Internet Mental Health

NARCISSISTIC PERSONALITY DISORDER





Diagnostic Features of Narcissistic Personality Disorder

SYMPTOM DEFINITION SELF-DESCRIPTION
ANTAGONISM (Harming Others)
Attention Seeking Excessive attempts to attract and be the focus of the attention of others; admiration seeking "I crave attention." "I do things so that people just have to admire me."
Arrogance Offensive display of superiority, self-importance, entitlement, or overbearing pride; often bragging "I'm better than almost everyone else." "I deserve special treatment."
Manipulation Using charm, ingratiation, glibness, or seduction to cheat or control others for personal gain "I use people to get what I want." "I'm good at conning people."
Callousness Lacking guilt about causing others harm; lacking empathy; cold and indifferent to others’ feelings "It's no big deal if I hurt other people's feelings."

Core Features of Personality Disorders:

The general requirements for the diagnosis of a personality disorder are:

  • a pervasive pattern of maladaptive traits and behaviours

  • beginning in early adult life

    • it usually has its first manifestations in childhood and is clearly evident in adolescence

    • it is not diagnosed before early adult life because these maladaptive traits are very common in childhood and adolescence, but most individuals age-out of these traits before early adulthood

  • leading to substantial personal distress and/or social dysfunction, and disruption to others

  • is of long duration, typically lasting at least several years

Severity Rating Scale For Personality Disorders:

Severity rating scale for personality disorders in the International Classification of Diseases (ICD)-11:

  • Mild Personality Disorder: There are notable problems in many interpersonal relationships and the performance of expected occupational and social roles, but some relationships are maintained and/or some roles carried out. Mild personality disorder is typically not associated with substantial harm to self or others .

  • Moderate Personality Disorder: There are marked problems in most interpersonal relationships and in the performance of expected occupational and social roles across a wide range of situations that are sufficiently extensive that most are compromised to some degree. Moderate personality disorder often is associated with a past history and future expectation of harm to self or others, but not to a degree that causes long-term damage or has endangered life .

  • Severe Personality Disorder: There are severe problems in interpersonal functioning affecting all areas of life. The individual's general social dysfunction is profound and the ability and/or willingness to perform expected occupational and social roles is absent or severely compromised. Severe personality disorder usually is associated with a past history and future expectation of severe harm to self or others that has caused long-term damage or has endangered life .

Onset:

Narcissistic Personality Disorder (NPD) occurs in between 0% to 6.2% of the U.S. population. Typical features of narcissistic personality disorder are variable and vulnerable self-esteem, with attempts at regulation through attention and approval seeking, and either overt or covert grandiosity.

Individuals with NPD commonly:

  • Are critical of others
  • Get into power struggles
  • Blame their own failures or shortcomings on other people or circumstances

For this diagnosis to be given, the individual must be at least in early adulthood. This disorder is only diagnosed when these behaviors become persistent and very disabling or harmful to others.

Treatment:

There is insufficient (randomized controlled trial) evidence to prove the effectiveness of any psychological intervention or medication for adults with this disorder. Lacking such evidence, it would be prudent to only offer crisis intervention or short-term psychotherapy, rather than long-term psychotherapy.

Prognosis:

Narcissistic Personality Disorder can persist for a lifetime. Individuals with this disorder are intolerant of criticism or defeat and respond with defiant counterattack or social withdrawal. Their feelings of entitlement, need for admiration, and disregard for the feelings of others significantly impair their social and occupational functioning. Some individuals with this disorder rise to high positions of power in society by becoming masters of manipulation and self-promotion. They lust after fame and fortune and become celebrity con artists.

Morbidity and Mortality:

"People with personality disorder have far higher morbidity and mortality than do those without. Life expectancy at birth is shorter by 19 years for women and 18 years for men than it is in the general UK population. Increased mortality can be explained partly by increased incidence of suicide and homicide in people with personality disorder. However, increased mortality from cardiovascular and respiratory diseases suggest that other factors are also important. Difficulties in interpersonal relationships, which lie at the heart of personality disorder, might have an effect on relationships with health-care professionals, resulting in misunderstandings, miscommunication, and poor quality care. Lifestyle factors are probably also important, with high prevalence of smoking, alcohol, and drug misuse in people with personality disorders."



SAPAS Personality Screening Test

Individuals with this disorder would have a significant impairment in the behaviors that are displayed in red :

Most of the time and in most situations:

      In general, do you have difficulty making and keeping friends?
      Would you normally describe yourself as a loner?
      In general, do you trust other people? (No)
      Do you normally lose your temper easily?
      Are you normally an impulsive sort of person?
      Are you normally a worrier?
      In general, do you depend on others a lot?
      In general, are you a perfectionist?

Answer "Yes" or "No" to each of these 8 questions.


7-Question Well-Being Screening Test (By P. W. Long MD, 2020

Individuals with this disorder would have a significant impairment in the behaviors that are displayed in red :

      Agreeableness: I was kind and honest. (Instead had attention seeking, arrogance, manipulation, callousness)
      Conscientiousness: I was diligent and self-disciplined.
      Openness/Intellect: I showed good problem-solving and curiosity.
      Sociality: I was gregarious, enthusiastic, and assertive.
      Emotional Stability: I was emotionally stable and calm.
      Physical Health: I was physically healthy.
      Role Functioning: I functioned well socially and at school/work.

How often in the past week did you do each of these 7 behaviors:


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Diagnose Narcissistic Personality Disorder

Diagnose All Personality Disorders

Limitations of Self-Diagnosis

Self-diagnosis of this disorder is often inaccurate. Accurate diagnosis of this disorder requires assessment by a qualified practitioner trained in psychiatric diagnosis and evidence-based treatment.

However, if no such professional is available, our free computerized diagnosis is usually accurate when completed by an informant who knows the patient well. Computerized diagnosis is less accurate when done by patients (because they often lack insight).

Example Of Our Computer Generated Diagnostic Assessment Of President Trump

Narcissistic Personality Disorder 301.81

This diagnosis is based on the following findings:
  • Has a grandiose sense of self-importance (still present)

  • Is preoccupied with grandiose fantasies (still present)

  • Feels special or high-status and wants to associate with only other high-status people (still present)

  • Requires excessive admiration (still present)

  • Has a sense of entitlement (still present)

  • Is interpersonally exploitative (still present)

  • Lacks empathy (still present)

  • Is often envious of others or believes that others are envious of him (still present)

  • Shows arrogant, haughty behaviors or attitudes (still present)

Treatment Goals:

  • Goal: learn humility.
    If this problem persists: He will continue to have a grandiose sense of self-importance. He will routinely overestimate his abilities and inflate his accomplishments, often appearing boastful and pretentious. He will devalue the contributions of others.

  • Goal: put aside grandiose fantasies.
    If this problem persists: He will continue to be preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. He may ruminate about "long overdue" admiration and privilege and compare himself favorably with famous or privileged people.

  • Goal: associate with ordinary people and learn to behave as their equal.
    If this problem persists: He will continue to feel 'special' and unique, and believe he can only be understood by, or should associate with, other special or high-status people (or institutions).

  • Goal: overcome the need for excessive admiration.
    If this problem persists: He will continue to go out of his way to encourage people to admire him. This often will take the form of a need for constant attention and admiration. He may constantly fish for compliments. However, his self-esteem will be very fragile. He may be very sensitive to criticism or defeat, and feel very humiliated or degraded. He may react to criticism with disdain, rage, or defiant counterattack.

  • Goal: overcome sense of entitlement.
    If this problem persists: He will continue to have an unreasonable expectation of especially favorable treatment. He will expect to be catered to and will be puzzled or furious when this does not happen.

  • Goal: do not exploit others.
    If this problem persists: He will continue take advantage of others to achieve his own ends. He will form friendships or romantic relationships only if the other person seems likely to advance his purposes or otherwise enhance his self-esteem.

  • Goal: show better regard for the feelings of others.
    If this problem persists: He will continue to discuss his own concerns in inappropriate and lengthy detail, while failing to recognize that others also have feelings and needs. He will be impatient with others who talk about their own problems and concerns. He may be oblivious to the hurt his remarks may inflict. He may view the needs or feelings of others as signs of weakness. He will be emotionally cold and lacking in interest in others.

  • Goal: overcome envy of others.
    If this problem persists: He will continue to be envious of others. He may harshly devalue the contributions of others.

  • Goal: overcome arrogance.
    If this problem persists: He will continue to display snobbish, disdainful, or patronizing attitudes.




Read This Before Diagnosing President Trump


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Diagnostic Features

"Narcissistic Personality Disorder is characterized by egocentricity, self-indulgence, continuous longing for appreciation, lack of consideration for others, feelings that are easily hurt, and persistent manipulative behaviour" (ICD10). It is "a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts" (DSM-5).

In terms of the "Big-6" Dimensions of Mental Health this disorder is characterized by antagonism (attention seeking, arrogance, manipulation, and callousness). This leads to substantial personal distress and/or social dysfunction, and disruption to others.

This is not diagnosed before early adult life because these maladaptive traits are very common in childhood and adolescence, but most individuals age-out of these traits before early adulthood. This disorder is of long duration, typically lasting at least several years.

The diagnosis of Narcissistic Personality Disorder requires five (or more) of the following:

  • Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).

  • Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.

  • Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).

  • Requires excessive admiration.

  • Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations.

  • Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends.

  • Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.

  • Is often envious of others or believes that others are envious of him or her.

  • Shows arrogant, haughty behaviors or attitudes.

Narcissistic Personality Disorder should not be diagnosed if its symptoms can be better explained as due to another mental disorder, substance use disorder, or another medical condition.

Although these individuals are usually very ambitious and confident; vocational functioning often is impaired because of their intolerance of criticism or defeat. As a result, it is very difficult for these individuals to maintain long-lasting, loving or loyal relationships. Hence their friends quickly come and go, but their enemies accumulate.

Like all personality disorders, Narcissistic Personality Disorder is a deeply ingrained and enduring behaviour pattern, manifesting as an inflexible response to a broad range of personal and social situations. This behavior represents an extreme or significant deviation from the way in which the average individual in a given culture relates to others. This behaviour pattern tends to be stable.

Most religious cult leaders have severe Narcissistic Personality Disorder.

Course

Narcissistic traits are very common in adolescents, but most adolescents grow out of this behavior. Unfortunately, for some, this narcissistic behavior persists and intensifies into adulthood; thus they become diagnosed with this disorder.

Complications

Individuals with Narcissistic Personality Disorder are intolerant of criticism or defeat. They usually respond with defiant counterattack or social withdrawal. Their feelings of entitlement, need for admiration, and disregard for the feelings of others usually significantly impair their social and occupational functioning.

A Political Warning From Forensic Psychiatry:

The combination of Narcissistic, Antisocial, and Paranoid Personality Disorders is very dangerous. Historically, this particular combination of three personality disorders was seen in all of history's worst tyrants (e.g., Hitler, Stalin etc.). These tyrants lust for wealth, fame and power, and callously destroy everyone that opposes them. As they gain more power, they become more grandiose, power-hungry, and paranoid. If unopposed, these tyrants initiate wars, which result in the mass slaughter of innocent civilians. The tragedy is that the public is easily seduced by these tyrant's grandiose fantasies of national "greatness", and their paranoid hatred of some scapegoated minority (e.g., Jews, Muslims, immigrants, or refugees). These tyrants know that is easier to mobilize people by teaching them hatred and paranoia, than by teaching them love and forgiveness.

Comorbidity

Some other disorders frequently occur with this disorder:

    Non-Personality Disorders

            Depressive Disorders:
      • Persistent Depressive Disorder (Dysthmia); Major Depressive Disorder
            Feeding and Eating Disorders:
      • Anorexia Nervosa
            Substance-Related and Addictive Disorders:
      • Substance Use Disorders, especially cocaine

    Personality Disorders

            Antisocial Personality Disorder
            Paranoid Personality Disorder

Associated Laboratory Findings

No laboratory test has been found to be diagnostic of this disorder.

Prevalence

The prevalence of Narcissistic Personality Disorder is ranges from 0% to 6.2% in community samples, and 50% to 75% are males.

Controlled Clinical Trials Of Therapy

Click here for a list of all the controlled clinical trials of therapy for this disorder.

Psychotherapy

The effectiveness of psychotherapy for Narcissistic Personality Disorder is unknown because there are no randomized controlled trials of therapy. Lacking such evidence, it would be prudent to only offer crisis intervention or short-term psychotherapy, rather than long-term psychotherapy.

