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This book is an attempt to bring together much of the current theoretical, clinical, and research knowledge about narcissistic personality disorder. The editor has included 18 chapters, written by 23 authors, and organized them into four sections: Diagnostic and Theoretical Considerations, Treatment Implications, Special Clinical Considerations, and Research. She has also written an introduction to the book, a separate introduction to each of the four sections, and one of the chapters in the Research section. The editor and several of the contributors had been advisors to committees that revised the diagnostic categories in versions of DSM III, DSM III-R, and DSM IV.
The foreword by John C. Nemiah provides a brief sketch of how 19th-century theorists of psychopathology, such as Ribot and Janet, developed ego-deficit models of pathogenesis. These models influenced the early Freud, who went on to develop a theory of psychopathology more grounded in conflict and fantasy, culminating in the creation of the structural model.
Section I, Diagnostic and Theoretical Considerations, includes five chapters on narcissistic personality disorder (NPD). Michael H. Stone notes that Freud established narcissism as a normal developmental stage necessary for self-esteem in adulthood but he questions how to determine when a person's charisma, leadership qualities, and creativity go beyond the boundary of normal narcissism and should be considered as psychopathology. Otto Kernberg summarizes his well-known theory of the various levels of pathological narcissism and contrasts it with Kohut's theory.
The next two chapters, one each by Arnold M. Cooper and Theodore Millon, tackle the difficulties of establishing the diagnosis of NPD in the context of creating DSM IV. Cooper suggests