Use of the SASB Dimensional Model to Develop Treatment Plans for Personality Disorders. I: Narcissism

Axis II of the DSM-III has been criticized for poor reliability, for confusing overlap in symptomatology among categories, and for failing to provide etiological or treatment implications. Nonetheless there is substantial clinical wisdom in the grouping of symptoms provided by Axis II. An application of Structural Analysis of Social Behavior (SASB) to one Axis II category, narcissistic personality, provides a rational hypothesis about its interpersonal etiology and that, in turn, suggests a treatment intervention plan. SASB analyses of borderline personality and histrionic personality, which share symptoms in common with the narcissistic personality (e.g., interpersonal demandingness), suggest different prior interpersonal learning experiences and different psychosocial treatment interventions. Dimensional analysis by SASB is a promising method for objectifying, teaching, and expanding upon the substantial clinical wisdom inherent in Axis II of the DSM-III.