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Obsessive Compulsive Disorder Is Associated With Heightened Activity In The

A personality disorder affects how a person feels, thinks, acts, and relates to others. A high sense of self-importance can mask low self-esteem in a person with a narcissistic personality disorder. Someone with narcissistic personality disorder (NPD) may have an excessive concern with prestige and power and a lack of empathy for others.To others, a person with NPD may seem to:act selfishly be manipulative and demandinghave difficulty empathizing or considering others’ needs or feelingsbe arrogant These behaviors often stem from a need to cover up deep feelings of insecurity.Health professionals group personality disorders into different clusters. NPD is a cluster B personality disorder. People with cluster B disorders find it hard to manage emotions and may have unpredictable behavior. NPD gets its name from a Greek myth in which a hunter named Narcissus saw his reflection in a pool of water and fell in love with it. A person with NPD may have an idealized self-image and an unrealistic sense of superiority. These traits can mask a lack of self-confidence and a deep sense of insecurity. A person with NPD may be unaware that they have a disorder. The following are key features of NPD:a need for admirationa pattern of grandiositya lack of empathy for othersResearch suggests that NPD affects between 0.5–5% of people in community samples in the United States. Across the whole population of the U.S., NPD may affect between 1–15% of people.How people with NPD see themselves can be very different from how others see them.Features of the condition that may be noticeable to others include:craving attention and admirationhaving fragile self-esteem and feeling disappointed when admiration is not forthcominghaving an excessive feeling of superiorityexaggerating intimacy with others, especially those with wealth or VIP statusoverestimating achievements and talentsundervaluing the achievements of othershaving a preoccupation with success, power, brilliance, beauty, or ideal lovebelieving in their uniqueness and that only “special” people can understand ithaving a sense of entitlementtaking advantage of others to achieve their own goalsbeing unable or unwilling to identify with the feelings or needs of othersfeeling jealous and believing that others are jealous of thembehaving in a way that seems arrogant or haughty to othersshowing great charm but quickly becoming irritated or angrytalking at length about their concerns but lacking interest in the concerns of othersshowing aggression when faced with a threat to their egoOther features may have a less obvious link with narcissism, such as:a sense of shame, humiliation, and emptiness when disappointedunwillingness to try something for fear of defeat difficulty maintaining relationshipsa sense of alienation or emotional disconnect from othershigh achievement due to overconfidence but poor performance in the face of defeat or criticismsuspiciousnesssocial withdrawaldifficulty managing emotions In some cases, other disorders such as depression and anxiety can accompany NPD.Diagnosing NPD can be challenging, as it is one of several types of personality disorders, and some features may overlap. A person may also have NPD alongside another condition that affects their mood and behaviors.In addition, a person with NPD may not recognize that problems in their life stem from their behavior and may blame others instead.Someone with NPD may be highly sensitive to perceived criticisms or slights, making it difficult for others to talk with them about their behavior and how it can be harmful.To diagnose NPD, a clinician needs to find at least five of the following criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition:a grandiose sense of self-importancea preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal lovea belief that they are unique and can only be understood by, or should only associate with, other special or high-status people or institutionsa need for excessive admirationan increased sense of entitlementa tendency to take advantage of others to achieve their own endsa lack of empathy and unwillingness to recognize or identify with the feelings and needs of othersenvy of others and the belief that others are envious of themarrogant, haughty behaviors or attitudesNPD is a spectrum disorder, and the symptoms can range from mild to severe. When diagnosing NPD, there are two subtypes health professionals look for: The grandiose subtype: This includes overt grandiosity, aggression, and boldness.The vulnerable subtype: This involves hypersensitivity and defensiveness, which may be easier to miss during a diagnosis.There is no standard treatment for NPD. However, certain therapies may help a person manage the condition and replace negative behavioral patterns with more positive ones.Medications may help certain symptoms if NPD occurs with another disorder, such as depression or anxiety. Currently, the most useful treatment method seems to be psychotherapy. This can help a person: create a more realistic self-imagebecome more aware of the conditionunderstand what underlies their behaviormanage their emotions more effectivelylearn to take responsibility for their actionslearn to build healthier relationshipsbuild up their self-esteemadjust their expectations of themselves and othersunderstand the impact of their behavior on others Cognitive behavioral therapy (CBT), family therapy, or group therapy are other types of psychotherapy that may also help. CBT aims to identify unhealthy or harmful beliefs and behaviors and replace them with healthy, more adaptive ones. Family or couples therapy can help the loved ones of a person with NPD. Sessions may involve improving communication, dealing with any relationship issues, and problem-solving.If people with NPD may be at risk of suicide, people will need to seek help from a health professional straight away.While the causes of personality disorders are unclear, they may involve a combination of genetic and environmental factors. During childhood, the following may increase the risk of developing NPD:excessive praise or criticismunpredictable care or neglecttraumaabuserejection fragile egoUncontrolled stress and low self-esteem may also play a part in NPD.According to research, complications of NPD may come from co-existing health conditions, such as mood disorders or substance use disorders.People with NPD and substance use disorder may display significantly more aggression and hostility, which may create more challenges during treatment.It is also common for people with NPD to have other personality disorders. People with NPD may have a higher risk of completing suicide than those with other personality disorders.NPD may also cause relationship problems or difficulties at work, school, or during everyday life.It is not possible to prevent any genetic predisposition to NPD. In childhood, it may be possible to prevent certain risk factors of NPD, such as:excessive praise or criticism from parents or caregiversabuse or traumarejectionBuilding healthy self-esteem and learning positive ways of dealing with stress may also help. NPD can be challenging for a person and their loved ones. However, treatment and support can improve the quality of life for everyone involved.Anyone who suspects that they have NPD can benefit from seeing a psychotherapist. There are various ways to find a suitable therapist online, including this tool from the American Psychological Association.For someone in any relationship with a person who has NPD, the following may help:prioritize their own mental and physical well-beingset clear boundariestalk with a healthcare professional if in need of supportconnect with others in a similar position by finding a local or online support groupCounseling services are also available for people who have experienced trauma in a relationship with a person who has NPD. Narcissistic personality disorder (NPD) is a mental health condition characterized by a high sense of self-importance and a lack of empathy for others. Diagnosing NPD can be challenging as some symptoms overlap with other personality disorders. People with NPD often feel a sense of superiority over others, can be grandiose, and need excessive admiration.There is no standard treatment for NPD. However, talking therapy may help people to break negative thinking and behavioral patterns. Support is also available for family and loved ones of people with NPD.

