Psychological Tests and Structured Interviews: Introduction
Personality assessment is an art form that uses psychological tests and structured interviews to render it as objective and standardized as possible. Most tests restrict the repertory of permitted answers, and the scoring and keying of results are automated. Interpretation is arguably more important than data gathering, and most practitioners administer a battery of tests and structured interviews. Projective tests are far less structured and thus a lot more ambiguous, and the scoring is done exclusively by humans and involves judgment and bias.
Personality Disorders Gender Bias
The Diagnostic and Statistical Manual (DSM) confesses to gender bias, with personality disorders such as borderline and histrionic being more common among women, while narcissistic, antisocial, schizotypal, passive compulsive, schizoid and paranoid disorders are more prevalent among men. The reason for this gender disparity may be due to culture-bound syndromes, with personality disorders reflecting biases and value judgments of the prevailing culture. Upbringing, environment, socialization, cultural mores, and genetics may also play a role in the pathogenesis of personality disorders. Ultimately, the ambiguity and equivocation of the diagnostic criteria may be the problem, with gender bias being everywhere in the psychiatric profession.
Twitter Narcissism
Twitter is not a platform for narcissists as it limits them to 140 characters, which can cause narcissistic injury. However, Twitter presents a challenge to its users to be creative and imaginative in their communication. Twitter is the digital reincarnation of earlier forms of direct communication, such as the telegraph and text message, and forces recipients to use their imagination to decipher the code. Twitter is unlikely to disappear and is unlikely to become a platform for verbose, uncontrollable narcissists.
Generalised Anxiety Disorder (GAD) Misdiagnosed as Narcissistic Personality Disorder (NPD)
Narcissists are anxious for social approval and seek narcissistic supply compulsively, which creates attendant anxiety. They require external feedback to regulate their sense of self-worth, self-confidence, and self-esteem, making them irritable. Narcissists are terrified of being embarrassed or criticized in public, and they fail to function well in various settings. It is easy to mistake the presenting symptoms of certain anxiety disorders with pathological narcissism, but the narcissist is egosyntonic, while the anxious patient is distressed and looking for help.
Narcissistic Personality Disorder Clinical Features
Narcissistic traits in childhood may lead to full-fledged narcissistic personality disorder later in life, especially if the child has experienced abuse or trauma. Narcissists use a false self to garner attention, or “narcissistic supply,” which helps them cope with pain and feel important. Narcissists are vulnerable to criticism and disagreement, and they struggle to maintain healthy relationships. Treatment for narcissistic personality disorder includes talk therapy and medication, but the prognosis for an adult with the disorder is poor.
Narcissism: Genetics or Abuse, Nature or Nurture?
The debate over whether pathological narcissism is caused by genetics or upbringing is a confluence of both nature and nurture. Mental illness cannot be explained without considering our genetic makeup and neurophysiology. Narcissistic personality disorder is probably the interplay between a genetic template and the abuse and trauma heaped upon this inner computer. It is safe to attribute the development of narcissistic personality disorder mostly to the environment, to nurture not to nature.
Narcissists: Somatic vs. Cerebral
Narcissists are addicted to narcissistic supply, which is attention, adoration, admiration, and adulation. There are two types of narcissists: somatic and cerebral. Somatic narcissists leverage their body and sexual prowess to garner attention, while cerebral narcissists use their intellect and knowledge to secure admiration. Both types prefer self-satisfaction to adult, mature, interactive, multidimensional, and emotion-laden relationships. Narcissists often fluctuate between the two types, especially after a life crisis.