The client with narcissistic personality disorder often behaves in grandiose and entitled ways, believes that he/she is perfect, and relies on constant reinforcement and admiration from people perceived as ideal. What is the best explanation for these clinical characteristics?

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A client with narcissistic personality disorder (NPD) exhibits a recurrent pattern of grandiosity, need for admiration, and lack of empathy. Clients with NPD may project a picture of superiority, uniqueness, and independence that hides their true sense of emptiness. From a psychodynamic perspective, individuals with NPD have a fragile and damaged ego resulting from a childhood environment that fostered a sense of inferiority, poor self-esteem, and severe self-criticism. Narcissistic characteristics develop as a way to regulate self-esteem and protect the ego from further psychic injury. (Option B) Delusions of grandeur are experienced by clients with a psychotic disorder; NPD is a personality disorder. (Option C) Clients with NPD may feel threatened if criticized or if others do not meet their emotional demands. However, this is not the best explanation of the clinical characteristics associated with NPD. (Option D) Panic attacks are characteristic of clients with an anxiety disorder, not NPD. Educational objective: The clinical characteristics of narcissistic personality disorder can best be explained as an attempt to maintain a fragile self-esteem that was damaged during childhood due to an environment that was highly critical, demanding, and fostered a sense of inferiority.

The Client with Narcissistic Personality Disorder Often Behaves in Grandiose