Axis I-V DSM IV-TR Diagnosis - Case Study Example

According to Campbell and Miller (2011), the following characteristics of people with NPD include a grandiose sense of self-importance, preoccupations with unlimited success, exhibitionism, rage in response to criticism, and at least two of the following, which include entitlement, interpersonal exploitativeness, unstable relationships, and a lack of empathy (pp. 15). Nick exhibits many symptoms.2. Provide evidence from the case study and your rationale related to your assigned diagnosis for meeting the criteria, as well as evidence when the criteria are not met.


 Nick’s behavior definitely seems erratic, dramatic, and emotional. He also seems to have met the symptom of having a grandiose sense of self-importance—which is probably related to his displays of worrying about whether he’s going to be famous or not. His preoccupation with actors and promoting talented people in order to gain fame himself have been eschewed by those in the acting community, as evidenced from the case study. Although Nick does not necessarily exhibit exhibitionism forthrightly, he does have some “show-and-tell” of his sacred objects in his briefcase.

He exuded rage in response to criticism. Nick exhibits exploitativeness within interpersonal relationships to some extent, trying even to manipulate the clinician while he was being seen. Also, Nick exhibits unstable relationship patterns and a lack of feeling for others. Without a doubt, Nick definitely exhibits most if not all of the behaviors of Narcissistic Personality Disorder. None of the criteria was really unmet—and, as far as one can tell, Nick is a classic case of NPD. The lack of empathy that Nick displays is quite characteristic of NPD.3. Indicate potential/feasible differential diagnoses in your discussion.


Differential potential diagnoses that might overshadow NPD would be Bipolar Disorder II, where the client would experience manic highs and depressive lows. Although the patient describes being depressed, he is also very high-strung, which could have a great deal to do with his attitude. He could have a mixed episode, and he might possibly be psychotic—after all, why would someone be wearing a white suit with a rose in the lapel unless he were absolute, if not totally, disconnected from reality?

Carrying around a briefcase full of newspaper clippings and certain items that give him a sense of self-importance is one of the characteristics of NPD, but if one thinks about it, this could also be part of the manic phase. Nick seems to be depressed by his lack of a love life, claiming that many people hurt or angered him in the past. However, on the other hand, he seems to have possible diagnoses of antisocial personality disorder or behavioral personality disorder (BPD)—depending on whether he meets the specific criteria.

Many times these diagnoses depend on how selfish the client is.