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What are the Causes of Narcissistic Personality Disorder?

written by: BettyHolt • edited by: Emma Lloyd • updated: 9/24/2010

Narcissistic Personality Disorder is named for the Greek god, Narcissus, who fell in love with his own reflection. Extreme self-absorption and a need for attention and admiration from others characterize this disorder. Find out here what causes it and who is at risk.

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    Narcissistic Personality Disorder

    Chances are that you've met up with some people in your life who feel that life revolves around them. They may come across as self-centered, manipulative, or demanding. Or they may seem charming, intelligent, and caring until you disagree with them or stop stroking their egos. Underneath the bravado is usually a fragile self-esteem. People with healthy self-esteem are able to have humility and don't value themselves more than others. Whether they are just narcissistic or have full-blown Narcissistic Personality Disorder is a matter of degree.

    The DSM-IV (Diagnostic Criteria of Mental Disorders) defines Narcissistic Personality Disorder as the following: 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, as indicated by at least five of the following:

    1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

    2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

    3. Believes 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)

    4. Requires excessive admiration

    5. Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations

    6. Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

    7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

    8. Is often envious of others or believes that others are envious of him or her

    9. Shows arrogant, haughty behaviors or attitudes

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    Causes and Risk Factors

    Narcissistic Personality Disorder is rare, affecting more men than women, and is usually evident by early adulthood. Some teenagers may seem to have narcissistic traits, but this is sometimes typical of their age and maturity level and doesn't necessarily mean they will eventually develop the full-blown disorder.

    There are two opposing schools of thought on the causes of narcissistic personality disorder. One viewpoint is that overly indulgent parents may give too much praise and admiration to their children, leading to a inflated sense of self which becomes pathological. A more recent theory is that parental neglect is the culprit. Even if we can't pinpoint the exact causes of narcissistic personality disorder, the following seem to be risk factors for developing it:

    1. Caregiving from parents which is either unreliable or unpredictable

    2. Emotional abuse and/or neglect during formative years

    3. Caretakers' disdain for needs or fears expressed by the child

    4. Learning how to manipulate others from parents' example

    5. Lack of praise and affection during childhood

    If the parents send a message that vulnerability is not acceptable, children may lose their ability to be empathetic to others' needs. They may also learn to cover up their own emotional needs with egotistical, grandiose behavior which makes them seem emotionally invulnerable.

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    Dealing With Narcissists

    Judith Orloff, a psychiatrist and author of Emotional Freedom, offers the following tips for dealing with narcissists:

    1. Don't fall in love with one and expect that they're able to give and take that true intimacy requires

    2. Enjoy their good qualities, but understand their emotional limitations

    3. Never allow them to determine your self-worth

    4. To successfully communicate with them, show how something will work to their benefit

    5. Don't expect that they will change much, even if they want to