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Impacto dos eventos de vida e padrões relacionais no desenvolvimento de perturbação da personalidade narcísica
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A Perturbação da Personalidade Narcísica (PPN) associa-se a um grande sofrimento psíquico e prejuízo funcional nas várias esferas da vida social, cursando com consideráveis dificuldades terapêuticas. O objetivo desta Revisão Sistemática é a comparação dos dados disponíveis sobre factores etiológicos envolvidos no desenvolvimento de Narcisismo Patológico e PPN, nomeadamente no que concerne ao relacionamento com as figuras parentais, à exposição a eventos traumáticos e outras circunstâncias capazes de condicionar os processos de socialização na infância. A pesquisa foi realizada nas bases de dados: MEDLINE, Academic Search Complete, APA PsycArticles, Psychology and Behavioral Sciences Collection e APA PsycInfo. Foram selecionados somente estudos originais, redigidos em Português, Inglês ou Espanhol, cujo foco incluísse a associação entre a PPN e/ou o Narcisismo Patológico e padrões relacionais estabelecidos com as figuras parentais e/ou eventos de vida. A análise final incluiu 9 artigos e foi realizada sob a forma de uma síntese narrativa e tabela de resumo.
Os resultados favorecem a existência de uma relação entre a PPN e estilos parentais autoritários, exposição a negligência e abuso físico (incluindo práticas de bullying no meio escolar) e baixo rendimento familiar. Os estudos também sugerem, embora sem conclusões claras, a potencial influência de outras variáveis e relações, tais como: a conduta parental permissiva e indiferente, o impacto materno e paterno diferencial sobre a PPN e uma possível variação na susceptibilidade e manifestações de PPN consoante o género dos pacientes.
Estes achados apoiam a relevância da inclusão destes fatores etiológicos numa abordagem multidimensional da PPN, com estabelecimento de terapêuticas direcionadas e implementação de medidas preventivas desde idades precoces, cuja aplicação seja transversal a instituições de saúde, meio escolar e ambiente familiar.
Narcissistic Personality Disorder (NPD) is associated with great psychological distress and functional impairment in the various spheres of social life, facing considerable therapeutic difficulties. The purpose of this systematic review is to compare the available data on etiological factors involved in the development of Pathological Narcissism and NPD, namely with regard to the relationship with parental figures, exposure to traumatic events and other circumstances capable of conditioning childhood socialization processes. The research was conducted in the databases: MEDLINE, Academic Search Complete, APA PsycArticles, Psychology and Behavioral Sciences Collection and APA PsycInfo. Only original studies, written in Portuguese, English or Spanish, whose focus included the association between NPD and/or Pathological Narcissism and relational patterns established with parental figures and/or life events, were selected. The final analysis included 9 articles and was carried out in the form of a narrative synthesis and summary table. The results favor the existence of a relationship between NPD and authoritarian parenting styles, exposure to neglect and physical abuse (including bullying in school settings) and low family income. Studies also suggest, albeit without clear conclusions, a potential influence of other variables and relations, such as: permissive and indifferent parental behavior, a differential maternal and paternal impact on NPD and a possible variation in susceptibility and manifestations of NPD depending on the patient's gender. These findings support the relevance of including such etiological factors in a multidimensional approach to NPD, with the establishment of directed therapies and implementation of preventive measures from an early age, which should be transversal to health institutions, school settings and family environment.
Narcissistic Personality Disorder (NPD) is associated with great psychological distress and functional impairment in the various spheres of social life, facing considerable therapeutic difficulties. The purpose of this systematic review is to compare the available data on etiological factors involved in the development of Pathological Narcissism and NPD, namely with regard to the relationship with parental figures, exposure to traumatic events and other circumstances capable of conditioning childhood socialization processes. The research was conducted in the databases: MEDLINE, Academic Search Complete, APA PsycArticles, Psychology and Behavioral Sciences Collection and APA PsycInfo. Only original studies, written in Portuguese, English or Spanish, whose focus included the association between NPD and/or Pathological Narcissism and relational patterns established with parental figures and/or life events, were selected. The final analysis included 9 articles and was carried out in the form of a narrative synthesis and summary table. The results favor the existence of a relationship between NPD and authoritarian parenting styles, exposure to neglect and physical abuse (including bullying in school settings) and low family income. Studies also suggest, albeit without clear conclusions, a potential influence of other variables and relations, such as: permissive and indifferent parental behavior, a differential maternal and paternal impact on NPD and a possible variation in susceptibility and manifestations of NPD depending on the patient's gender. These findings support the relevance of including such etiological factors in a multidimensional approach to NPD, with the establishment of directed therapies and implementation of preventive measures from an early age, which should be transversal to health institutions, school settings and family environment.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
Palavras-chave
Perturbação da personalidade narcísica Narcisismo patológico Figuras parentais Eventos traumáticos Etiologia Psiquiatria