One glance at how Antisocial, Borderline and Narcissistic Personality Disorder overlap will illustrate how difficult it is to treat this disorder. Individuals with NPD view themselves as being superior, and thus feel entitled to be callous, self-centered, and greedy. Their viewpoint is that life is the "survival of the fittest", and they are the "fittest". These individuals lust after fame, fortune and power. Their grandiosity and defensiveness usually prevents them from acknowledging their problems.

Many of these individuals achieve high positions in politics, religion or commerce.

Individuals with NPD are more likely to cause pain and suffering to others, rather than to themselves. Since individuals with NPD lack empathy and experience little psychological distress, they usually are oblivious to the suffering that they cause others; hence they lack motivation to change. Individuals with NPD may eventually develop psychological distress once they experience a significant rejection, such as divorce or separation.

Individuals with this disorder may threaten suicide during a crisis (e.g., when discovering their spouse's infidelity). The individual may then use hospitalization as a manipulative ploy to win back their spouse, or to publicly expose their spouse's infidelity. Usually only brief hospitalization is required, with the therapist's goal being to de-escalate the crisis.

Individuals with NPD often generate such strong anger and resentment in others that even trained clinicians become reluctant about continuing therapy with these clients.

Pharmacotherapy

There are currently no medications approved by the FDA to treat this disorder.

Trustworthy Research (PubMed.gov)


A Dangerous Cult: Videos


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Videos



There is a brilliant definition of Narcissistic Personality Disorder in the song "God Help The Outcasts" (from the "Hunchback Of Notre Dame").

Stories

Rating Scales

Parental Behaviors Which Increase The Risk Of Developing A Personality Disorder

Research has shown that genetic, environmental, and prenatal factors all play important roles in the development of personality disorder. Research has also shown that low parental affection and harsh parenting increase the risk of a child later developing a personality disorder.



"Low affection" was defined as: low parental affection, low parental time spent with the child, poor parental communication with the child, poor home maintenance, low educational aspirations for the child, poor parental supervision, low paternal assistance to the child's mother, and poor paternal role fulfillment. "Harsh parenting" was defined as: harsh punishment, inconsistent maternal enforcement of rules, frequent loud arguments between the parents, difficulty controlling anger toward the child, possessiveness, use of guilt to control the child, and verbal abuse.


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(USE SLIDER ON RIGHT SIDE OF THE ABOVE PAGE TO SEE FULL CHECKLIST)



This disorder is characterized by pathological personality traits in the following domains:

  • Extraversion , characterized by:

    • Attention seeking:
      Excessive attempts to attract and be the focus of the attention of others; admiration seeking.

      Question: "Do you really like to be the center of attention? Do you like to show off if you get the chance? Do you really want to be admired by others?"
      • "Requires excessive admiration." (DSM-5)
      • "Continuous longing for appreciation." (ICD-10)

  • Antagonism , characterized by:

    • Arrogance:
      Offensive display of superiority, self-importance, entitlement, or overbearing pride; often bragging.

      Question: "Are you a superior person? Are other people envious of you? Do you only associate with people of your caliber? Do you not waste your time hanging out with people who are beneath you? Do you insist upon getting the respect that is due to you? Do some people think you are cocky or arrogant?"
      • "Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)." (DSM-5)
      • "Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love." (DSM-5)
      • "Believes that he or she is 'special' and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)." (DSM-5)
      • "Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations." (DSM-5)
      • "Is often envious of others or believes that others are envious of him or her." (DSM-5)
      • "Shows arrogant, haughty behaviors or attitudes." (DSM-5)
      • "Egocentricity." (ICD-10)
      • "Self-indulgence." (ICD-10)
      • "Excessive sensitivity to setbacks and rebuffs." (ICD-10)

    • Manipulation:
      Using charm, ingratiation, glibness, or seduction to cheat or control others for personal gain.

      Question: "Can you make anybody believe anything you want them to? Are you pretty good at manipulating people? Can you talk your way into and out of anything?"
      • "Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends." (DSM-5)
      • "Persistent manipulative behaviour." (ICD-10)

    • Callousness:
      Lacking guilt about causing others harm; lacking empathy; cold and indifferent to others’ feelings.

      Question: "Are you usually not interested in other people's problems? Do you seldom feel sorry for others? Do you have more important things to worry about than other people’s feelings?"
      • "Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others." (DSM-5)
      • "Lack of consideration for others." (ICD-10)



(Note: Recovery = symptomatic remission + full-time gainful employment + weekly contact with friends)


Narcissistic Personality Disorder F60.8 - ICD10 Description, World Health Organization

Narcissistic personality disorder is not classified as a specific personality disorder by the World Health Organization's ICD-10. The ICD-10 classification includes narcissistic personality traits under the classification of Histrionic Personality Disorder. Thus, the ICD-10 classification of Histrionic Personality Disorder includes the narcissistic personality traits of: egocentricity, self-indulgence, continuous longing for appreciation, lack of consideration for others, feelings that are easily hurt, and persistent manipulative behaviour. The following diagnostic criteria for Narcissistic Personality Disorder is not in the ICD-10, but was created (by this editor) by splitting off the narcissistic personality traits that are included in the ICD-10 classification of Histrionic Personality Disorder.

Screening Questions

  • I am an extraordinary person.

  • I will never be satisfied until I get all that I deserve.

  • It's very important to me to stand out, and have my achievements recognized.

  • I really don’t care if I make other people suffer.

  • I don't react well when someone offends me.

  • I find it easy to manipulate people.

ICD-10 Diagnostic Criteria (For Research)

Note: This diagnostic criteria uses the narcissistic personality traits included in ICD-10 Histrionic Personality Disorder.

A. The general criteria of personality disorder must be met:

  • Evidence that the individual's characteristic and enduring patterns of inner experience and behaviour deviate markedly as a whole from the culturally expected and accepted range (or 'norm').

  • The deviation must manifest itself pervasively as behaviour that is inflexible, maladaptive, or otherwise dysfunctional across a broad range of personal and social situations (i.e. not being limited to one specific 'triggering' stimulus or situation).

  • There is personal distress, or adverse impact on the social environment, or both, clearly attributable to the behaviour.

  • There must be evidence that the deviation is stable and of long duration, having its onset in late childhood or adolescence.

  • The deviation cannot be explained as a manifestation or consequence of other adult mental disorders.

  • Organic brain disease, injury, or dysfunction must be excluded as possible cause of the deviation.



B. At least four of the following must be present:

  • Egocentricity.
      (E.g., "I am an extraordinary person.")

  • Self-indulgence.
      (E.g., "I will never be satisfied until I get all that I deserve.")

  • Continuous longing for appreciation.
      (E.g., "It's very important to me to stand out, and have my achievements recognized.")

  • Lack of consideration for others.
      (E.g., "I really don’t care if I make other people suffer.")

  • Excessive sensitivity to setbacks and rebuffs.
      (E.g., "I don't react well when someone offends me.")

  • Persistent manipulative behaviour.
      (E.g., "I find it easy to manipulate people.")

Narcissistic Personality Disorder - Diagnostic Criteria, American Psychiatric Association

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by 5 (or more) of the following:

  • Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).

  • Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.

  • Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).

  • Requires excessive admiration.

  • Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations.

  • Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends.

  • Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.

  • Is often envious of others or believes that others are envious of him or her.

  • Shows arrogant, haughty behaviors or attitudes.

  • This enduring pattern of inner experience and behavior must deviate markedly from the expectations of the individual's culture.

  • This enduring pattern is inflexible and pervasive across a broad range of personal and social situations.

  • This enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.

  • Empirically Derived Taxonomy for Personality Diagnosis: Narcissistic Personality Disorder

    (This section uses an alternative classification system to that of the American Psychiatric Association)

    These individuals:
    • Have an exaggerated sense of self-importance.

    • Feel privileged and entitled, expect preferential treatment, and seek to be the center of attention.

    • Have fantasies of unlimited success, power, beauty, or talent, and tend to treat others primarily as an audience to witness their importance or brilliance.

    • Believe they can only be appreciated by, or should only associate with, people who are high-status, superior, or "special."

    • Have little empathy and seem unable to understand or respond to others' needs and feelings unless they coincide with their own.

    • Are dismissive, haughty, and arrogant.

    • Are critical, envious, competitive with others, and prone to get into power struggles.

    • Attempt to avoid feeling helpless or depressed by becoming angry instead, and tend to react to perceived slights or criticism with rage and humiliation.

    • Their overt grandiosity may mask underlying vulnerability. They are invested in seeing and portraying themselves as emotionally strong, untroubled, and emotionally in control, often despite clear evidence of underlying insecurity or distress.

    Refining the Construct of Narcissistic Personality Disorder: Diagnostic Criteria and Subtypes

    This study found the features that best described Narcissistic Personality Disorder.

    Features (in order of decreasing frequency) that are highly characteristic and highly distinctive of Narcissistic Personality Disorder:

    • Has an exaggerated sense of self-importance (e.g., feels special, superior, grand, or envied)

    • Feels privileged and entitled, expects preferential treatment

    • Is critical of others

    • Gets into power struggles

    • Blames own failures or shortcomings on other people or circumstances, attributes his or her difficulties to external factors rather than accepting responsibility for own conduct or choices

    • Is controlling

    • Is manipulative

    • Is dismissive, haughty, or arrogant

    • Has little empathy; seems unable or unwilling to understand or respond to others’ needs or feelings

    • Seeks to be the center of attention

    • Is competitive with others (whether consciously or unconsciously)

    Features (in order of decreasing frequency) that are highly descriptive of Narcissistic Personality Disorder but not specific to it:

    • Is angry or hostile (whether consciously or unconsciously)

    • Is articulate; can express self well in words

    • Has extreme reactions to perceived slights or criticism (e.g., may react with rage, humiliation, etc.)

    • Feels misunderstood, mistreated, or victimized

    • Holds grudges; may dwell on insults or slights for long periods

    • Fears that he or she will be rejected or abandoned

    • Feels unhappy, depressed, or despondent

    • Lacks close friendships and relationships

    • Emotions tend to spiral out of control, leading to extremes of anxiety, sadness, rage, etc.

    • When upset, has trouble perceiving both positive and negative qualities in the same person at the same time (e.g., may see others in black or white terms, shift suddenly from seeing someone as caring to seeing him or her as malevolent and intentionally hurtful, etc.)

    • Tends to feel anxious

    Features that are specific to Narcissistic Personality Disorder but not necessarily characteristic of it:

    • Treats others primarily as an audience to witness own importance, brilliance, beauty, etc.

    • Believes he or she can only be appreciated by, or should only associate with, people who are high status, superior, or otherwise “special”

    • Has fantasies of unlimited success, power, beauty, talent, brilliance, etc.

    • Takes advantage of others; has little investment in moral values (e.g., puts own needs first, uses or exploits people with little regard for their feelings or welfare, etc.)

    • Experiences little or no remorse for harm or injury caused to others

    • Seeks power or influence over others (whether in beneficial or destructive ways)

    • Elicits dislike or animosity in others

    • Attempts to dominate a significant other (e.g., spouse, lover, family member) through violence or intimidation

    • Is emotionally intrusive (e.g., may not respect other people’s needs for autonomy, privacy, etc.)

    • Shows reckless disregard for the rights, property, or safety or others

    • Is oppositional, contrary, or quick to disagree

    How Narcissistic, Borderline, and Antisocial Personality Disorder Overlap

    In the DSM-4 and DSM-5, there are certain diagnostic criteria for Narcissistic, Borderline, and Antisocial Personality Disorder that overlap, and can't differentiate between these disorders. The following table lists which diagnostic criteria poorly differentiate between these 3 personality disorders.

    DIAGNOSTIC CRITERIA NARCISSISTIC PERSONALITY BORDERLINE PERSONALITY ANTISOCIAL PERSONALITY
    Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating.) Present Present Present
    Irritability and aggressiveness , as indicated by repeated physical fights or assaults. Present Present Present
    Reckless disregard for safety of self or others. Present Present Present
    Is interpersonally exploitative , i.e., takes advantage of others to achieve his or her own ends. Present Present Present
    Is often envious of others or believes that others are envious of him or her. Present Present Present
    Lacks empathy : is unwilling to recognize or identify with the feelings and needs of others. Present . Present
    Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. . Present Present
    Transient, stress-related paranoid ideation or severe dissociative symptoms. Present Present .
    Fantic efforts to avoid real or imagined abandonment . Present Present .
    Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. Present Present .



    The significant overlap of symptoms in Narcissistic, Borderline, and Antisocial Personality Disorder illustrates how similar these personality disorders are. It could be argued that these overlapping symptoms are the core features of the Narcissistic, Borderline, and Antisocial cluster of Personality Disorders.

