自恋型人格障碍and Borderline Personality

自恋者ic personality disorder (NPD) is a人格障碍that frequently co-occurs with borderline personality disorder (BPD). The addition of NPD into the diagnostic picture may complicate the treatment and course of BPD.

自恋型人格障碍

NPD is one of 10 personality disorders recognized in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). NPD is one of the“集群B”或戏剧性的/不稳定的人格障碍。

自恋者ic personality disorder is characterized by the presence of five (or more) of the following symptoms:

• Has an inflated sense of self-importance
• 全神贯注于对成功、权力、辉煌、美丽或理想爱情的幻想
• 认为他或她是“特殊的”，只能被其他特殊或高地位的人理解
• Requires excessive admiration
• 有权利感
• 占别人便宜
• 缺乏移情
• Is often envious of others or believes others are envious of him or her
• 表现在一个傲慢,任性的,或傲慢佤邦y

简言之，NPD患者可能被描述为非常自我专注或自负。这种自我吸收上升到临床疾病的水平，因为它显著干扰人际关系、职业或生活中其他重要领域。许多专家认为，这种利己主义风格实际上是NPD个体试图应对潜在的自我价值感低下。

NPD和BPD同时发生的频率

While the overlap between NPD and BPD are discussed quite often in the popular psychology literature and online, very few careful studies of the co-occurrence of NPD and BPD have been conducted.

However, another study that drew from a community (rather than a treatment-seeking) sample found that almost 39% of people with BPD also have NPD.

How NPD Affects BPD

这个re are a number of theoretical reasons to believe that someone with both NPD and BPD would be less likely to get better over time. People with NPD have been described as very resistant to treatment, and often have poor insight into the ways that their behaviors are detrimental to themselves or others.

此外，NPD患者可能会给他人造成比自己更大的情感痛苦。因此，他们改变行为的动机可能很低。

One study that followed BPD patients over six years found that rates of co-occurring NPD were fairly low (about 6%) in patients whose BPD eventually went away (remitted). However, rates of co-occurring NPD were higher (around 19%) in patients whose BPD did not remit after six years.因此，有一部分人患有非缓解性BPD和较高的NPD发生率。

关系and NPD and BPD

这个relationships of individuals with BPDare often quite dysfunctional. However, adding NPD into the mix can create even more disordered conditions.

除了混乱的情感生活和fears of abandonmentassociated with BPD, a person with co-occurring NPD may also take advantage of or manipulate others while having little empathy for others' concerns. This combination can be incredibly destructive in relationships.

Treatment for NPD and BPD

目前还没有经验支持的治疗NPD的方法，也没有发表单独治疗NPD或与BPD合并治疗NPD的临床试验。

Published research on the treatment of NPD is limited to some case studies or anecdotal accounts, but these types of studies tend to be unreliable and subject to bias. The case study literature on the treatment of NPD has primarily centered around the use of modified psychoanalytic techniques and has recognized the challenges of successfully treating this disorder.

Some people believe that because there is some overlap between NPD andBPD症状（如冲动性和破坏性行为），针对类似BPD的治疗辩证行为疗法may also work with NPD. However, this remains to be seen, and more research on the topic is sorely needed.