Malignant narcissism refers to a specific, less common manifestation ofnarcissistic personality disorder。一些expertsconsider this presentation of narcissism the most severe subtype.

在精神障碍的诊断和统计手册中，它不被认为是第五版（DSM-5）的正式诊断。但是，许多心理学家和心理健康专家都使用此术语来描述一组特定的人格特征。

According toCampbell’s Psychiatric Dictionary, malignant narcissism combines characteristics of:

继续阅读以了解有关恶性自恋的更多信息，包括共同特征，与社会病的比较以及是否可以治疗。

恶性自恋可以以多种方式呈现 - 没有一定的特征清单。这也非常困难，尤其是对于不是精神卫生专家的人，可以区分恶性自恋和严重的NPD。

这就是为什么最好避免使用这个术语（或相关的词，例如自恋者）来指代某人的原因，尤其是如果您不是对人的背景知识的心理健康专家。

再说一次，关于恶性自恋的标准没有专家共识。但是，许多心理健康专家作为自恋谱系的一部分支持其存在。关于症状的可能表现也有一些普遍的共识。

But this type of narcissism might appear with any combination of symptoms from the following categories.

NPD

Like other personality disorders, NPD occurs on a spectrum and involves a range of symptoms. The DSM-5 lists nine traits that help identify NPD, but only five are needed for diagnosis.

NPD的常见症状包括：

  • grandiose fantasies and behavior, such as a preoccupation with thoughts of personal success, power, and attractiveness or sex appeal
  • 对他人的情绪或感觉很少或根本没有同理心
  • a significant need for attention, admiration, and recognition
  • an inflated sense of self-importance, such as a tendency to exaggerate personal talent or achievements
  • a belief in personal specialness and superiority
  • 权利感
  • 倾向于利用他人或利用人们以个人利益的趋势
  • 傲慢或自负的行为和态度
  • 嫉妒他人并相信他人羡慕他们的趋势

患有NPD的人通常难以处理变化。他们可能会感觉到郁闷或者当他们感到轻轻时被羞辱，遇到不安全感和脆弱性的困难，并在其他人似乎不以他们需要和觉得应得的钦佩对待他们时愤怒地做出反应。

This condition also tends to involve difficulty managing emotions and behavioral responses to压力。

APD

这种情况的主要特征是始终如一地无视他人的感受。这可以包括操纵和欺骗以及身体或情感虐待。另一个关键组成部分是缺乏不法行为的re悔。

暴力或侵略性行为可能是这种情况的迹象，但是有些患有APD的人从不猛烈地行事。

患有APD的人通常会显示出症状品行障碍in childhood. This may include violence toward other people and animals, vandalism, or theft. They generally don’t consider or care about the consequences of their actions.

Only adults are diagnosed with APD. A diagnosis requires at least three of the following symptoms:

  • 持续非法或违法行为表现出对权威和社会规范的鄙视
  • a pattern of deceit, including exploitation and manipulation of other people
  • reckless, impulsive, or risky behavior that shows disregard for personal safety or the safety of other people
  • little or no remorse for harmful or illegal actions
  • 通常敌对，易怒，攻击性，不安或激动的心情
  • a pattern of irresponsible, arrogant, or disrespectful behavior
  • difficulty planning ahead

Aggression

Aggression describes a type of behavior, not a mental health condition. People can’t be diagnosed with aggression, but a mental health professional or other expert may note acts of aggression as part of a diagnostic profile.

攻击行为可以作为对愤怒或其他情绪的反应，通常涉及伤害或破坏的意图。侵略性有三种主要类型：

  • Hostile侵略。这是专门旨在伤害或破坏某人或某物的行为。
  • 乐器侵略。这是一种与特定目标有关的侵略性行为，例如砸碎汽车窗户以窃取钱包。
  • 情感侵略。This refers to behavior usually directed at a person or object that triggered an emotion. It may also be redirected if it isn’t possible to target the actual source. Punching a wall instead of punching another person is an example of affective aggression, particularly when the action involves a desire to cause damage.

Sadism

Sadism is taking pleasure in humiliating someone or causing them pain.