    Although these disruptive behaviors slowly disappear as the individual ages; these maladaptive behaviors may cause decades of unemployment or be very damaging to social relationships.

    Where Do Narcissistic, Borderline, and Antisocial Personality Disorder Not Overlap?

    In the DSM-4 and DSM-5, there are certain diagnostic criteria for Narcissistic, Borderline, and Antisocial Personality Disorder that don't overlap, and thus differentiate between these disorders. The following table lists which diagnostic criteria statistically differentiate between these 3 personality disorders.

    DIAGNOSTIC CRITERIA NARCISSISTIC PERSONALITY BORDERLINE PERSONALITY ANTISOCIAL PERSONALITY
    Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements) Present . .
    Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions) Present . .
    Requires excessive admiration Present . .
    Has a sense of entitlement , i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations Present . .
    Shows arrogant , haughty behaviors or attitudes Present . .
    A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation . Present .
    Identity disturbance: markedly and persistently unstable self-image or sense of self . Present .
    Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lastig a few hours and only rarely more than a few days) . Present .
    Chronic feelings of emptiness . Present .
    Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest . . Present
    Deceitfulness , as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure . . Present
    Consistent irresponsibility , as indicated by repeated failure to sustain consistent work behavior or honor financial obligations . . Present
    Lack of remorse , as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another . . Present




    What Is The Opposite Of The Narcissistic, Borderline, and Antisocial Personality Disorders?

    The following lists the unhealthy core features of Narcissistic, Borderline, and Antisocial Personality Disorders. Opposite each unhealthy core behavior is listed its healthy alternative.

    UNHEALTHY CORE FEATURES OF ANTISOCIAL, BORDERLINE, AND NARCISSISTIC PERSONALITY DISORDERS HEALTHY ALTERNATIVE
    Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating.) Self-Control
    Irritability and aggressiveness , as indicated by repeated physical fights or assaults. Peacefulness
    Reckless disregard for safety of self or others. Caution
    Is interpersonally exploitative , i.e., takes advantage of others to achieve his or her own ends. Generosity
    Is often envious of others or believes that others are envious of him or her. Contentment
    Lacks empathy : is unwilling to recognize or identify with the feelings and needs of others. Kindness
    Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. Life Having Purpose and Meaning
    Transient, stress-related paranoid ideation or severe dissociative symptoms. Trust
    Fantic efforts to avoid real or imagined abandonment . Confidence
    Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. Being Realistic



    This suggests that effective treatment for Antisocial, Borderline, and Narcissistic Personality Disorder should concentrate on increasing these healthy alternative behaviors.

    Antagonism

    The following table summarizes the antagonistic personality traits of individuals with Borderline, Narcissistic, and Antisocial Personality Disorders.

    BORDERLINE PERSONALITY TRAITS:
    Unstable emotions that are easily aroused, intense, and / or out of proportion to events "I get emotional easily, often for very little reason." "I'm very moody."
    Having unstable self-image (“who-am-I”) or self-direction (instability in values or career plans) "I can't decide what kind of person I want to be."
    Chronic feelings of emptiness "I often feel empty inside."
    Having a pattern of unstable and intense social relationships "I get into very intense relationships that don't last."
    Feeling uncomfortable or helpless when alone or when separated from caretakers "I go to extremes to try to keep people from leaving me."
    Feeling down, depressed, or hopeless "I often feel down, depressed, or hopeless."
    Having thoughts of deliberate self-harm or suicide OR showing severe self-neglect "A number of times, I've threatened suicide or injured myself on purpose."
    Having odd or unusual perceptions e.g. feeling unreal, things looking unreal, out-of-body feeling "I often 'zone out' and then suddenly come to and realize that a lot of time has passed.
    Using threats or force against others; being verbally abusive, bullying, mean, or vengeful "I argue or fight when people try to stop me from doing what I want."
    Acting suddenly or rashly without a plan or consideration of the consequences "I feel like I act totally on impulse." "I'm not good at planning ahead."
    Doing unnecessary, risky, dangerous activities, without regard for self-damaging consequences "I take chances and do reckless things."
    NARCISSISTIC PERSONALITY TRAITS:
    Excessive attempts to attract and be the focus of the attention of others; admiration seeking "I crave attention." "I do things so that people just have to admire me."
    Offensive display of superiority, self-importance, entitlement, or overbearing pride; often bragging "I'm better than almost everyone else." "I deserve special treatment."
    Using charm, ingratiation, glibness, or seduction to cheat or control others for personal gain "I use people to get what I want." "I'm good at conning people."
    Lacking guilt about causing others harm; lacking empathy; cold and indifferent to others’ feelings "It's no big deal if I hurt other people's feelings."
    ANTISOCIAL PERSONALITY TRAITS:
    Dishonesty and fraudulence; lying, stealing, or cheating others "I don't hesitate to cheat if it gets me ahead." "Lying comes easily to me."
    Using charm, ingratiation, glibness, or seduction to cheat or control others for personal gain "I use people to get what I want." "I'm good at conning people."
    Lacking guilt about causing others harm; lacking empathy; cold and indifferent to others’ feelings "It's no big deal if I hurt other people's feelings."
    Being physically violent towards others (e.g. physical assault or property damage) "I often get into physical fights."
    Failing to fulfill or honor commitments and obligations "I make promises that I don't really intend to keep."
    Using threats or force against others; being verbally abusive, bullying, mean, or vengeful "I argue or fight when people try to stop me from doing what I want."
    Acting suddenly or rashly without a plan or consideration of the consequences "I feel like I act totally on impulse." "I'm not good at planning ahead."
    Doing unnecessary, risky, dangerous activities, without regard for self-damaging consequences "I take chances and do reckless things."


    A Good Life

    How does one live a good life?

    One approach to answering this question is to study the behavior of individuals who live troubled lives. Could the opposite of their maladaptive personality traits define how to live a good life?

    Research has shown that academic, vocational, economic, marital and social failure - plus crime - correlate highly to individuals having antagonism (i.e., individuals with Borderline, Narcissistic, and Antisocial Personality Disorder).

    Could the opposite of the personality traits seen in Borderline, Narcissistic, and Antisocial Personality Disorder be a clue as to how to live a good life? If so, the right side of the following table would define a good life. (This table uses DSM-5 diagnostic criteria.)


    BORDERLINE PERSONALITY DISORDER THE OPPOSITE OF BORDERLINE PERSONALITY DISORDER
    Has unstable emotions with frequent mood changes; over-reacts with intense emotions Has calm and stable moods
    Has unstable: self-image (“who-am-I”), core personal values, life goals and career plans Has stable: self-image (“who-am-I”), core personal values, life goals and career plans
    Has a pattern of unstable and intense social relationships Has a pattern of stable and peaceful interpersonal relationships
    Finds it difficult to handle separation or rejection from significant others Shows little fear of separation or rejection from significant others
    Has thoughts of deliberate self-harm or suicide OR shows severe self-neglect Has no thoughts of deliberate self-harm or suicide AND no evidence of severe self-neglect
    Has angry outbursts; is verbally abusive; has mean, bullying, or vengeful behavior Respects others and treats them with dignity; makes others feel appreciated; is polite
    Acts suddenly or rashly without a plan or consideration of the consequences Thinks carefully before acting or speaking; takes care to avoid mistakes or danger
    NARCISSISTIC PERSONALITY DISORDER THE OPPOSITE OF NARCISSISTIC PERSONALITY DISORDER
    Has a grandiose sense of self-importance Doesn't exaggerate own achievements and talents
    Is preoccupied with grandiose fantasies Has realistic goals (e.g., isn't preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love)
    Shows arrogant, haughty behaviors or attitudes Doesn't show arrogant, haughty behavior or attitudes
    Feels special or high-status and wants to associate with only other high-status people Doesn't believe that she is so "special" and unique that she can only be understood by, or should associate with, other special or high-status people (or institutions)
    Requires excessive admiration Doesn't require excessive admiration
    Has a sense of entitlement Doesn't unreasonably expect especially favorable treatment or automatic compliance with her expectations
    Is often envious of others or believes that others are envious of her Isn't envious of others or believe that others are envious of her
    Lacks empathy Shows empathy (e.g., respects the feelings and needs of others)
    Is interpersonally exploitative Doesn't exploit others (e.g., doesn't take advantage of others to achieve her own ends)
    ANTISOCIAL PERSONALITY DISORDER THE OPPOSITE OF ANTISOCIAL PERSONALITY DISORDER
    Irritable and aggressive Good anger control
    Breaks the law Law-abiding
    Lacks remorse Feels remorse when appropriate
    Lies, uses aliases, or cons others Honest
    Irresponsible at work or with money Responsible at work and with money
    Impulsive or fails to plan ahead Cautious; plans ahead
    Reckless disregard for the safety of herself or others Careful regard for the safety of herself and others



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    Treatment

    Setting Goals In Therapy

      Questions To Ask When Setting Goals

      In The Past Week:
      • WHO: was your problem?

      • EVENT: what did he/she do?

      • RESPONSE: how did you respond to that event?

      • OUTCOME: did your response help?

      • TRIGGER: what did you do that could have triggered this problem?

      • GOAL: what life skill(s) do you have to work on? (from checklist)

      Example Of Setting Goals In Interviewing A Person With Narcissistic Personality Disorder

      In The Past Week:
      • WHO: was your problem?
        "The doctors in my university hospital."

      • EVENT: what did he/she do?
        "I am the newly appointed chairman of our department, but the physicians in my department are insubordinate."

      • RESPONSE: how did you respond to that event?
        "I complained to the Dean of Medicine, and asked that he support me against these doctors."

      • OUTCOME: did your response help?
        "No, my going to the Dean has escalated the problem. Now these doctors have gone to their Medical Association alleging that I am asking for a "kickback" on their salaries."

      • TRIGGER: what did you do that could have triggered this problem?
        "At the first meeting I had with these doctors; I asked them all to contribute a portion of their salaries to my research fund. I told them that this was a condition of their continued employment."

      • GOAL: what life skill(s) do you have to work on? (from checklist)
        "I don't think there is anything wrong with my life skills." (Patient refuses to cooperate)

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    Narcissistic Personality Disorder: Tips for Spotting and Coping with a Narcissist

    Self-Help Resources

    Monitoring Your Progress

    NOTE: When each of the following presentations finish; you must exit by manually closing its window in order to return to this webpage.

    The Healthy Social Behavior Scale lists social behaviors that research has found to be associated with healthy social relationships. You can keep score (totaling its 4-point scale answers) on a separate piece of paper to monitor your progress.



    The Mental Health Scale lists behaviors and symptoms that research has found to be associated with mental health (or disorder). You can keep score (totaling its 4-point scale answers) on a separate piece of paper to monitor your progress.



    The Life Satisfaction Scale lists the survey questions often used to measure overall satisfaction with life. You can keep score (totaling its 4-point scale answers) on a separate piece of paper to monitor your progress.



    Life Satisfaction Scale (5-Minute Video)

    The "Big 6" Dimensions of Mental Health

    Research has shown that there are 5 major dimensions (the "Big 5 Factors" or Five-Factor Model) of personality disorders and other mental disorders.

    This website uses these 5 major dimensions of human behavior (i.e., Agreeableness, Conscientiousness, Openness/Intellect, Extraversion/Sociability, and Emotional Stability) to describe all mental disorders. This website adds one more dimension, "Physical Health", to create the "Big 6" dimensions of mental health.

    The behaviors of the "Five Factor Model of Personality" represent five adaptive functions that are vital to human survival. For example, when one individual approaches another, the individual must: (1) decide whether the other individual is friend or foe [ "Agreeableness" ], (2) decide if this represents safety or danger [ "Emotional Stability" ], (3) decide whether to approach or avoid the other individual [ "Extraversion/Sociability" ], (4) decide whether to proceed in a cautious or impulsive manner [ "Conscientiousness" ], and (5) learn from this experience [ "Openness/Intellect" ].



    Desiderata (5-Minute Video)



    The following "Morning Meditation" allows you to plan your day using these "Big 6" dimensions of mental health.



    The following "Evening Meditation" allows you to review your progress on these "Big 6" dimensions of mental health.




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      "In physical science a first essential step in the direction of learning any subject is to find principles of numerical reckoning and practicable methods for measuring some quality connected with it. I often say that when you can measure what you are speaking about and express it in numbers you know something about it; but when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory kind: it may be the beginning of knowledge, but you have scarcely, in your thoughts, advanced to the stage of science, whatever the matter may be."

