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Narcissism and narcissistic personality disorder are subjects of great interest in contemporary society. The modern world, with its strongly individualistic values, encourages people to focus on themselves. Psychotherapy, although used to treat narcissism, is influenced by the same values, and runs the danger of making patients worse rather than better. This book, written from the perspective of empirical research in psychology, psychiatry, and the social sciences, suggests a different approach to psychotherapy, moving away from a focus on the self, and guiding patients to develop better social capital and social networks.

Personality disorders are pathological amplifications of normal personality traits. Although the form of personality pathology largely depends on underlying traits, which are under strong genetic influence, different social structures tend to reinforce some traits and discourage others. The most important social factors in the personality disorders are those risk or protective factors that influence the process by which traits are amplified. Modernity, most particularly an increasing rate of social change, is acting as a major stressor for individuals with many types of personality structure. The mechanisms most probably involve negative effects on family functioning, as well as a diminishing availability of buffering factors in the larger community.

Evolutionary principles can explain many aspects of human social behaviour. Despite important contro versies concerning the theory of sociobiology, evol utionary models offer cogent explanations for social phenomena such as altruism and parental investment. Evolutionary social science also has an important relevance for transcultural psychiatry, in that it is consistent with a biopsychosocial model for the etiology of psychiatric disorders, and points to the universals which underlie cultural variations in psychopathology.