Malignant narcissism

Malignant narcissism is a theoretical personality disorder construct conceptually distinguished from typical narcissistic personality disorder (NPD) by the presence of antisocial behavior, egosyntonic sadism, and a paranoid orientation, while still retaining some capacity for guilt and loyalty.

Malignant narcissism is not recognized as a diagnostic category in any major classification system for mental disorders, namely DSM-5-TR, or ICD-11, the latter of which diagnoses personality disorders dimensionally rather than categorically. Rather, it is conceptualized as a subcategory of NPD. Although it is not recognized as its own distinct disorder, the Alternative DSM-5 Model for Personality Disorders - presented in section III of both DSM-5 and DSM-5-TR - explicitly mentions "malignant narcissism" as an example of a case when additional antagonistic traits characteristic of antisocial personality disorder may be specified for NPD.

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