Which disorder may lead individuals to experience a distorted self-image and requires a focus on self-esteem?

The disorder that often leads individuals to experience a distorted self-image and necessitates a focus on self-esteem is narcissistic personality disorder. Individuals with this condition typically have an inflated sense of self-importance and a constant need for admiration; however, beneath this façade often lies a fragile self-esteem that is highly sensitive to criticism. This combination can result in a distorted self-image, where individuals may perceive themselves in exaggerated terms or face significant anxiety when their self-worth is challenged.

In contrast to this, avoidant personality disorder involves a pattern of social inhibition and feelings of inadequacy, which leads to avoidance of social interactions. Although self-esteem is a factor, the primary concern is not the distorted self-image seen in narcissistic personality disorder.

Schizophrenia primarily involves a disconnection from reality, including hallucinations and delusions, rather than a focus on self-image or self-esteem issues.

Major depressive disorder can affect self-esteem but typically does so in a way that leads to feelings of worthlessness and hopelessness, rather than a distorted self-perception focused on self-importance.

Therefore, narcissistic personality disorder is identified as the disorder most aligned with experiencing a distorted self-image and is deeply intertwined with issues of self-esteem.