Narcissistic Personality Disorder (NPD) and Attention Deficit Hyperactivity Disorder (ADHD) are recognized to possibly co-occur, a phenomenon long noted by therapists in the field. Research suggests a potential higher risk of individuals with ADHD developing NPD (Ronningstam et al., 2014; Sibley et al., 2014). NPD is characterized by a pervasive pattern of grandiosity, a need for admiration, and a lack of empathy, often accompanied by arrogant behavior and disregard for others' feelings. Conversely, ADHD is a neurodevelopmental disorder affecting attention, impulse control, and behavior regulation.
Factors associated with ADHD, like impulsivity, difficulty with self-regulation, sensitivity of perceived criticism (among others), might contribute to the development of NPD. Those with undiagnosed and untreated ADHD in childhood may face harsh treatment or ostracism, impacting identity formation. Conversely, in the realm of childhood dynamics, when a child is neurodivergent and exhibits exceptional qualities associated with conditions like ADHD, parents may engage in excessive admiration and doting, contributing to a scenario where the child is overly indulged, fostering a grandiose self-perception. In turn adults with ADHD might also exhibit narcissistic traits such as grandiosity and entitlement more frequently than those without ADHD (Sibley et al., 2014). Recognizing this potential link is crucial when assessing and developing a treatment plan.
The co-occurrence of NPD and ADHD could significantly impact couples therapy. Partners with NPD may require individual treatment before participating effectively in couples therapy. NPD's complexity in interpersonal relationships and resistance to treatment may hinder acknowledgment of the need for therapy. Couples therapy might not effectively address individuals with NPD, given their grandiose self-perception interfering with the therapeutic process. Therefore, addressing the unique challenges of individuals with NPD through individual treatment before couples therapy is essential (Ronningstam et al., 2014).
Clinicians aiming for positive outcomes must conduct thorough assessments to determine if individuals have one or both conditions. This ensures the development of personalized treatment plans addressing each person's unique needs. In the context of couples therapy, someone with NPD may require individual treatment before engaging in joint sessions (Ronningstam et al., 2014).
Ongoing research on the relationship between NPD and ADHD continues, with recent studies shedding light on the topic. A 2021 study in the Journal of Attention Disorders found individuals with ADHD and NPD exhibiting more severe ADHD symptoms than those with ADHD alone. Another 2020 study in the Journal of Personality Disorders noted that patients with NPD and ADHD displayed more severe symptoms of both disorders compared to those with only one condition.
While additional research is necessary for a comprehensive understanding, it is crucial for clinicians to be mindful of the potential implications of NPD and ADHD co-occurrence. Through thorough assessment and tailored treatment, individuals with these conditions can work towards a better quality of life.
References:
-
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
-
Fossati, A., & Widiger, T. A. (2012). Sex differences and personality disorders. Journal of personality disorders, 26(2), 195-199.
-
Sibley, M. H., Pelham, W. E., Molina, B. S., Gnagy, E. M., Waxmonsky, J. G., Waschbusch, D. A., & Kuriyan, A. B. (2012). When diagnosing ADHD in young adults emphasize informant reports, DSM items, and impairment. Journal of Consulting and Clinical Psychology, 82(2), 358-368.
-
Ronningstam, E. F., Hopwood, C. J., & Weinberg, I. (2014). Narcissistic personality disorder: a current review. Current psychiatry reports, 16(12), 1-10.
-
Ronningstam, E., & Weinberg, I. (2013). Understanding narcissistic personality disorder. Harvard Mental Health Letter, 30(6), 1-3.
-
Winstanley, S. J., Eagle, D. M., & Robbins, T. W. (2006). Behavioral models of impulsivity in relation to ADHD: translation between clinical and preclinical studies. Clinical psychology review, 26(4), 379-395.
Meet Dr. Melissa Hudson, an experienced licensed marriage and family therapist and couples counselor in Frisco. She offers both in-person sessions and Telehealth services to clients in Plano, The Colony, McKinney, Allen, Richardson, Carrollton, and Frisco. Her office is conveniently located close to Stonebriar Country Club in Frisco. Dr. Hudson specializes in couples and relationships, providing personalized and effective therapy to address a range of concerns such as communication issues, infidelity, and conflict. With her expertise and compassion, she can help you achieve the positive change you need to build a healthier, happier relationship. Click here for more information on the services provided.