A 50-year-old man displays a pervasive pattern of grandiosity, need for admiration, and lack of empathy. He exploits colleagues and reacts with rage to any perceived criticism. Under DSM-5 Alternative Model of Personality Disorders (AMPD), which is the CORE pathological trait domain that MOST defines narcissistic personality disorder?
- A Disinhibition (impulsivity, risk-taking)
- B Negative affectivity (emotional lability, anxiousness)
- C Antagonism (especially grandiosity and attention-seeking) ✓
- D Detachment (restricted affect, withdrawal)
Explanation
The DSM-5 Alternative Model of Personality Disorders (AMPD, Section III) characterises NPD through impairments in self-functioning (identity: excessive reference to others for self-definition; self-direction: goal-setting based on approval) and interpersonal functioning (empathy impairment; intimacy: relationships are self-serving). The pathological personality trait domain most central to NPD is Antagonism — specifically grandiosity (entitled, condescending) and attention-seeking. Negative affectivity, disinhibition, and detachment are not primary trait domains in NPD under AMPD.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
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Written and medically reviewed by the StethoPrep medical team.