DSM-5将性虐待疾病列为一种涉及性唤醒的疾病，与造成不同意的人不必要的疼痛联系在一起。但是虐待狂本身并不是心理健康的诊断，也不总是性诊断。

有虐待狂倾向的人可能：

  • 享受伤害别人
  • 喜欢看别人体验痛苦
  • 从痛苦中看到他人的性兴奋
  • 花费大量时间幻想伤害他人，即使他们实际上没有这样做
  • want to hurt others when irritated or angry
  • enjoy humiliating others, especially in public situations
  • tend toward aggressive actions or behavior
  • 以控制或霸气的方式行事

一些expertssuggest that sadistic behavior helps set NPD and malignant narcissism apart. Narcissism often involves self-centered pursuit of desires and goals, but people with NPD might still show some remorse or regret for hurting others in the process.

Many people use the term社会变态in casual conversation. You might hear it used to describe people who don’t seem to care about other people or who take advantage of and manipulate their loved ones.

社交病usually refers to the characteristics and behavior commonly seen with APD. But similarly to malignant narcissism, sociopathy is only used as an informal term, not a specific diagnosis.

Malignant narcissism isn’t the same as sociopathy, since APD traits are only part of this narcissism subtype.

In general, therapy can help anyone who seeks treatment with the intent of putting in the effort to improve their feelings, behaviors, or emotional reactions.

It’s certainly possible people living with malignant narcissism, or any other type of narcissism, can go to therapy and work to change behaviors that have a negative effect on their quality of life or on their family members, partners, and friends.

在线治疗选择

Read our review of the最佳在线治疗选择to find the right fit for you.

寻求帮助

拥有任何类型的自恋特征的人可能不会自己寻求帮助。他们常常没有意识到自己的行为和行为有任何问题。

But they might have other symptoms that prompt them into treatment, including:

  • depression
  • 易怒
  • 愤怒管理问题

在其他情况下，由于法院命令，浪漫伴侣或家庭成员的最后通atum或其他原因，他们可能会激励他们进入治疗。

但是，要使治疗有效，他们必须最终需要自己的治疗。

治疗选择

如果你认为有人接近你可能处理with a personality disorder, such as NPD or APD, it’s important to remember that it’s absolutely possible to change. Therapycan帮助，只要他们愿意努力完成所涉及的工作。

治疗通常很困难，但通常会带来重大好处，包括：

  • 更牢固的人际关系
  • improved emotional regulation
  • 更好地实现目标的能力

某些类型的治疗可能对治疗自恋更有帮助。

A2010年研究评论查看恶性自恋指出，治疗可能会充满挑战，尤其是在治疗关系中出现侵略性或虐待狂倾向时。

但是，对待治疗的个人责任可以带来更好的结果。推荐的治疗类型包括修改dialectical behavior therapy (DBT)以及适用的夫妻和家庭咨询。

抗精神病药和选择性5-羟色胺再摄取抑制剂（SSRIS）may also improve some symptoms, including anger, irritability, and psychosis.

来自 2015 suggests thatschema therapy也可能有助于NPD和相关问题。其他researchsupports this finding.

其他approaches that could improve treatment outcomes include transference-focused therapy and mentalization-based therapy.

However, clinical data on this topic is lacking. More research is needed on therapy for narcissism.

自恋and related issues usually involve difficulty relating to and understanding the feelings of other people. You might notice标志，例如自我服务的行为，操纵性的单词和行为，或一种不健康或失败的关系模式。

Maintaining family or interpersonal relationships may be even more challenging for a person with malignant narcissism. It’s not uncommon for relationships to involve controlling behavior,气灯， 和情感虐待。

如果您与患有恶性自恋的人亲近，那么重要的是要照顾好自己并注意虐待迹象。

There are many different types of abusive behavior, and some may not seem as clearly abusive as others. Common signs can include:

  • pointing out “flaws” and seeming to enjoy making you feel discouraged or upset, or saying they’re doing it for your own good
  • 撒谎或操纵您实现自己的目标，并证明自己的行为是合理的，如果您召唤他们的行为，没有内gui或后悔
  • putting you down, humiliating you, or threatening you, in public or private
  • appearing to enjoy inflicting physical harm
  • showing no interest in your needs or feelings
  • 以风险或危险的方式行事，不关心您或其他人在此过程中受伤（例如，在表达恐惧时危险地驾驶和笑）
  • saying or doing unkind or cruel things and appearing to enjoy your distress
  • 表现一个ggressively toward you and other people or things

某人的心理健康不是虐待行为的借口。同样重要的是要记住，虐待行为并不总是是精神健康状况的结果。

如果您认为自己的关系已经不健康，与治疗师交谈可以帮助您决定该怎么做。您还可以在他们的国家家庭暴力热线中寻求支持website或致电800-799-7233。