      Lord Kelvin (1824 – 1907)


    • The best summary on bad research is given by Laura Arnold in this TEDx lecture. If you read nothing else about research, you owe it to yourself to watch this short video - it is excellent!

    • Economist in grim battle against deceptive scholarship

    • List of Predatory Journals and Publishers

    • The power of asking "what if?"

    • The active placebo effect: 2300 years ago, the Greek Stoic philosophers taught that it is not the objective event, but our subjective judgment about the event, that determines our behavior. The active placebo effect bears witness to this ancient wisdom.

    • Criteria For High Quality Research Studies

    • It is troubling that a recent study found that two-thirds of important psychological research studies couldn't be replicated. High quality research must meet the following criteria:

      • Randomized Controlled Trial:
        Ask: Was the trial randomized? Was the randomization procedure described and was it appropriate? The best research design is to have research subjects randomly assigned to an experimental or control group. It is essential that confounding factors be controlled for by having a control group or comparator condition (no intervention, placebo, care as usual etc.).

      • Representative Sample:
        Ask: Do the research subjects represent a normal cross-section of the population being studied? Many psychological research studies using university students are flawed because their subjects are not representative of the normal population since they are all W.E.I.R.D. (White, Educated, Intelligent, Rich, and living in a Democracy).

      • Single Blind Trial:
        Ask: Was the treatment allocation concealed? It is essential that the research subjects are kept "blind" as to whether they are in the experimental or control group (in order to control for any placebo effects).

      • Double Blind Trial (Better Than Single Blind Trial):
        Ask: Were blind outcome assessments conducted? In a double blind study, neither the research subjects nor the outcome assessors know if the research subject is in the experimental or control group. This controls for both the placebo effect and assessor bias.

      • Baseline Comparability:
        Ask: Were groups similar at baseline on prognostic indicators? The experimental and control groups must be shown to be comparable at the beginning of the study.

      • Confounding Factors:
        Ask: Were there factors, that weren't controlled for, that could have seriously distorted the study's results? For example, research studies on the effectiveness of mindfulness cognitive therapy in preventing depressive relapse forgot to control for whether the research subjects were also simultaneously receiving antidepressant medication or other psychological treatments for depression.

      • Intervention Integrity:
        Ask: Was the research study protocal strictly followed? The research subjects must be shown to be compliant (e.g., taking their pills, attending therapy) and the therapists must be shown to be reliably delivering the intervention (e.g., staying on the research protocol).

      • Statistical analysis:
        Ask: Was a statistical power calculation described? The study should discuss its statistical power analysis; that is whether the study size is large enough to statistically detect a difference between the experimental and control group (should it occur) and usually this requires at least 50 research subjects in the study.

        Ask: Are the results both statistically significant and clinically significant? Many medical research findings are statistically significant (with a p-value <0.05), but they are not clinically significant because the difference between the experimental and control groups is too small to be clinically relevant.

        For example, the effect of a new drug may be found to be 2% better than placebo. Statistically (if the sample size was large enough) this 2% difference could be statistically significant (with a p-value <0.05). However, clinicians would say that this 2% difference is not clinically significant (i.e., that it was too small to really make any difference).

        Statistically, the best way to test for clinical significance is to test for effect size (i.e., the size of the difference between two groups rather than confounding this with statistical probability).

        When the outcome of interest is a dichotomous variable, the commonly used measures of effect size include the odds ratio (OR), the relative risk (RR), and the risk difference (RD).

        When the outcome is a continuous variable, then the effect size is commonly represented as either the mean difference (MD) or the standardised mean difference (SMD) .

        The MD is the difference in the means of the treatment group and the control group, while the SMD is the MD divided by the standard deviation (SD), derived from either or both of the groups. Depending on how this SD is calculated, the SMD has several versions such, as Cohen's d, Glass's Δ, and Hedges' g.

          Clinical Significance: With Standard Mean Difference, the general rule of thumb is that a score of 0 to 0.25 indicates small to no effect, 0.25-0.50 a mild benefit, 0.5-1 a moderate to large benefit, and above 1.0 a huge benefit. It is a convention that a SMD of 0.5 or larger is a standard threshold for clinically meaningful benefit.

        The statistical summary should report what percentage of the total variance of the dependent variable (e.g., outcome) can be explained by the independent variable (e.g., intervention).

        In clinical studies, the study should report the number needed to treat for an additional beneficial outcome (NNTB), and the number needed to treat for an additional harmful outcome (NNTH).

          Number Needed To Benefit (NNTB): This is defined as the number of patients that need to be treated for one of them to benefit compared with a control in a clinical trial. (It is defined as the inverse of the absolute risk reduction.) Note: Statistically, the NNTB depends on which control group is used for comparison - e.g., active treatment vs. placebo treatment, or active treatment vs. no treatment.

          Number Needed To Harm (NNTH): This is defined as the number of patients that need to be treated for one of them to be harmed compared with a control in a clinical trial. (It is defined as the inverse of the absolute increase in risk of harm.)

          Tomlinson found “an NNTB of 5 or less was probably associated with a meaningful health benefit,” while “an NNTB of 15 or more was quite certain to be associated with at most a small net health benefit.”

        Ask: Does the researcher accept full responsibility for the study's statistical analysis? The researcher should not just hand over the study's raw data to a corporation (that may have $1,000 million invested in the study) to do the statistical analysis.

      • Completeness of follow-up data:
        Ask: Was the number of withdrawals or dropouts in each group mentioned, and were reasons given for these withdrawals or dropouts? Less than 20% of the research subjects should drop out of the study. The intervention effect should persist over an adequate length of time.

      • Handling of missing data:
        Ask: Was the statistical analysis conducted on the intention-to-treat sample? There must be use of intention-to-treat analysis (as opposed to a completers-only analysis). In this way, all of the research subjects that started the study are included in the final statistical analysis. A completers-only analysis would disregard those research subjects that dropped out.

      • Replication of Findings:
        Ask: Can other researchers replicate this study's results? The research study's methodology should be clearly described so that the study can be easily replicated. The researcher's raw data should be available to other researchers to review (in order to detect errors or fraud).

      • Fraud:
        Ask: Is there a suspicion of fraud? In a research study, examine the independent and dependent variables that are always measured as a positive whole number (e.g., a variable measured on a 5-point Likert-type scale ranging from "1 = definitely false to 5 = definitely true" etc.). For each of these variables, look at their sample size ( n ), mean ( M ) and standard deviation ( SD ) before they undergo statistical analysis. There is a high suspicion of fraud in a study's statistics:

        • If the M is mathematically impossible (online calculator): This is one of the easiest ways to mathematically detect fraud. The mean ( M ) is defined as "the sum ( Sum ) of the values of each observation divided by the total number ( n ) of observations". So: M = Sum / n . Thus: ( Sum ) = ( M ) multiplied by ( n ). We know that, if a variable is always measured as a positive whole number, the sum of these observations always has to be a whole number. For these variables to test for fraud: calculate ( M ) multiplied by ( n ). This calculates the Sum which MUST be a positive whole number. If the calculated Sum isn't a positive whole number; the reported mean ( M ) is mathematically impossible - thus the researcher either cooked the data or made a mistake. A recent study of 260 research papers published in highly reputable psychological journals found that 1 in 2 of these research papers reported at least one impossible value , and 1 in 5 of these research papers reported multiple impossible values. When the authors of the 21 worst offending research papers were asked for their raw data (so that its reliability could be checked) - 57% angrily refused. Yet such release of raw data to other researchers is required by most scientific journals. (Here is an example of a research paper filled with mathematically impossible means.)

        • If the SD is mathematically impossible (online calculator): When researchers fraudulently "cook" their data, they may accidently give their data a mean and standard deviation that is mathematically impossible.

        • If the SD/M is very small (i.e., the variable's standard deviation is very small compared to the mean suggesting data smoothing).

        • If the SD's are almost identical (i.e., the variables have different means but almost identical standard deviations).

        • If the 4th digit of the values of the variables aren't uniformly distributed - since each should occur 10% of the time (Benford's Law).

        • If the researcher is legally prevented from publishing negative findings about a drug or therapy because that would violate the "nondisclosure of trade secrets" clause in the research contract (i.e., it is a "trade secret" that the drug or therapy is ineffective - hence this can not be "disclosed"). Approximately half of all registered clinical trials fail to publish their results.

        • If the researcher refuses to release his raw data to fellow researchers (so that they can check its validity). In order to be published in most scientific journals, a researcher must promise to share his raw data with fellow researchers. Thus a researcher's refusal to do so is almost a sure indicator of fraud.

        • If the research study's data contradicts the study's own conclusions - surprisingly, this often occurs.

    • Calling Bullshit In The Age of Big Data - "Bullshit is language, statistical figures, data graphics, and other forms of presentation intended to persuade by impressing and overwhelming a reader or listener, with a blatant disregard for truth and logical coherence." Reading the syllabus of this university course should be required reading for every student of mental health. This syllabus is absolutely fantastic!

    • Statistical Methods in Psychology Journals: Guidelines and Explanations - American Psychologist 1999

    • Not All Scientific Studies Are Created Equal - video

    • The efficacy of psychological, educational, and behavioral treatment

    • Estimating the reproducibility of psychological science

    • Psychologists grapple with validity of research

    • Industry sponsorship and research outcome (Review) - Cochrane Library

    • 'We've been deceived': Many clinical trial results are never published - (text and video)

    • Junk science misleading doctors and researchers

    • Junk science under spotlight after controversial firm buys Canadian journals

    • Medicine with a side of mysticism: Top hospitals promote unproven therapies - Are some doctors becoming modern witchdoctors?

    • When Evidence Says No, But Doctors Say Yes


    • Cochrane Collaboration - the best evidence-based, standardized reviews available

    Research Topics

    Narcissistic Personality Disorder - Core Clinical Journals

    Narcissistic Personality Disorder - All Journals

    Narcissistic Personality Disorder - Review Articles - Core Clinical Journals

    Narcissistic Personality Disorder - Review Articles - All Journals

    Narcissistic Personality Disorder - Treatment - Core Clinical Journals

    Narcissistic Personality Disorder - Treatment - All Journals

    Recommended Free Full Text Articles


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    Normal Distribution Of Human Attributes

    Regre>ssion to the Mean (Or Why Scientific Experiments Require A Control Group)

    The "Big 6" Dimensions of Mental Health

    Research has shown that there are 5 major dimensions (the "Big 5 Factors" or Five-Factor Model) of personality disorders and other mental disorders. There are two free online personality tests that assess your personality in terms of the "Five Factor Model of Personality". Although not computerized online, the Big Five Inventory (BFI) is a 44-item test often used in personality research.

    This website uses these 5 major dimensions of human behavior to describe all mental disorders. (This website adds one more dimension, "Physical Health", to create the "Big 6" dimensions of mental health.)

    The behaviors of the "Five Factor Model of Personality" represent five adaptive functions that are vital to human survival. For example, when one individual approaches another, the individual must: (1) decide whether the other individual is friend or foe [ "Agreeableness" ], (2) decide if this represents safety or danger [ "Emotional Stability" ], (3) decide whether to approach or avoid the other individual [ "Extraversion/Sociability" ], (4) decide whether to proceed in a cautious or impulsive manner [ "Conscientiousness" ], and (5) learn from this experience [ "Openness/Intellect" ].

    Which "Big 6" Dimensions of Mental Health are Impaired in Narcissistic Personality Disorder?

    THE POSITIVE SIDE OF THE "BIG 6" DIMENSIONS OF MENTAL HEALTH THE NEGATIVE SIDE OF THE "BIG 6" DIMENSIONS OF MENTAL HEALTH THIS DISORDER
    Agreeableness
    Being kind and honest.
    Antagonism
    Being unkind or dishonest.
          Antagonism
    Conscientiousness
    Being diligent and self-disciplined.
    Disinhibition
    Being distractible, impulsive, or undisciplined.
    Openness/Intellect
    Showing good creativity, problem-solving, and learning ability
    Impaired Intellect
    Showing decreased creativity, problem-solving, or learning ability.
    Extraversion
    Being gregarious, assertive and enthusiastic.
    Detachment
    Being detached, unassertive, or unenthusiastic.
    Emotional Stability
    Being emotionally stable and calm.
    Emotional Distress
    Being emotionally unstable/distressed.
    Physical Health
    Being physically fit and healthy.
    Physical Symptoms
    Being physically unfit or ill.





    The Following Will Only Discuss The Dimensions of Mental Illness That Are Abnormal In This Disorder

    The problems that are characteristic of this disorder are highlighted with this pink background color.


