Rex Walls’ Narcissistic Personality Disorder and Analysis, in the Book ‘The Glass

The document is an academic paper titled "Rex Walls' Narcissistic Personality Disorder and Analysis in the Book 'The Glass Castle'". It uses the DSM-5 criteria to provide a retrospective analysis and diagnosis of the fictional character Rex Walls and discusses the etiology, prevalence, evidence-based treatments, and controversies surrounding Narcissistic Personality Disorder (NPD). Description The paper functions as a psychological case study of the character Rex Walls from Jeannette Walls' memoir, The Glass Castle. Analysis of Rex Walls: The paper asserts that Rex Walls exhibits the required symptoms for Narcissistic Personality Disorder (NPD) , aligning with several of the nine DSM-5 criteria: Exploitative/Manipulative: He uses deceit to make his family yield to his ideas and elude debt collectors. Arrogance/Grandiose: He displays an excessive sense of self-concept, believing himself to be clever and all-knowing, and is unsatisfied with others' ideas. He searches for admiration by constantly talking about his achievements and big dreams. Lack of Empathy: He is insensitive to his children's feelings, failing to consider the impact of removing his daughter from the hospital or making fun of his son's head injury. Etiology (Causes) and Prevalence: The exact cause of NPD is elusive, but risk factors are categorized as biological, environmental, and neurobiological. Environmental: Factors include harsh parenting, being a victim of bullying, and helicopter parenting, which may lead to exploitative behavior or excessive self-concept. Certain cultures that promote personal independence and individualism may also nurture the disorder. Biological: NPD has a genetic inheritability risk of at least 50%. Neurobiological: Structural deficits (e.g., low-level or lesions) in the anterior insular cortex (AIC), the part of the brain responsible for understanding others' feelings, are linked to NPD symptoms like poor empathy. Prevalence is estimated at 6% in the general population. It is more prevalent among males, young people, and racial minorities (e.g., African Americans). Evidence-Based Practice: Assessment: The Narcissistic Personality Inventory is a key tool used to assess NPD symptoms, which are then cross-checked against the DSM-5 criteria (requiring at least five of nine symptoms for diagnosis). Treatment: Individuals with NPD are often resistant to treatment. The most common interventions are: Dialectal Behavioral Therapy (DBT): Focuses on acknowledging reality and helping patients overcome undesired behaviors like self-centeredness and intolerance for criticism. Cognitive Behavioral Therapy (CBT): Effective, especially in group therapy with Motivational Interviewing, by promoting cognitive restructuring and reducing maladaptive core beliefs and behaviors