Clinical Assessment for NPD: Standardized DSM-5-TR Guide

CLINICAL ASSESSMENT RECORD: NARCISSISTIC PERSONALITY DISORDER (NPD)

DSM-5-TR STANDARDIZED EVALUATION PROTOCOL

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I. PATIENT IDENTIFICATION & DEMOGRAPHICS

Patient Name: [__________________________________________________]
Date of Birth: [____/____/________] Age: [______]
Assessment Date: [____/____/________] Practitioner: [__________________________________]
Clinical Facility: [__________________________________________________]
Case Reference ID: [__________________________________]

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II. CLINICAL PRESENTATION & DIAGNOSTIC CRITERIA

In accordance with DSM-5-TR (301.81), a pervasive pattern of grandiosity, need for admiration, and lack of empathy is indicated by 5 (or more) of the following criteria.

Please indicate presence (Yes/No) and provide brief clinical justification/evidence for each.

1. Grandiose sense of self-importance: (e.g., exaggerates achievements and talents)
   [ ] Yes [ ] No | Evidence: [__________________________________________________]

2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love:
   [ ] Yes [ ] No | Evidence: [__________________________________________________]

3. Belief that they are "special" and unique and can only be understood by/associated with other special/high-status people:
   [ ] Yes [ ] No | Evidence: [__________________________________________________]

4. Requirement of excessive admiration:
   [ ] Yes [ ] No | Evidence: [__________________________________________________]

5. Sense of entitlement: (e.g., unreasonable expectations of favorable treatment)
   [ ] Yes [ ] No | Evidence: [__________________________________________________]

6. Interpersonally exploitative behavior: (e.g., takes advantage of others to achieve ends)
   [ ] Yes [ ] No | Evidence: [__________________________________________________]

7. Lack of empathy: (e.g., unwilling to recognize/identify with feelings of others)
   [ ] Yes [ ] No | Evidence: [__________________________________________________]

8. Envy of others or belief that others are envious of them:
   [ ] Yes [ ] No | Evidence: [__________________________________________________]

9. Arrogant, haughty behaviors or attitudes:
   [ ] Yes [ ] No | Evidence: [__________________________________________________]

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III. CLINICAL SUMMARY & FUNCTIONAL IMPAIRMENT

Psychosocial Impact Assessment:
[__________________________________________________________________________]
[__________________________________________________________________________]

Diagnostic Impression:
[ ] Confirmed Narcissistic Personality Disorder (301.81)
[ ] Rule Out: [__________________________________________________]
[ ] Differential Diagnosis: [__________________________________________________]

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IV. RECOMMENDATIONS & TREATMENT PLAN

Recommended Modality:
[ ] Individual Therapy [ ] Group Therapy [ ] Pharmacotherapy [ ] Other: [__________]

Treatment Focus:
[__________________________________________________________________________]
[__________________________________________________________________________]

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V. AUTHORIZATION & SIGNATURES

I hereby certify that the information provided above is a true and accurate reflection of the clinical assessment conducted on the date specified.

Practitioner Signature:

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Date: [____/____/________]
License Number/Credentials: [________________________]

Witness/Supervisor Signature (if applicable):

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Date: [____/____/________]

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CONFIDENTIALITY NOTICE: This document contains sensitive medical information protected by HIPAA and relevant local privacy statutes. Unauthorized disclosure is strictly prohibited.

The Checklist: Clinical Assessment for NPD: Standardized DSM-5-TR Guide

Work through the list and tick each item as it is completed.

• Grandiose sense of self-importance: (e.g., exaggerates achievements and talents)

• Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love:

• Belief that they are "special" and unique and can only be understood by/associated with other special/high-status people:

• Requirement of excessive admiration:

• Sense of entitlement: (e.g., unreasonable expectations of favorable treatment)

• Interpersonally exploitative behavior: (e.g., takes advantage of others to achieve ends)

• Lack of empathy: (e.g., unwilling to recognize/identify with feelings of others)

• Envy of others or belief that others are envious of them:

• Arrogant, haughty behaviors or attitudes:

• Completed by: [Full name]

• Signature: ______________________

• Date: [Date]