by Tami Port MS

Created on: July 02, 2009   Last Updated: September 20, 2009

Extreme narcissism and antisocial PD (psychopathy) are two personality disorders that have a lot in common, even when you look at the DSM-IV-TR diagnostic criteria that clinicians use to differentiate between them.

* Clinical Psychologists Must Diagnose *

Clinical psychologists (mental health PhDs concerned with the diagnosis and treatment of mental disorder) must be able to make diagnoses, and bill insurance companies for services. This requires a marked distinction between what is considered "normal" and what is "pathological." But narcissism is essentially self-absorption, so couldn't

psychopathy, or antisocial personality, be a case of narcissism to the extreme?

* Research Psychologists See Personality as Continuum *

In contrast, social psychologists are researchers who tend to see these disorders as the extreme within of a spectrum, or dimension, of personality, not as a category. They do not believe that there is a specific point within the continuum of personality where "normal" suddenly becomes "pathological". It is all a matter of degree.

* Spectrum of Narcissistic Behavior *

Otto Kernberg, a thought leader in the study of personality disorders, believed psychopathy to be an extreme form of narcissism. Kernberg saw narcissistic behavior as existing in a spectrum, ranging from Narcissistic Personality Disorder (NPD), at the low end to psychopathy, which represented the extreme of narcissistic severity.

Dr. Kernberg even coined the term "malignant narcissism" to describe the area of personality in between these two extremes; considering malignant narcissism to be a syndrome of narcissistic behavior that went beyond NPD but was less extreme than psychopathy (Kerberg 2003).

* Spectrum of Psychopathic Behavior *

Other experts see psychopathy as being different from narcissism, even if, within the category of psychopathology, there exists a continuum of extremes. These psychologists assert that psychopathy is distinct, but does itself occur in degrees, and that there are individuals who should be considered psychopathic even if they never get into trouble with the law. This would include Martin Kantor's "psychopaths of everyday life", Robert Hares "subcriminal psychopaths", Donald Black's "successful bad boys", and Hervey Cleckly's "mild psychopaths"; selfish people who have no qualms about taking advantage of others, but who may not be committing any crime in doing so.

* Conclusion *

So which is it? Do personality disorders exist within distinct categories or are the divisions entirely of our own creation, with little relationship to reality? Regardless of the words used (narcissist, antisocial, psychopath), the school of psychological thought, an the diagnostic lines drawn in the sand, these disorders are all defined by varying degrees of selfish behavior, with increasing severity typically resulting in increased damage to the people who find themselves in the wake of the self-absorbed.

* Sources *

American Psychiatric Association APA (2000) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR).

Hare, Robert (1999) Without Conscience: The Disturbing World of Psychopaths Among Us. Guilford Press.

Kantor, Martin (2006) The Psychopathy of Everyday Life: How Antisocial Personality Disorder Affects All of Us. Praeger Publishers.

Kernberg, Otto and Akhtar, Salman. (2003) Broken Structures: Severe Personality Disorders and Their Treatment.

* This article is a summary of antisocial and narcissistic traits and disorders. The contents of this article are not meant to be a substitute for professional help and counseling.

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