Video about Obsessive Compulsive Disorder Is Associated With Heightened Activity In The

2-Minute Neuroscience: Obsessive-Compulsive Disorder (OCD)

​Obsessive-compulsive disorder, or OCD, is a condition characterized by obsessions and/or compulsions. Although the neuroscience of OCD is not completely understood, in this video I discuss one supported perspective on what happens in the brain to cause the obsessions and compulsions that occur in OCD.

For a more in-depth discussion of the neuroscience of OCD (on my website), click this link: https://neuroscientificallychallenged.com/posts/know-your-brain-obsessive-compulsive-disorder-ocd

TRANSCRIPT:

Obsessive-compulsive disorder, or OCD, is a condition characterized by obsessions and/or compulsions. Obsessions are recurrent unwanted thoughts, while compulsions are repetitive behaviors or mental acts often performed in response to obsessions, typically with the goal of reducing anxiety and discomfort. It’s important to note that OCD is often very distressing, and is not just a preference for orderliness, as the term is sometimes used to imply.

The neuroscience of OCD is not completely understood, and it’s likely that different neural circuits may be involved based on a person’s age and symptom profile, among other factors. One supported perspective on the neuroscience of OCD, however, points to a prominent role for circuits that connect the orbitofrontal cortex with a group of structures called the basal ganglia. According to this perspective, increased activity in the orbitofrontal cortex is associated with a heightened focus on concerns that spawn obsessive thoughts. When the orbitofrontal cortex is activated in response to something the brain perceives as a danger or concern, it communicates with the basal ganglia. A simplified version of basal ganglia circuitry suggests it consists of two opposing pathways: an excitatory pathway called the direct pathway, and an inhibitory pathway called the indirect pathway. When the orbitofrontal cortex sends a signal to the basal ganglia, it often leads to an action designed to alleviate the discomfort caused by the perceived danger; that action is mediated by the direct pathway. In a healthy person, the indirect pathway then inhibits further action. In someone with OCD, however, the direct pathway is over-excitable, drowning out the activity of the indirect pathway and causing a difficult time switching to a different behavior or turning focus away from the concern causing the discomfort. Thus, according to this model, overactivity in the orbitofrontal cortex and the direct pathway of the basal ganglia increases the occurrence of both obsessions and compulsions.

REFERENCES:

Lanciego JL, Luquin N, Obeso JA. Functional neuroanatomy of the basal ganglia. Cold Spring Harb Perspect Med. 2012 Dec 1;2(12):a009621. doi: 10.1101/cshperspect.a009621. PMID: 23071379; PMCID: PMC3543080.

Pauls DL, Abramovitch A, Rauch SL, Geller DA. Obsessive-compulsive disorder: an integrative genetic and neurobiological perspective. Nat Rev Neurosci. 2014 Jun;15(6):410-24. doi: 10.1038/nrn3746. PMID: 24840803.

Saxena S, Rauch SL. Functional neuroimaging and the neuroanatomy of obsessive-compulsive disorder. Psychiatr Clin North Am. 2000 Sep;23(3):563-86. doi: 10.1016/s0193-953x(05)70181-7. PMID: 10986728.

Stein DJ, Costa DLC, Lochner C, Miguel EC, Reddy YCJ, Shavitt RG, van den Heuvel OA, Simpson HB. Obsessive-compulsive disorder. Nat Rev Dis Primers. 2019 Aug 1;5(1):52. doi: 10.1038/s41572-019-0102-3. PMID: 31371720; PMCID: PMC7370844.

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