    AGREEABLENESS VS. ANTAGONISM

    AGREEABLENESS (Helping Others)
    Description: Agreeableness is synonymous with compassion and politeness. Compassion reflects empathy, sympathy, and caring for others. Politeness reflects respect for others. Individuals with high Agreeableness do not hold grudges, are lenient in judging others, are willing to compromise and cooperate with others, and can easily control their temper. The Agreeableness dimension measures the behaviors that are central to the concept of JUSTICE and equality (fair, honest, and helpful behavior - living in harmony with others, neither harming nor allowing harm). Basic human rights are enshrined in the UN Universal Declaration of Human Rights. Individuals with high Agreeableness avoid manipulating others for personal gain, feel little temptation to break rules, are uninterested in lavish wealth and luxuries, and feel no special entitlement to elevated social status. High Agreeableness is associated with better: longevity, helping others, giving to charity, job [team] performance, and marital success. (This dimension appears to measure the behaviors that differentiate friend from foe.)
    Descriptors: Honest, humble, compassionate, polite, cooperative, nonaggressive.
    • Compassion:
      • Forgiving nature
      • Considerate and kind
      • Feel other's emotions
      • Inquire about others’ well-being
      • Sympathize with others’ feelings
      • Take an interest in other people’s lives
      • Like to do things for others
    • Politeness:
      • Seldom rude
      • Respect authority
      • Hate to seem pushy
      • Avoid imposing my will on others
      • Rarely put people under pressure
    • From International Personality Item Pool:
      • Would never cheat on taxes
      • Sympathize with the homeless
      • Trust others
      • Make people feel welcome
      • Am easy to satisfy
      • Dislike being the center of attention
    Chimpanzees: The Agreeableness-Antagonism dimension of human behavior can be traced back to our chimpanzee ancestory. Chimpanzee communities, like every social species, organize themselves according to status (video). In such status hierarchies, the dominant members actively protect their privileged status within the community by using domineering, antagonistic behavior towards subordinate members. This antagonistic, competitive behavior by high-status dominant members of the community is in contrast to the agreeable, cooperative behavior of the low-status, subordinant members. In humans, this same antagonistic behavior is used by those seeking to dominate others.
    Evolution: The brains of social species evolved to allow cooperation and altruism which require coordinating one’s goals with those of others. The core features of Agreeableness are empathy and fairness. In more intelligent species, there appears to be an almost instinctual sense of empathy and fairness (video).
    Language Characteristics: Pleasure talk, agreement, compliments, empathy, few personal attacks, few commands or global rejections, many self-references, few negations, few swear words, few threats, many insight words.
    Research: Higher scores on Agreeableness are associated with deeper relationships. Are you a giver or taker? (video). *MRI research found that Agreeableness was associated with increased volume in regions that process information about the intentions and mental states of other individuals.
    "I am helpful and unselfish with others."
    "I have a forgiving nature."
    "I am generally trusting."
    "I am considerate and kind to almost everyone."
    "I like to cooperate with others."
    "I don't find fault with others."
    "I don't start quarrels with others."
    "I am not cold and aloof."
    "I am not rude to others."
    "I feel other's emotions."
    "I inquire about others' well-being."
    "I sympathize with others' feelings."
    "I take an interest in other people's lives."
    "I like to do things for others."
    "I respect authority."
    "I hate to seem pushy."
    "I avoid imposing my will on others."
    "I rarely put people under pressure."
    ANTAGONISM (Harming Others)
    Description: Antagonism is synonymous with being very self-centered and lacking empathy. They find it hard to forgive, are critical of others' shortcomings, are stubborn in defending their point of view, and readily feel anger when provoked. They will flatter others to get what they want, break rules for personal profit, and feel a strong sense of self-importance.
    ICD-11 Description: The core feature of the Antagonism (or Dissociality) trait domain is disregard for the rights and feelings of others. Common manifestations of Antagonism (or Dissociality) include: self-centeredness (e.g., sense of entitlement, expectation of others’ admiration, positive or negative attention-seeking behaviors, selfishness); and lack of empathy (i.e., indifference to whether one’s actions hurt others, which may include being deceptive, manipulative, and exploitative of others, being mean and physically aggressive, callousness in response to others' suffering, and ruthlessness in obtaining one’s goals).
    Descriptors: Dishonest, arrogant, callous, rude, manipulative, aggressive, irresponsible.
    • Callousness:
      • Am not interested in other people’s problems
      • Can’t be bothered with other’s needs
      • Am indifferent to the feelings of others
      • Take no time for others
      • Don’t have a soft side
    • Manipulativeness:
      • Insult people
      • Believe that I am better than others
      • Take advantage of others
      • Seek conflict
      • Love a good fight
      • Am out for my own personal gain
    • From International Personality Item Pool:
      • Use flattery to get ahead
      • Believe in eye for eye
      • Distrust people
      • Look down on others
      • Have a sharp tongue
      • Think highly of myself
    Language Characteristics: Problem talk, dissatisfaction, little empathy, many personal attacks, many commands or global rejections, few self-references, many negations, many swear words, many threats, little politeness, few insight words.
    Video Example: Here is an example of a very antagonistic person - President Trump at a Mississippi political rally.
    Screening Questions:
    • "It’s no big deal if I hurt other peoples’ feelings."
    • "I crave attention."
    • "I often have to deal with people who are less important than me."
    • "I use people to get what I want."
    • "It is easy for me to take advantage of others."
    • "Others see me as irresponsible."
    * Attention Seeking:
    "I like to draw attention to myself."
    "I crave attention."
    "I do things to make sure people notice me."
    "I do things so that people just have to admire me."
    "My behavior is often bold and grabs peoples' attention."
    * Arrogance:
    "I'm better than almost everyone else."
    "I often have to deal with people who are less important than me."
    "To be honest, I'm just more important than other people."
    "I deserve special treatment."
    * Manipulation:
    "I use people to get what I want."
    "It is easy for me to take advantage of others."
    "I'm good at conning people."
    "I am out for my own personal gain."
    * Callousness:
    "It's no big deal if I hurt other people's feelings."
    "Being rude and unfriendly is just a part of who I am."
    "I often get into physical fights."
    "I enjoy making people in control look stupid."
    "I am not interested in other people's problems."
    "I can't be bothered with other's needs."
    "I am indifferent to the feelings of others"
    "I don't have a soft side."
    "I take no time for others,"
    ("Agreeableness vs. Antagonism" modified from "PID-5" by Kreuger RF, Derringer J, Markon KE, Watson D, Skodol AE and Between facets and domains: 10 aspects of the Big Five) [More Information]
    *MRI Research:
    Testing predictions from personality neuroscience. Brain structure and the big five.



    Back to top



    Comment by Phillip Long MD (Psychiatrist and Editor):


    It's A Wonder We're Still Alive

    The Man Who Saved The World


    The Man Who Saved The World

    The world barely avoided being annihilated in 1983. On 26 September 1983, the satellite early warning system of the Soviet Union erroneously reported an incoming attack against Russia by American intercontinental missiles. Russia has a "launch on warning" policy whereby it launches its missiles against America on the first warning of an incoming American missile attack.

    Fortunately this missile attack warning was correctly identified as a false alarm by Stanislav Petrov, lieutenant colonel of the Soviet Air Defence Forces. Petrov's decision to disregard the erroneous satellite warnings is credited with having prevented a retaliatory nuclear attack on the United States and its NATO allies that could have resulted in large-scale nuclear war.

    Stanislav Petrov had the courage to disobey his military orders (to "launch on warning") because of his personal knowledge and convictions. He knew that launching a large-scale nuclear war would annihilate humanity, and he knew that the Russian early warning system could not be trusted.

    9 Times the World Was at the Brink of Nuclear War — and Pulled Back

    Due to human error, there have been nine times that the world was at the brink of nuclear war — but pulled back. Accidental false alerts which could trigger a nuclear war are not a rare occurrence. Given how incompetent our nuclear "launch on warning" system is - it is a miracle that we haven't already annihilated all life on earth.



    The 2 Men Who Could End The World

    America and Russia possess 93% of the world's nuclear weapons. Thus Valdimir Putin and President Trump are the only two people on earth who could single-handedly start a nuclear World War III and thus annihilate all life on our planet.

    The problem now is that the leaders of Russia and America have severe personality flaws that make them incapable of appreciating the enormity of harm that they may cause.

    Both Vladimir Putin and President Trump have Antisocial, Narcissistic, and Paranoid Personality Disorders.

    Why is the mental health of Vladimir Putin or President Trump important?

    The world's fate is now in the hands of two leaders who have the following severe personality flaws:

    Antisocial Personality Disorder

    Narcissistic Personality Disorder

    • Arrogance:
      Being boastful or excessively proud; offensive display of superiority or self-importance.

    • Manipulation:
      Exploiting, conning, or taking unfair advantage of others.

    • Callousness:
      Lack of guilt or remorse about causing others harm; indifference to the suffering of others.

    • Attention Seeking:
      Trying to be the center of attention; being overly dramatic or flamboyant.

    Paranoid Personality Disorder

    • Suspiciousness:
      Suspecting, without sufficient basis, that others are harming or deceiving him.

    • Bearing grudges:
      Blaming others; seeking revenge

    • Being Hot-Headed:
      Easily angered; quick to take offense; unable to take criticism, blame or rejection.


    Tony Schwartz wrote "The Art of the Deal" for Donald Trump, and spent 18 months in Donald Trump's office observing him in order to write this Donald Trump biography. In 2016, immediately before the presidential election, Tony Schwartz gave a scathing lecture entitled "The Truth About Trump" at Oxford University. Every American who voted for President Trump should watch this Oxford lecture video.

    Jan. 29, 2017: Alexandre Bissonnette, a white, 27-year-old, French-Canadian male far right extremist shot 25 Muslims in the back while they were at prayer in their mosque in Quebec City, Canada. Six were killed, 5 were hospitalized in critical condition, and the other wounded required only brief hospitalization. All of Canada mourned this barbaric act of senseless hatred against Muslims. Canadians are now asking how can the flood of far right anti-Muslim hatred coming into Canada from other countries be stopped? Take a good look at where the far right anti-Muslim hatred is taking us. [Racism can be untaught: How getting beat up taught a new Canadian not to be racist]

    P.S. In the past 2 years, Canada has accepted more than 40,000 Syrian refugees. Not one of these Syrian refugees has attempted a terrorist attack in Canada or America.

    A Counterargument To President Trump's Xenophobia:
    (Interview with Jack Ma, a Chinese businessman worth US$ 35 billion) "In the past 30 years, America has had 13 wars spending US$ 14.2 trillion . What if they spent a fraction of that money building up [America's] infrastructure, and helping white collar and blue collar workers? ... You are supposed to spend money on your own people. The money has gone to Wall Street. And what happened? In 2008, the financial crisis wiped out US$ 19.2 trillion in USA alone, and destroyed 34 million jobs globally . What if that money wasn't spent on Wall Street? What if that money was spent on middle America and the rest of the United States developing the industry there? So it's not the other countries stealing jobs from America, it is your strategy [over-spending on war and on Wall Street]. You did not distribute your money in the proper way."

    Tyrants Have A Dangerous Combination of Personality Disorders



    All of history's worst tyrants had the same combination of Narcissistic + Paranoid + Psychopathic (Antisocial) Personality Disorders.

    Social Skills That Are Lacking In History's Worst Dictators

    PERSONALITY DISORDER LACKING LACKING LACKING
    Paranoid Personality Trust (had suspiciousness) Forgiveness (had bearing grudges) Gratitude (had feeling victimized)
    Narcissistic Personality Humility (had arrogance) Cooperation or generosity (had manipulation) Compassion (had callousness)
    Antisocial/Psychopathic Personality Respect (had disrespect) Responsibility (had irresponsibility) Honesty (had dishonesty)


    The Rise of a Tyrant

    In the beginning, the tyrant's followers believe that the tyrant's narcissism represents a confident, "strong man" who would lead their nation to greatness. The tyrant uses his own paranoia to mobilize his followers' fears and anger toward "the enemy". A tyrant will say and do whatever he has to in order to gain power. Once the tyrant gains power, it becomes obvious that all the tyrant ever cared about was his own fame, fortune and power. Once entrenched in power, the tyrant's deadly psychopathic (antisocial) traits become more apparent. First, the tyrant centralizes all political, military and economic power around himself and his cronies. Then the tyrant solidifies his power by imprisoning or killing all those that oppose him.

    Thus narcissistic-paranoid-psychopathic individuals should never be allowed to gain political power because of the great danger that they will become tyrants.

    Former President Obama voiced a warning about the rise of tyrants.




