| Abstract [eng] |
The main features of narcissistic personality disorder are the need for admiration, grandiosity and lack of empathy. From a psychodynamic point of view, the main feature of the narcissistic personality is neither a sense of superiority nor inferiority, but a conflict between these feelings (superiority is used as a defence against inferiority). Antisocial personalities are characterised by an entrenched, rigid and dysfunctional thought process, which manifests itself in socially irresponsible, exploitative, criminal behaviour, lack of empathy, disregard for the rights of others, manipulation, and inability to form lasting relationships. Antisocial personality disorder is defined in the DSM-5 classification in terms of a person's behaviour, but not in terms of the motives for that behaviour, the inner qualities of the personality, and is criticised for this. The lifetime prevalence of narcissistic personality disorder is 6%, with a higher prevalence in men than in women. The prevalence of Antisocial Personality Disorder ranges from 0.2% to 3.3%, is more common in men, and is higher in prison populations. The etiology of both personality disorders is not precisely known, but genetic, biological (neurophysiological, structural brain changes) and social (childhood experiences, parenting style) factors are thought to play a role. These personality disorders share common etiological factors and traits (lack of empathy, jealousy, manipulative behaviour, aggression, underestimation of others), they can occur together, and it is difficult to assess and diagnose such patients because of their lack of open communication. For these reasons, it is often difficult to differentiate between these personality disorders. Neuroimaging and neuropsychological tests could help to differentiate between these personality disorders, but they are currently not widely used. The prognosis for psychotherapeutic treatment of antisocial personality disorder and narcissistic personality disorder is poor, patients lack self-reflection skills, are reluctant to change and seek help. There is insufficient data on the effectiveness of medication treatment. |
