Prompt

A 36-year-old woman has been told she has 'narcissistic traits / possible NPD' after repeated workplace conflicts. She is offended, fears the label means she is 'evil and untreatable,' and asks whether medication will fix her personality. She recently had passive death wishes after a public performance review.

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the outpatient clinic. ^[1]

Candidate instructions. Explain what narcissistic personality patterns mean in plain language without moral attack, outline why structured talking therapy and a clear therapeutic frame are central, clarify that medication does not cure NPD itself, address shame-related suicide risk after criticism, and check understanding. The examiner plays the patient. ^[1]^[2]

References3Show

[1]Caligor E, Levy KN, Yeomans FE Narcissistic personality disorder: diagnostic and clinical challenges Am J Psychiatry, 2015.PMID 25930131
[2]Gabbard GO Narcissism and suicide risk Ann Gen Psychiatry, 2022.PMID 35065658
[3]Crisp H, Gabbard GO Principles of Psychodynamic Treatment for Patients With Narcissistic Personality Disorder J Pers Disord, 2020.PMID 32186987

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the outpatient clinic. ^[1]

References3Show

[1]Caligor E, Levy KN, Yeomans FE Narcissistic personality disorder: diagnostic and clinical challenges Am J Psychiatry, 2015.PMID 25930131
[2]Gabbard GO Narcissism and suicide risk Ann Gen Psychiatry, 2022.PMID 35065658
[3]Crisp H, Gabbard GO Principles of Psychodynamic Treatment for Patients With Narcissistic Personality Disorder J Pers Disord, 2020.PMID 32186987

Explain NPD formulation and treatment limits — CASC communication station

Station brief

Explain NPD formulation and treatment limits — CASC communication station

Station brief