    Dictators have a total disregard for the casaulties they cause in war. To them, war is just a chess game, and soldiers are just pawns to be sacrificed. For example, during the Napoleonic Wars, Napoleon had 3 million troops, of which 1.7 million were killed. The following movies depict how Napoleon sacrificed his troops for his own personal glory and wealth.



    Waterloo (full movie)

    Napoleon (full movie)


    This second, full-length movie about Napoleon gives a better depiction of his personality. Note especially how, like all dictators, Napoleon would be diagnosed as having Narcissistic Personality Disorder using the following diagnostic criteria:

    An individual diagnosed with Narcissistic Personality Disorder needs to show at least 5 of the following criteria:

    • Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
      Napoleon didn't have to invade Russia. By 1812, Napoleon had conquered all of Europe except Russia. He could have stopped there, but decided to attack Russia solely to add to his conquests and to increase his glory.

    • Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
      Napoleon was consumed by his unlimited ambition to conquer all of Europe.

    • Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
      Although of lowly birth, Napoleon always aspired to be a king and live in aristocratic splendor, associating only with European aristocracy.

    • Requires excessive admiration.
      Napoleon went to extremes to stiffle the free press and to constantly release propaganda that lionized him and his accomplishments.

    • Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations.
      Napoleon sacrificed the lives of 1.7 million of his soldiers so that he could pursue his grandiose dream of conquering Europe.

    • Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends.
      Napoleon repeatedly exploited his wives and lovers for his own advantage.

    • Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
      Napoleon attacked Russia with 680,000 of his soldiers; yet only 22,000 survived this defeat. Nevertheless, Napoleon returned to Paris and tried to portray this collosal defeat as only a temporary retreat. He later raised another army and callously led them to be slaughtered at the battle of Waterloo. To Napoleon, his soldiers were just replaceable pawns in a military game of chess.

    • Is often envious of others or believes that others are envious of him or her.
      Napoleon was constantly comparing his glory to that of other European kings.

    • Shows arrogant, haughty behaviors or attitudes.
      Napoleon insisted on living like an European monarch, surrounded by the finest that money could buy. He showed no compassion for the poor.

    Were it not for the blind obedience of their followers, dictators could never continue their endless quest for fame, fortune and power.

    The story of Adolf Hitler will always be a testament to how extremely dangerous a leader with Paranoid + Narcissistic + Psychopathic Personality Disorder can be. The following documentary movie is an excellent summary of the senseless slaughter of millions caused by Adolf Hitler.

    Adolf Hitler (1 hour documentary)

    One Holocaust Survivor's Story (3-minute video)


    Hate-filled, Hitler-like individuals with Paranoid + Narcissistic + Psychopathic Personality Disorder must be stopped before they ever assume power.




    The Philippine tyrant, Rodrigo Duterte, has orchestrated the killing of 20,000 drug addicts since his election as president in 2016.

    The Philippines elected a tyrant, Rodrigo Duterte, as their new president. Duterte said he has personally killed 1,700 criminals, and promises to kill 100,000 criminals as President. After being elected, Duterte said he would give a medal to anyone who kills a drug dealer or addict.

    Duterte also promised that he would kill journalists - "Just because you're a journalist you are not exempted from assassination, if you're a son of a bitch." He even called the Catholic Bishops who criticized him "sons of whores".

    This Philippine tyrant was duly elected - just like Hitler was in Germany. Like Hitler, this new Philippine tyrant wants to immediately rewrite his nation's constitution.

    Just as he promised, in his first three months in office, Duterte orchestrated the killing of more than 3,000 people. Most of the deaths were caused by police and government-sanctioned death squads.

    Philippino police now immediately execute suspected drug traffickers and addicts on the street without a trial. Duterte invites citizens to do likewise. Now Philippinos can freely kill their enemies as long as they claim their enemy is a drug trafficker or addict.

    In a democracy, tyrants get elected by promising to make their nation great again by restoring "law and order" (e.g., Hitler, Philippine President Duterte). The irony is that, once in power, the tyrant unleashes a rule of terror and bloodshed.

    The tragedy unfolding in the Philippines stands as a warning to not elect a leader that has the personality profile of a tyrant - namely the combination of narcissistic, paranoid and psychopathic personality disorders.

    Duterte has now accused his political enemies of having links to the drug trade. Apparently Duterte wants to have show trials which will find his political enemies guilty, so that he can have them executed. Tyrants always kill their political enemies, and Duterte is no different.

    Comforting Fake News



    How We Prefer Fake News To The Upsetting Truth


    Tyrants know how to feed the fears and resentments of their audience. The tyrant's propaganda attempts to confirm their audience's existing prejudices and increase their paranoia. The above video explains how the phenomenon of "fake news" operates.

    What Tyrants Want You To Believe


    They were ruthless men with unchecked power, controlling their people with an iron fist

    The tyrant's propaganda promotes authoritarian, supremist beliefs like:

    • "The only way our country can get through the crisis ahead is to get back to our traditional values, put some tough leaders in power, and silence the troublemakers spreading bad ideas."

    • "The facts on crime, sexual immorality, and the recent public disorders all show that we have to crack down harder on deviant groups and troublemakers if we are going to save our moral standards and preserve law and order."

    • "The established authorities generally turn out to be right about things, while the radicals and protestors are usually just loudmouths showing off their ignorance."

    • "Some groups of people are simply inferior to others."

    • "To get ahead in life, it is sometimes necessary to step on other groups."

    • "Sometimes other groups must be kept in their place."

    How To Stop A Tyrant

    First Understand How Tyrants Seize Power

    • Promoting fear and hatred:
      Tyrants are demagogues who gain power and popularity by arousing fear and hatred. Tyrants do this by inflaming the prejudices of people by targeting minority groups (e.g., immigrants, refugees, blacks, drug addicts, Jews, Muslims) who they define as criminal. Tyrants then expand their incendiary rhetoric of fear and demonization to other groups as part of an attempt to deepen and expand a culture of terror and insecurity.

    • Promoting violence:
      The tyrants' incendiary rhetoric of fear, demonization and violence is aimed to embolden some of their followers to violence. For example, the Philippine tyrant, Rodrigo Duterte, has orchestrated the killing of 20,000 drug addicts since his election as president in 2016.

    • Destroying democratic institutions:
      Tyrants violently oppose all those who criticize them. Thus tyrants attempt to build power through aggressive attacks on their critics, media, and the judiciary. Evntually this involves jailing or murdering their political opponents.

    • Promoting the dictatorship of the rich over the poor:
      Tyrants attempt to centralize all political, economic, and military power under their control and that of their cronies. This usually takes the form of "fascist corporatism" wherein a few of the tyrant's cronies own massive corporations which control the nation's economy. This results in extreme income inequality between the few ultrarich and the remainder of the population who become poor.

    • Destroying civil rights and ethics:
      As tyrants consolidate their power; they progressively destroy civil rights and the rule of law. To the tyrant, all that matters is power, fame, and fortune. Tyrants are amoral. Thus tyrants and their cronies attempt to be above the law and literally get away with murder.

    • Promoting war:
      Tyrants eventually push their nations into aggressive (rather and defensive) war. All such wars are started just to expand the tyrants' financial holdings and that of their cronies. Eventually, such wars bankrupt the tyrant's nation.

    Counter The Tyrant's Propaganda

    To counter the tyrant's propaganda it is essential to promote democratic, egalitarian beliefs like:

    • "Everyone should have justice, freedom, equality, respect, and the ability to live in safety."

    • "Everyone should have their own lifestyle, religious beliefs, and sexual preferences, even if it makes them different from everyone else."

    • "Our country needs free thinkers who have the courage to defy traditional ways, even if this upsets many people."

    • "We should do what we can to equalize conditions for different groups."

    • "All groups should be given an equal chance in life."

    Counter The Tyrant's Power Grab

    Tyrants must not be allowed to:

    • Shut down the free press.

    • Override and corrupt the legal system.

    • Politically destabiliize the nation in order to make the tyrant's "strong man rule" appear essential for restoring "law and order".

    • Monopolize the nation's power and wealth.

    • Use fear-mongering and hatred to wip up national paranoia (and eventually war).

    William Wilberforce (1759–1833) Reformed A Very Immoral Nation



    William Wilberforce had more influence on the course of history than any other Englishman. It was primarily through his 30-year fight in the British parliament that slavery was finally abolished in the British Empire in 1832.

    What makes his accomplishment so remarkable was that Britain, and especially London, in his time was an extremely immoral, corrupt society. Wilberforce's accomplishment proves that individuals can rise above the immorality and political corruption of their time to change history forever for the better.

    How The Rich Neglect The Poor

    Certain very narcissistic individuals have amassed great power and wealth. They, and the corporations they control, do everything in their power to avoid paying their fair share of taxes. Although they may give millions to charity, many of their corporations avoid paying billions in taxes every year. In 2018, the world's richest corporation, Amazon, paid no taxes. Likewise, Microsoft avoided billions in taxes.


    60 of America's biggest companies paid no federal income tax in 2018 - CBS News




    Billionaire Bonanza 2018: Inherited Wealth Dynasties of the United States

    Income inequality in the US has a hit a record high. Meet the 15 richest American family 'dynasties,' who have a combined net worth of $618 billion.


    Bernie Sanders says 'billionaires shouldn't exist' as he rolls out a wealth tax plan that's even more aggressive than Elizabeth Warren's



    The 62 Richest People Are As Wealthy As The Poorest Half Of The World

    The richest 1% now own a staggering portion of the world's wealth

    Half of England is owned by less than 1% of the population

    The top 0.1% of American households hold the same amount of wealth as the bottom 90%

    What the 1% Don't Want You to Know

    All the ways billionaires like Jeff Bezos and Mark Zuckerberg spend their billions — from lavish real estate to vintage car collections

    Jeff Bezos got so rich in 2018 that he now makes more per minute than most people do in a year

    The wealth of these 8 men equals the bottom 50% of the entire world

    How Amazon gets away with not paying taxes


    Beware, fellow plutocrats, the pitchforks are coming | Nick Hanauer - TED

    Having Money Makes You Ruder And Less Empathetic




    The "Five Factor Model of Personality" as Shown In Dogs

    All animals have personalities - that is, consistent individual differences in behavior. Within virtually any population, some individuals are consistently more active, more aggressive, or are more willing to engage in risk-taking behavior. Thus the same "Big 5 Factors" of personality found in humans can be found in dogs.



    AGREEABLENESS VS. ANTAGONISM
    Agreeableness ("Friend")
    Dog is friendly towards unfamiliar people.
    Dog is friendly towards other dogs.
    When off leash, dog comes immediately when called.
    Dog willingly shares toys with other dogs.
    Dog leaves food or objects alone when told to do so.
    Antagonism ("Foe")
    Dog is dominant over other dogs.
    Dog is assertive with other dogs (e.g., if in a home with other dogs, when greeting).
    Dog behaves aggressively towards unfamiliar people.
    Dog shows aggression when nervous or fearful.
    Dog aggressively guards coveted items (e.g., stolen item, treats, food bowl).
    Dog is quick to sneak out through open doors, gates.

    CONSCIENTIOUSNESS VS. DISINHIBITION
    Conscientiousness ("Self-Controlled")
    Dog works at tasks (e.g., getting treats out of a dispenser, shredding toys) until entirely finished.
    Dog works hard all day herding or pulling a sleigh (if a "working dog" on the farm or in the snow). *
    Dog is curious.
    Disinhibition ("Disinhibited")
    Dog is boisterous.
    Dog seeks constant activity.
    Dog is very excitable around other dogs.

    OPEN-MINDEDNESS / INTELLECT VS. CLOSED-MINDEDNESS / IMPAIRED INTELLECT
    Intellect
    Dog is able to focus on a task in a distracting situation (e.g., loud or busy places, around other dogs).
    Impaired Intellect
    Dog is slow to respond to corrections.
    Dog ignores commands.
    Dog is slow to learn new tricks or tasks.

    EXTRAVERSION VS. DETACHMENT
    Sociality ("Approach")
    Dog is attention seeking (e.g., nuzzling, pawing or jumping up on family members looking for attention and physical contact).*
    Dog seeks companionship from people.
    Dog is affectionate.
    Detachment ("Avoidance")
    Dog is aloof.
    Dog gets bored in play quickly.
    Dog is lethargic.

