768 Alternative DSM-5 Model for Personality Disorders
B. Both of the following pathological personality traits:
1.Grandiosity (an aspect of Antagonism ): Feelings of entitlement, either overt or co-
vert; self-centeredness; firmly holding to the belief that one is better than others;
condescension toward others.
2.Attention seeking  (an aspect of Antagonism ): Excessive attempts to attract and
be the focus of the attention of others; admiration seeking.
Specifiers. Trait and personality functioning specifie rs may be used to record additional
personality features that may be  present in narcissistic person ality disorder but are not re-
quired for the diagnosis. For example, other traits of Antagonism (e.g., manipulativeness, de-
ceitfulness, callousness) are not diagnostic criteria for narcissistic personality disorder (see
Criterion B) but can be specified when more pervasive antagonistic features (e.g., “malignant
narcissism”) are present. Other traits of Negative Affectivity (e.g., depressivity, anxiousness)
can be specified to record more “vulnerable”  presentations. Furthermore, although moderate
or greater impairment in person ality functioning is required for the diagnosis of narcissistic
personality disorder (Criterion A), the level of  personality functioning can also be specified.
Obsessive-Compulsive Personality Disorder
Typical features of obsessive-compulsive person ality disorder are difficulties in establish-
ing and sustaining close relationships, associated with rigid perfectionism, inflexibility,
and restricted emotional expression. Characteristic difficulties are apparent in identity,
self-direction, empathy, and/or intimacy, as described below, along with specific mal-
adaptive traits in the domains of Ne gative Affectivity and/or Detachment.
Proposed Diagnostic Criteria