Toward a Clinically More Useful Model for Diagnosing Narcissistic Personality Disorder

Limitations of the categorical model include an inadequate research base for some personality disorders (of which narcissistic personality disorder is an excellent example), excessive co-occurrence with other personality disorders, arbitrary and unstable diagnostic boundaries between axis I and II disorders, and the likelihood that one patient will differ from another in the criteria utilized to reach a diagnosis (5). The most common personality disorder diagnosis in clinical practice may be personality disorder not otherwise specified, which perhaps reflects a widespread dissatisfaction with the current axis II criteria.) A dimensional approach, on the other hand, assesses personality traits on a continuum with psychopathology, hopefully yielding an overarching hierarchical model (6.