from not-so-few of the current kids who have gone too far in aggrandizing their false identities that become their escape from inner insecurity? How many DJTs should we expect in the future?...

[kikixiong]

I would like to see explanations of comorbidity of OCPD and PN or NPD

[janicedixon]

There was a lot of info provided in this video. I’ll need to watch a couple times to
grasp the differences.

[camuscat]

It seems pathological narcissism could be a risk factor for psychosis, as one feels vulnerable, that person might succumb to paranoia to preserve a fragile ego. Are there ways to measure varying degrees of pathological narcissism to determine severity and vulnerability to psychosis? It seems those who suffer from pathological narcissism must experience high blows to the ego before seeking treatment. Thanks so much! Always enlightening and thought provoking!

[virginiamurrey]

This was a great video in defining the differences between pathological narcissism and NPD.

[TheMateoFischerShow]

Do you believe a vulnerable narcissist could have the potential to continuously belittle others in an attempt to heal their low self-esteem?

[veronicabetz]

All of your videos on this disorder are very complex and interesting. I would like to see one video that combines all of your work on Narcissistic Personality Disorder

[wandamixon]

I found the compensatory property associated with pathological narcissism interesting. It emphasizes the need to understand both the grandiose and vulnerable features. Also, I can see how primarily vulnerable narcissism can be comorbid with depression.

[MarcassCarcass]

Dr. Todd Grande Could you make a quick/short (like not even 5 minutes) video on how people that are recovering memories of abuse/molestation (in voodoo rituals) can have major outbursts of rage (even towards their loved ones), like integrating DID while suffering in CPTSD? I need something quick/short to help get my family to understand that I couldn't help what I was going thru. Perhaps you could even go into how to talk someone down from a fit, so they stop yelling?

This was great. Thanks for the illustrations!👍🏾🌟

[markstahl]

I don't understand how you can have pathological narcissism and not have a personality disorder. The whole "pathological narcissism is a construct, not a personality disorder" comes off to me as a mincing of words. Perhaps there should be a personality disorder that encompasses and unifies the constructs of pathological narcissism? I was friends with a girl who sure showed signs of vulnerable narcissism. I don't know that she would fit the diagnostic criteria of NPD, but she certainly left a trail of destruction in my life. To say that she didn't have some type of personality disorder is something that's hard to buy in my mind.

[MrAlexH]

I think it’s really interesting how vulnerable narcissism and borderline personality disorder have so much overlap that they might as well be the the exact same thing.

[wishcraftu]

My question is: is narcissism really always pathological? I'd swear I've known people that have a very strong love of self that were really quite kind, they just seemed to be content grooming their own self-image from a self perceived standard of beauty. I don't feel like these people really were altogether indifferent from other people's judgments. It just seems to me that for some people, they seem to avoid the social tensions that seem to occur with pathological narcissism. In fact it seems to me that such people are very good at creating this kind of social space for other people where they can just shower each other in flattery in a way that may seem inane or distasteful to others, but that they don't need to become vicious about it, so that in fact it has a kind of restorative power.
I mean after all, it seems kind of suspicious to me that a type of person that could just suffice with love of self, or perhaps flattery of their self by others (I note that these are already very different things) should always, always need to twist people's arms onto their backs to get what they want. To put it in short: love of self is still love, does it necessarily need to go wrong?
I'm sorry if you already explained this in another video or whatever. I'm new to this channel.

[didilinha]

I really like your videos.
You are explaining so well.
Thank you so much.
I am learning about my ex Narc who almost destroyed my life.
But I am survival..
I wil be oke.
Further now I just have learnt from you that my ex Narc is pathological Narcissist.
Again. Big thank you for to bring me to understanding.

[jackiesorrells]

This was helpful. There is quite a bit of overlap so the distinctions made were useful.