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The spectrum of narcissistic disturbances described in the psychoanalytic literature is not reflected in the rather narrow criteria of the third revised edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R, American Psychiatric Association, 1987). Narcissistic personality disorder can be conceptualized as occurring on a continuum between two extremes. At one end of the continuum is the oblivious subtype, and on the other end is the hypervigilant subtype. These two entities may be distinguished by characteristic transference and countertransference patterns.
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