    EMOTIONAL STABILITY VS. EMOTIONAL DISTRESS
    Emotional Stability ("Safety")
    Dog tends to be calm.
    Dog is relaxed when greeting people.
    Dog is confident.
    Dog adapts easily to new situations and environments.
    Emotional Distress ("Danger")
    Dog is anxious.
    Dog is shy.
    Dog behaves fearfully towards unfamiliar people.
    Dog exhibits fearful behaviors when restrained.
    Dog avoids other dogs.
    Dog behaves fearfully towards other dogs.
    Dog behaves submissively (e.g., rolls over, avoids eye contact, licks lips) when greeting other dogs.
    Modified from Jones, A. C. (2009). Development and validation of a dog personality questionnaire. Ph.D. Thesis. University of Texas, Austin.

    * New items added by Phillip W. Long MD

    The "Five Factor Model of Personality" In A Social Species

    The behaviors of the "Five Factor Model of Personality" serve adaptive functions that are vital to human survival. For example, when one individual approaches another, the individual must: (1) decide whether the other individual is friend or foe [ "Agreeableness" ], (2) decide if this represents safety or danger [ "Emotional Stability" ], (3) decide whether to approach or avoid the other individual [ "Extraversion/Sociality" ], (4) decide whether to proceed in a self-controlled or disinhibited manner [ "Conscientiousness" ], and (5) learn from this experience [ "Openness to Experience" ].

    Spider Personalities

    All animals have personalities (defined as consistent behavioral differences among individuals). Animals can consistently differ on: (1) Antagonism (e.g., aggression), (2) Disinhibition (e.g., risk taking), (3) Intellect (e.g., inventiveness), (4) Extraversion (e.g., assertiveness), and (5) Emotional Stability (e.g., calmness).

    Some social spiders live in colonies of up to several hundred individuals, and exhibit cooperative behaviours such as prey capture and maternal care. Researchers have found that spider personalities differ in aggressiveness:
    • Aggressive spiders are more likely to attack their mirror image than are shy spiders who are more likely to run away.
    • In a spider colony, individual spiders differ in degree of boldness (aggression) vs. shyness (nonaggression). [Aggressive spiders show shorter latencies to attack prey and to resume movement after a disturbance.] Hunting prey for these social spiders is a collective effort. The presence of a bold spider causes the shy spiders to become bolder which increases the effectiveness of their collective hunting effort. A positive feedback loop is established whereby hunting success increases spider boldness which increases future collective hunting success. However, when researchers removed these bold "leader" spiders, the collective hunting by the remaining spiders became less successful. The bold "leader" spiders thus were shown to have a disproportionately large impact on the group, and so were named "keystone individuals". Because of their special personality characteristic (boldness) the "leader" spiders performed a vital function (making the shy spiders bolder) which fascilitated collective social action.

      This research made the very important finding that the spiders modified each other's personalities. The bold spiders became bolder because of their hunting success. However their hunting success was entirely dependent upon gaining the collective support of the shy spiders. Likewise, the shy spiders owed their hunting success to being made bolder by association with the bold spider. Thus for more successful collective action, the bold "leader" spider needed to have followers, and the shy "follower" spiders needed to have a "leader". To make their collective social action more successful, the different spider personalities had to bring out the "best" in each other.

    The "Five Factor Model of Personality" and Personality Disorders

    The following diagram shows the relationship between the "Five Factor Model of Personality" and personality disorders. This diagram is based on the research of Sam Gosling, Jason Rentfrow, and Bill Swann, Gerard Saucier, Colin G. DeYoung, and Douglas Samuel and Thomas Widiger.


    Enlarge Image


    3D Models of How the Personality Disorders Are Correlated



    The DSM-IV personality disorders in the National Comorbidity Survey Replication study determined how personality disorders statistically correlated with each other. The above 3D model was created (by P.W. Long MD) from this correlational data.

    This statistical model shows that all of the personality disorders are highly correlated - they are overlapping entities that blend into each other with no clear boundaries. This 3D model groups personality disorders into two highly interrelated large clusters (named "greed" and "fear" by PWL).

    The fact that these personality disorders are so highly interrelated suggests that it is common for individuals to have multiple personality disorders.




    Section III of the DSM-5 presents an alternative model for personality disorders. Based on research findings, this model drops four personality disorders: Schizoid, Paranoid, Dependent, and Histrionic.

    The above 3D model shows the statistical correlations between personality disorders in this alternative DSM-5 model.

      Note: Borderline Personality Disorder plays a central role in this model. It is correlated to all of the other major personality disorders (except Schizotypal Personality Disorder). It could be argued that Borderline Personality Disorder may not be a true personality disorder. Instead, it may more represent chaotic instability - an advanced stage in which a previous stable personality disorder becomes unstable and goes from order into chaos. This would explain why Borderline Personality Disorder is usually diagnosed in combination with another personality disorder.

      Thus, it is argued, instead of diagnosing someone as having both "Naricissistic and Borderline Personality Disorders"; it would be more correct to diagnose "Narcissistic Personality Disorder with Emotionally Unstable Traits".

      Chaos theory states that balanced systems under stress can be pushed into instability. Specifically, as stress on a stable system is increased, a "tipping point" is reached wherein the system quickly goes from stability to instability. The following animated graphs illustrate this mathematical principle. The vertical (y) axis represents the stress level. As the stress level increases, a tipping point is reached whereafter the system becomes more unstable. (These animations recycle.)

      Logistic map animation.gif
      By Snaily CC BY-SA 3.0, The "tipping point" between stability and instability



      According to chaos theory, these animations could represent what happens when a personality disorder is under increasing stress. Initially, the personality disorder remains stable; then under increasing stress a tipping point is reached wherein the previously stable personality disorder becomes chaotic. Any further stress makes the personality disorder even more unstable.

      Thus the emotional instability, chaotic social functioning, and self-harming behavior of Borderline Personality Disorder could represent a chaotic, unstable state of a previously stable personality disorder.


    Primate Evolution

    There appears to be three different ways in which primates have evolved socially:

    • The chimpanzees have evolved to be socially antagonistic, competitive, callous, and manipulative. Chimpanzees are the only primates (apart from humans) that wage organized war. Thus chimpanzee social behavior most closely mirrors the antagonistic behavior of the antisocial-paranoid-narcissistic-histrionic-borderline cluster of personality disorders.

    • In contrast, the bonobos have evolved to be socially anxious, peaceful, cooperative, and loving. Thus bonobo social behavior most closely mirrors the emotional distress (anxious) behavior of the avoidant-dependent cluster of personality disorders.

    • Another separate evolutionary path was followed by the orangutans. They evolved to become solitary hermits. Thus orangutan social behavior most closely mirrors the detached behavior of the schizoid-schizotypal cluster of personality disorders.


    The Blueprint For Virtue Is Built Into Your DNA

    More than 2,300 years ago, the ancient Greek philosopher, Aristotle (384–322 BC), said: " What is the essence of life? To serve others and to do good. " Aristotle taught that "doing good" was synonymous with living a life of virtue. He believed these virtues were in keeping with the laws of nature.

    Aristotle and other ancient Greek philosophers believed that the main virtues were justice, self-control/moderation, wisdom, sociability, courage, and physical health.

    Psychological research now has shown that these virtues do predict success and good health. It can be argued that these virtues represent basic evolutionary principles that are evident at every level of our existence: physiological, psychological, and social.

    DNA, The Basis of Life

    First let's examine the chemical basis of life - the DNA molecule.



    • The DNA molecule is the foundation of all life on earth. DNA is a double helix molecule that is like a spiral ladder with rungs. Each rung on this ladder consists of 2 base pairs; altogether there are 4 bases used by DNA. These four bases are abbreviated A, T, C, and G. These 4 bases form the "4 letter chemical code" in DNA which stores all the chemical information necessary for life.

    • The DNA molecule's spiral ladder has millions of rungs (base pairs). Part of DNA's chemical code is read by messenger RNA (which takes it out of the cell nucleus to the nearby ribosomes who use this code to create proteins). All the DNA chemical code in our 46 chromosomes is estimated to be about 3.2 billion base pairs long.

    • Proteins are built as chains of amino acids, which then fold into unique three-dimensional shapes that have different functions. Proteins compose structural and motor elements in the cell, and they serve as the catalysts for virtually every biochemical reaction that occurs in living things.

    DNA Replication



    • The mutual attraction between opposite bases (G-C and A-T) allows for DNA replication, since the DNA molecule can divide lengthwise into two halves. Then each half can attract the necessary opposite bases to create a complementary new strand of DNA.

    • This chemical replication only works because of the mutual attraction between opposite base pairs.

    Virtues Manifested at The Physiological, Psychological, and Social Levels

    • Justice:

    • In terms of survival, it is better that members of a species cooperate. With one's own species, cooperation requires that an individual neither harms nor allows harm (which is the definition of justice). Justice requires mutually beneficial interaction in which no party gains an unfair advantage. It ensures service to the common good - not just good for the privileged few.

      • Physiological Level:

        [Evolutionary Principle] The Most Adaptable Survive

        Evolution isn't survival of the fittest; it is survival of the most adaptable.


        In evolution, it is not the strongest or smartest organism that survives - it is the organism that can best adapt to its changing environment.

        [Evolutionary Principle] Live In Harmony

        An organism must be able to flourish in harmony with its environment.


        For example, all the cells in a healthy body grow in harmony. Cancer represents the harmful breakdown in these harmonious cellular relationships. Cancer results from mutated DNA that is self-destructive because it causes uncontrollable growth which kills the organism and itself.

        [Evolutionary Principle] No Species Escapes Extinction

        Nothing lives forever; nearly all species that ever lived are now extinct. They did not survive the sudden climate changes that caused mass extinctions of nearly all life on earth. Fortunately, a few species did survive the last mass extinction.


        There have been five mass extinction events in Earth's history. In the worst one, 250 million years ago, 96 percent of marine species and 70 percent of land species died off. Humans almost went extinct 60,000 years ago when only approximately 1,000 humans survived a global drought. Nowadays, many scientists are predicting that we're on track for a sixth mass extinction due to human destruction of the environment. This human-caused mass extinction of life on earth is the greatest injustice that humanity has ever created.

      • Psychological Level:

        Justice means neither harming nor allowing harm.

        Injustice is more than just being deceitful (e.g., lying, stealing, cheating). Justice requires that we neither harm nor allow harm to others and our environment. Justice is the public manifestation of love.

      • Social Level:

        Social injustice occurs when one group unfairly harms another. Social justice requires that we treat others the way we want them to treat us.

        Evolution doesn't care if we are beautiful, strong, intelligent, or happy. Evolution only cares if we can flourish by living in harmony with others and our environment.

        Injustice occurs when groups or nations harmfully violate the rights of others. Once there is a breakdown in the rule of law, it is just a matter of time until the group or nation degenerates into corruption and a violent struggle for power.

        Humanity's survival now depends upon whether love, brotherhood, and peace can overcome hate, nationalism, and war.

    • Self-Control:

    • To survive, all organisms have homeostatic mechanisms that strive to balance their functioning at an optimal level between excess and deficiency. Some organisms have strong homeostatic mechanisms; hence their functioning is highly regulated and orderly. Other organisms have weak homeostatic mechanisms; hence their functioning is weakly regulated and disorderly or chaotic. [Golden Mean: The Greek poet Hesiod (c.700 bc) said that "moderation is best in all things'. Ancient Greek philosophers taught that self-control or moderation is about finding the Golden Mean or balance between two extremes, excess and deficiency.]

      • Physiological Level:

        [Evolutionary Principle] Maintain Stability By Self-Regulation (Homeostasis)

        Life involves constant change, and all organisms evolve ways to moderate these changes to maintain their stability (i.e., homeostasis). The goal of this homeostasis is to maintain optimal conditions for life (i.e., to avoid deficiency or excess).


        For example, DNA is self-controlling; it moderates its functioning by turning itself on or off depending upon its environment. Thus, by moderating its own functioning, DNA can better survive environmental change. However, there is a limit to how much change organisms can withstand (e.g., a fish out of water).

        [Evolutionary Principle] Certain Vices Shorten Life

        Certain excesses (smoking, obesity, and alcohol) damage DNA; hence must be seen as vices.


        "A major cause of aging is 'oxidative stress.' It is the damage to DNA, proteins, and lipids (fats) caused by oxidants, which are highly reactive substances containing oxygen. These oxidants are produced normally when we breathe, and also result from inflammation, infection, and consumption of alcohol and cigarettes. In one study, scientists exposed worms to two substances that neutralize oxidants, and the worms' lifespan increased an average 44%.

        Another factor in aging is 'glycation.' It happens when glucose, the main sugar we use as energy, binds to some of our DNA, proteins, and lipids, leaving them unable to do their jobs. The problem becomes worse as we get older, causing body tissues to malfunction, resulting in disease and death. Glycation may explain why studies in laboratory animals indicate that restricting calorie intake extends lifespan." [reference]

      • Psychological Level:

        Self-control and moderation in all things (i.e., good behavioral homeostasis) is the core feature of conscientiousness.

