Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Narcissistic Personality Disorder


Related Terms

  • Ego Personality Disorder

Differential Diagnosis

Specialists

  • Clinical Psychologist
  • Psychiatrist

Comorbid Conditions

  • Any other psychiatric illness
  • Substance abuse

Factors Influencing Duration

Influences from their interpersonal relationships and job, if unstable, affect length of disability. Loss or rejection, even if resulting from their own behavior, creates further stress and more dysfunctional behavior that lengthens disability.

Medical Codes

ICD-9-CM:
301.81 - Narcissistic Personality Disorder

Diagnosis

History: Narcissistic personality disorder often presents in combination with another personality disorder such as borderline, histrionic, antisocial, or passive-aggressive. This can complicate making the diagnosis.

According to the Diagnostic and Statistical Manual of Mental Disorders, both 4th Edition, Text Revision (DSM-IV-TR) and 5th Edition (DSM-5), individuals with narcissistic personality disorder show a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy beginning by early adulthood and present in a variety of contexts. Five or more of the DSM-IV-TR/DSM-5 criteria need to be met for this diagnosis. These include a grandiose sense of self-importance and expectation of being recognized as superior without commensurate achievements; a preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love; a belief that he or she is "special" and unique and can only be understood by or should associate with other special or high-status people (or institutions); a need for excessive admiration; a sense of entitlement (unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations); interpersonal exploitation (takes advantage of others to achieve his or her own ends); a lack of empathy and an unwillingness or inability to recognize or identify with the feelings and needs of others; envy of others, or a belief that others are envious of him or her; and arrogant, haughty behaviors or attitudes (DSM-IV-TR, DSM-5).

Individuals with narcissistic personality disorder may handle the aging process poorly as they value beauty, strength, and youthful attributes. They have a tendency to frequently seek cosmetic surgery, especially when it is not necessary. Family history may reveal an emotionally distant parent who tried to mold the individual according to the parent's needs. Individuals with narcissistic personality disorder often have trouble forming intimate relationships and are overly sensitive to criticism and disapproval and may be emotionally labile.

Physical exam: The physical exam is not particularly useful in diagnosing this disorder. Observation of the individual's orientation, dress, mannerisms, behavior, and content of speech provide essential clues in diagnosing this illness.

Tests: In conjunction with the individual's history, the psychiatric interview and mental status examination are the main tools leading to diagnosis of this disorder. A variety of psychological tests can be done, including the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Eysenck Personality Inventory (EPI), which may help identify and classify personality disorders; however, none of these tests provide a foolproof diagnosis.

A urine toxicology screen should be done, because many individuals with personality disorders are also substance abusers. A screening for sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection, should also be done, because lack of impulse control may put the individual at a higher risk of contracting STDs.

Note: It must be kept in mind that just because a physical diagnosis cannot be established as the cause of the presenting symptomatology, it does not necessarily mean that the cause is a mental one. That is to say that the presence of medically unexplained symptomatology does not necessarily establish the presence of a psychiatric condition. The first step in identifying the presence of a mental disorder is excluding the presence of malingering and/or of factitious disorder. Although factitious disorder is conscious and purposeful, it is classified as a psychiatric disorder. The strong need for this step is especially true whenever there is a medicolegal context associated with the presenting problem(s). Additionally, using DSM-5 and/or ICD-9-CM or ICD-10-CM, the clinician will find that many presentations fail to fit completely within the boundaries of a single mental disorder. There are systematic ways to go about making psychiatric diagnoses, however.

Source: Medical Disability Advisor






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