Example of a Professional Psychological DSM-IV Report on Narcissistic Personality Disorder

Postal Address: Southern Rd, Southampton, Hampshire SO15 1AN, United Kingdom

Visiting Adress: Southern Rd, Southampton, Hampshire SO15 1AN, United Kingdom

Telephone: 101 or 999 (emergency)

Fax: (020) 1212 69 21

Email: mailto:[email protected]

Website: http://www.hampshire.police.uk

Southampton, 22 November 2014

Patient: Lance Blackthorn

Date of birth: 01-01-1987

SSN: 332154453

Case No: 03825

Instruments Administered: SSRI: 50mg

Reason for Referral:
The patient was referred to me for a work related issue. The Hampshire Constabulary referred Mr. Blackthorn after he conducted severe uncooperative and disruptive behavior during Case No. 03825.

Clinical interview of the patient:
At the beginning of the clinical interview I conducted on Lance, he sat in a very relaxed manner and showed littlie interest in contributing in our conversation as he typically looked away whilst fixing his hair and rarely replied in anything other than nippy smirks and remarks such as “what makes you think that I would speak you?” and “Why should I answer your questions when everyone here is just jealous of me?” Throughout the interview he began to open up, he spoke in a very clear and confident tone and often repeated facts of his proud achievements and how “it was easy, since it is difficult to find competition for someone like me.”

Lance does seem to enjoy hearing his own voice as he talked a lot after the initial silent treatment. Even without specific questions Lance was always very opinionated and self-righteous when discussing any topics and used words such as “I will, I want, I can, I know.” When Lance was asked why he chose to join the force he replied with: “Before; when I blessed people with my knowledge and criticism they just shrugged it off and did not listen to me, but now everyone has to do everything that I tell them to since what I say is the law!”

When Lance was asked what happened during Case No. 02714 my patient started to get worked up and immediately insisted that he did not do anything wrong and what he did was undoubtedly the correct action. According to Mr. Blackthorn he had the right to assault his partner, Det. Morgan since it was unacceptable to claim that he was not right. “What makes him think that he is better than me?” stated Lance when ranting about the subject. He ended our interview with the statement: “I know everyone is out to get me, well I guess it is normal to want what you can’t have.”

Clinical interview of a co-worker:
Detective Harrison Morgan was assaulted by my patient during Case No. 02714. Mr. Morgan commented on the fact that “ever since day one that self-righteous prick has been on everyone’s nerves, always telling people what to do and showing off, who does he think he is?” Mr. Morgan continued by explaining that in Lance’s year at the police station he has swapped partners three times, since “it is impossible, you cannot work with that guy.”

Mr. Morgan also expressed his take on the case. He explained how my patient abruptly started to shoot at the culprit, which was not planned and compromised the case. When Mr. Morgan expressed his opinion to Mr. Blackthorn, Lance started to punch him screaming, “How dare you!”

Clinical interview of the parents:
Lance’s mother, Mrs. Blackthorn started the interview by commanding me to stop this madness of accusing her perfect son. As a child Lance never had to face any real challenge as whenever something was bothering him, his parents would always righteously defend him. In school Lance insulted and got mad at teachers when he was told to carry out tasks. As a child Lance never addressed teachers and doctors correctly, often calling them by their first name whilst demanding to be called Mr. Blackthorn himself.

Lance Blackthorn was raised in an extremely sterile environment and therefore never learned to respect others or understand what they are feeling. He was educated in a way that lacked discipline or any kind of rules or constrictions.

Testing:
After conducting the interviews with each relevant individual it was clear that Lance suffers from severe NPD. My professional duty calls me to present each of my patients with a test to confirm my hypotheses.

The online test Lance took would evaluate to what extent of NPD he suffers from. The average score of this test is: 12 – 15. Celebrities have an average of 18. In conclusion Lance scored 33, which is 10 more than the average narcissist’s score. The test revealed that Lance showed clear distinctions in the superiority, entitlement and authority as he scored exceptionally high in these sections of the test.

Health History:
The physical health evaluation did not reveal any physical problems. In fact, the patient is quite fit as he has a low muscle to fat ratio. When tested against the Body Mass Index criteria my patient falls under the Normal Weight Category.

However, Mr. Blackthorn has been smoking ever since he was 15. The patient has never attempted to quit smoking cigarettes.

Current Medications:
None.

Intoxications:
Tobacco addiction.
Has a past record of alcohol abuse.

Employment:
Lance Blackthorn is employed by the Hampshire Constabulary; he has been serving the state as a detective since 2013.

Record:
• Case contributions – 28%
• Case solve rate – 62%

Partners (2013):
• Detective John Snow (9/13 – 1/14)
• Detective Jamie Lannister (2/14 – 7/14)
• Detective Harrison Morgan (current)

Academy Results:
• Field – 57% (verified by Deputy Captain Mustang)
• Written – 38% (verified by Deputy Captain Mustang)

Conclusion of psychological evaluation:
Lance Blackthorn is a textbook-example of an individual with Narcissistic Personality disorder as he displays traits that suggest so, such as a strong feeling of entitlement and authority. When expressing himself orally he is very self-righteous and comes across as extremely vain. He fails to understand why he should not be entitled to everything and is unable to take any form of criticism. Lance clearly struggles when working in a team as he never listens and expects his partners to accept every decision he makes. This condition may have occurred because of the excessive pampering my patient received from his conceited parents during his early childhood.

DSM-IV classification:
AS-I No Diagnosis

AS-II Narcissist Personality Disorder

AS-III EDE-Q

AS-IV Excessive parental pandering, unrealistic expectations set by parents, lack of siblings.

AS-V GAF: 52

Recommended treatment:
It has been concluded than Lance will attend group therapy, psychotherapy and CBT
twice a week and will be temporarily suspended from the police force. Lance will be
under the care of Li Shengshun, Johan Liebert and Fabio Cannavaro. If a lack of
improvement in Lance’s condition is noted during treatment admittance to Hampshire
Adult Conduct and Personality Disorder Unit (HACPDU) will be advocated.