1242 – A Continuum Paradigm Of Psychopathology: Narcissism As The Core Construct In Mental Illness

Abstract

Recommendations for DSM-V and future diagnoses of psychiatric disorders include complementing the current standard categorical approach with a dimensional approach (Swanson, Wigal, & Lakes, 2009). This paper proposes that the Narcissistic Spectrum Personality Questionnaire (NSPQ) developed based on Lowen's (1985) definition of Narcissism as the “denial of the true self,” may potentially provide the framework for designing a measurement tool to assess psychiatric disorders on a continuum. In this design Attention-Deficit/Hyperactivity Disorder (ADHD) and Bipolar Disorder were selected to be placed on this continuum to support that both disorders are similar in their psychodynamic underpinnings. It is proposed that a longitudinal study be conducted with ADHD and Bipolar participants who will be randomly assigned to three groups,

1. a) actual drug,

2. b) active placebo (that mimics the side effects of the drug), and

3. c) inert placebo (merely a sugar pill).

The NSPQ scores are expected to decrease with time for all groups and significantly less so for participants receiving the inert placebo. Such findings may suggest that the side effects of drugs render a psychodynamically punishing insult to the participant resulting in their improvement. The study will help elucidate the psychological impact of placebo, therefore, unraveling a possible explanation to the long sought question of why placebos are almost as effective as drugs. The reader will be able to see narcissism on a continuum that includes a range of pathological elements and will be challenged with the idea that categorical diagnoses can be looked at on this new continuum theory.