        Conscientious individuals have good homeostatic control of their behavior - it is neither excessively inhibited nor disinhibited. They are careful, responsible, hard-working, cautious, focused, and organized. In contrast, individuals lacking conscientiousness are careless, irresponsible, impulsive, easily distracted, and disorganized.

      • Social Level:

        Vices (behavioral excesses or deficiencies) must be controlled or they will destroy a group or nation.

        When a group or nation is overcome by its excesses (e.g. alcoholism, drug abuse, or corruption) or deficiencies (e.g. injustice or massive poverty); it withers and dies.

    • Wisdom:

    • Learning requires attention, reasoning, and memory. Of the 21 different hominids that have existed; 20 are now extinct. Only our species, homo sapiens, has survived. It appears evolution has favored our species, compared to the extinct hominids, because of our superior adaptability and ability to learn. [Our Attention May Blind Us: The biggest problem with learning is that our selective attention may blind us to much of what we see. We create our own reality - seeing only what we are interested in seeing. Thus we are blinded by our desires and biases.].

      • Physiological Level:

        [Evolutionary Principle] Experiment To Improve Adaptation

        Evolution creates better adapted organisms by using mutation and natural selection.


        The sugar-phosphate backbone of DNA preserves the specific order of the rungs on the DNA ladder. Chance mutation causes deletion (or multiplication) of these rungs. Sometimes the rung of one DNA molecule breaks off and attaches itself to another DNA molecule. Natural selection then determines if the mutated DNA survives better than the original DNA. If so, this mutated DNA creates a more adaptable organism. Without this constant experimentation and evaluation (mutation and natural selection), evolution would stop.

        [Evolutionary Principle] Replicate Experiments

        Evolution uses the scientific experimental method to discover the truth.


        Evolution is constantly experimenting - comparing the adaptive success of new DNA mutations against the success of their original DNA. As in science, evolution requires that the findings of its experiments be repeatedly replicated. This requirement for repeated replication of success eliminates unstable mutant DNA which can't successfully replicate its initial adaptive success.

        [Evolutionary Principle] Share Information

        Organisms survive because they genetically share adaptive information from one generation to the next.


        For example, all the information needed to create an elephant is coded in its 56 chromosomes. This also includes all the elephant's instinctual behaviors. That's an incredible amount of adaptive information passed by DNA from one generation to the next.

        [Evolutionary Principle] Have Contingency Plans

        In evolution, most of the information stored in DNA is contingency plans.


        Only a tiny amount of the information stored in DNA's base pairs tells how to make proteins. Far more of the information stored in DNA determines when and where these proteins are to be produced. Thus, DNA stores more information on contingency plans for "when" and "where" to do a task (e.g., produce protein) than it stores information on "how" to do it.

        [Evolutionary Principle] Use A Standardized Language To Share Information

        Every living cell stores all of the adaptive information that evolution has taught it by using the same "4 letter chemical code" (4 base pairs repeated billions of times) in its DNA.


        Without using this universal, standardized language to store information, evolution could not pass on adaptive information within the body or between generations.

        [Evolutionary Principle] Chance Directs Evolution

        Evolution is not guided by any plan; the direction it takes is determined solely by chance events.


        In evolution, there is no evidence of a grand plan, and that everything happened for a reason according to this universal plan. Instead, each organism's evolution was solely determined by random DNA mutation and natural selection.

        For example, our hominid lineage diverged from the ape lineage 7 to 8 million years ago. There were 21 hominid species - and 20 became extinct. Thus evolution tried 21 different experiments in creating hominids, and all proved to be evolutionary dead-ends - except our species, Homo sapiens. Our species has existed for about 100,000 years, and now we could be on the verge of extinction due to nuclear war or climate change.


      • [Evolutionary Principle] Expect Unexpected Consequences

        Making a small change in a complex system will often cause major unintended consequences.


        For example, when nature causes a DNA mutation or humans engineer a genetic modification, the unintended consequence can be: (1) a positive unexpected benefit (e.g. a recent spontaneous mutation in crayfish has produced a "super crayfish" that clones itself), or (2) a negative unexpected detriment (e.g. Monsanto genetically engineered its plants to make them resistant to the most used herbicide, Roundup [glyphosate], in order to help their plants survive during weed spraying. Monsanto's plants did become resistant to this herbicide, but this promoted the development of the same resistance in several weed species and insects. Now millions of acres of U.S. farmland have been destroyed by these pesticide resistent "superweeds" and insects.)

        [Evolutionary Principle] Nature Constantly Changes

        Everything in nature cycles and eventually dies.


        DNA has a built-in time bomb (shortening of its telomeres with each reproduction) that causes it to age. Old DNA doesn't divide: thus all organisms eventually die.

        Cancer occurs when DNA fails to age and keeps dividing until the resulting unchecked cell growth destroys the organism. Thus, nature prevents continuous growth; hence "no tree grows to heaven". Similarly, the competing forces in nature ensure that nothing remains the same - everything cycles.


      • Psychological Level:

        Humans are rational animals that evolution has given the ability to reason and learn. Wise, open-minded individuals that ask "why?" consistently outperform close-minded individuals that never question "why?". The hallmark of open-minded individuals is their curiosity and willingness to logically experiment and make mistakes in order to learn.

        Throughout human history, open-minded, inventive, quick learning individuals prospered better than close-minded, uncreative, and slow learning individuals. Open-minded individuals are more likely to gather relevant information and create contingency plans before they act.

        Wise individuals that keep a record of their progress (in diaries, business records, etc.) outperform those individuals that don't keep such records.

        Such records allow individuals to look back over the years to analyze their successes and failures. Otherwise, without these backup records, individuals must rely on their notoriously faulty memories. The most efficient record keeping involves using: (1) standardized language to avoid confusion, and (2) mathematically quantified data.

      • Social Level:

        War is the greatest threat to civilization and the accumulation of knowledge. Those that start wars never foresee war's unexpected consequences.

        History's Dark Ages occur when wars cause a collapse of civilization. The worst Dark Age occurred at the end of the Bronze Age around 1200 BC. For 40-50 years, war destroyed all the ancient Mediterranean civilizations (except Egypt's, which came close to collapsing). Almost every significant city in the eastern Mediterranean world was destroyed. These cultures (except Egypt) lost their literacy, political organization, and ability to build cities or conduct international trade. Their people barely survived and were forced to return to simple, small village life.

    • Sociality:

    • In a social species, social networking is vital for survival since it permits cooperation and sharing of information. Single celled organisms banded together to form multicellular organisms because of the additional survival benefits that such multicellular cooperation bestowed upon them.

      • Physiological Level:

        [Evolutionary Principle] Combine Forces

        Sharing of genetic diversity speeds up evolution.


        The genetic sharing of DNA during sexual reproduction increases genetic diversity, which speeds up evolution. Even single-celled organisms, like bacteria, survive better in diverse communal groups (where they can exchange their DNA), rather than surviving as solitary organisms.

      • Psychological Level:

        Sociality increases one's chances for survival.

        Individual humans are too weak to survive solo; human survival requires that individuals cooperate for mutual benefit. Socially outgoing individuals, compared to solitary individuals, are more likely to acquire adaptive information from others in a social group. Also socially outgoing individuals belong to more social networks; hence are more likely to receive social support in times of need.

      • Social Level:

        Like all social species, humans form dominance hierarchies ("pecking orders").

        Humans survive better living in social groups. These groups permit specialization of labor which dramatically increases the group's productivity - hence its chances for survival.

        All social species, including humans, organize their social groups in terms of dominance hierarchies ("pecking orders"). Such dominance hierarchies unequally distribute power and wealth within the group. For humans, a child on the bottom of our dominance hierarchy is often chronically hungry, unsafe, or neglected.

        Nature establishes social dominance hierarchies as a cruel survival strategy which maximizes the adaptive advantages for those at the top of the dominance hierarchy at the expense of those at the bottom. This is often a matter of life and death because, when the social group is stressed by famine or disease, it is those at the bottom of a social dominance hierarchy who are most likely to starve or die.

        Social groups and nations that freely share adaptive information are the most likely to succeed.

        Nations that freely share information democratically support freedom of speech and of the press, universal education, social equality, social mobility, and social mixing of their members. This social sharing and mixing strengthens the social cohesiveness of these groups and improves their quality of life.

    • Courage:

    • An organism's primary objective is to stay alive; hence it must be able to differentiate safety from danger. Courage, like everything else, must be exercised in moderation. Too little courage results in cowardice, and too much courage results in foolish recklessness. [Fight-Flight-Freeze-Fantasize: There are three main coping strategies that all animals use: (1) "Fight" or angry attack, (2) "Flight" or fearful retreat, and (3) "Freeze" or depressive immobilization. Humans uniquely have a fourth main coping strategy, "Fantasize", in which they respond to stress by creating comforting delusions or false beliefs which are strongly held against all evidence to the contrary.]

      • Physiological Level:

        [Evolutionary Principle] Remain Stable

        The DNA molecule is extremely stable.


        During evolution, natural disasters have caused repeated near-total mass extinctions of all life on earth; yet life has always recovered. Now DNA life forms have spread to virtually every corner of our planet, and humans have spread to every continent.

      • Psychological Level:

        Courage involves remaining calm and emotionally stable in the face of adversity.

        Courage doesn't mean rushing headlong into danger. The courageous person will assess the situation, and take the appropriate "fight/flight/freeze/fantasize" response that best solves the problem. There is no one response that is always right. Individuals must remain calm and emotionally stable while facing adversity - otherwise strong emotion can severely impair their problem-solving ability.

      • Social Level:

        Leaders must instill courage in their followers in order to maintain morale.

        Once a group loses its courage, and its morale is broken, it quickly becomes dysfunctional.

    • Physical Health:

    • In order to stay alive; an organism must maintain its physical health.

      • Physiological Level:

        [Evolutionary Principle] Evolution's Only Goal Is Survival

        Evolution selects for traits that help organisms survive, but doesn’t necessarily find optimal solutions.


        The goal of evolution is to create living organisms - even if they aren't perfect. Thus, evolution has produced many types of organisms - some are in a gray area between living and nonliving (e.g., viruses), the majority are single-celled (e.g., bacteria), and a few are multicellular (e.g., most animals and plants). It is an error to believe that the sole purpose of evolution is to create more complex or intelligent organisms. In terms of global biomass, single-celled organisms far outweigh multicellular organisms. So, in that sense, evolution has favored single-celled, unintelligent organisms.

        [Evolutionary Principle] Avoid Extremes

        Nature hates extremes and rewards moderation.


        The optimal conditions for DNA survival are usually the midpoint between deficiency and excess. For example, DNA thrives at the temperature of liquid water, but is destroyed when water freezes or boils. Organisms flourish when they maintain their functioning in the midpoint between deficiency and excess. Nature punishes those organisms that slip into conditions of deficiency or excess.

      • Psychological Level:

        Our physical vices are leading causes of disability and death.

        Usually virtue is physically helpful; whereas vice is physically harmful. The modern vices of cigarette smoking, alcohol and drug abuse, sedentary lifestyle, obesity, and unsafe sex are leading causes of physical disability and death. Chronic users of cigarettes lose 13% of their expected lifespan, chronic users of alcohol lose 29%, chronic users of cocaine lose 44%, chronic users of methadone lose 49%, chronic users of heroin lose 52%, and chronic users of methamphetamine lose 53% of their expected lifespan.

      • Social Level:

        Leading global risks:

        The leading global risks for mortality in the world are high blood pressure (responsible for 13% of deaths globally), tobacco use (9%) , high blood glucose (6%), physical inactivity (6%) , and overweight and obesity (5%) .

        The leading global risks for burden of disease as measured in disability-adjusted life years (DALYs) are underweight (6% of global DALYs) and unsafe sex (5%) , followed by alcohol use (5%) and unsafe water, sanitation, and hygiene (4%).

        Globally, it appears that "modernization" increases addiction, sedentary lifestyle, obesity, unsafe sex, environmental destruction, and disastrous climate change. Thus, our modern civilization may severely impair our future evolution, or lead to our own extinction. [The Second Law of Thermodynamics: In physics, this law states that, in order to create order in one part of a system, more disorder (entropy) is automatically created in another part of the system. This law would predict that, in order to create and maintain our civilization, we will automatically create greater disorder and chaos in our environment. This is a chilling prediction given what is currently happening with climate change.]


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