What is Narcissistic Personality Disorder (NPD)?
Narcissistic personality disorder is a disorder from the dramatic or emotional “B cluster” of personality disorders. It involves a pervasive pattern of grandiosity and superiority, where the sufferer shows an inflated sense of their own importance, significance, or value.
This sense of grandiosity exists in a person’s view of themselves, in fantasies, or in actual behavior. The person lacks empathy, behaves insensitively, and has an excessive need for admiration or praise. The pattern is long-term and will be evident quite early in life, certainly by early adulthood.
To diagnose narcissistic personality disorder, other disorders must first be ruled out.
Diagnostic Characteristics of Narcissistic Personality Disorder
Not all characteristics of narcissistic personality disorder manifest in the exact same way in different people. Diagnosis of narcissistic personality disorder requires a professional to use specialized clinical training.
In clinical diagnosis, a person is generally considered to have narcissistic personality disorder if they meet the criteria above, and if they display at least five of the following characteristics across many situations:
- Needs excessive admiration or praise
- An inflated sense of self-importance: Exaggerates their own achievements; or expects to be specially recognized with or without particularly outstanding achievements
- Displays attitudes or behaviors that are haughty, arrogant, or egotistical
- Unable to show empathy – cannot or will not recognize or identify with the feelings of others
- Exploits or takes advantage of others for his or her own ends
- Preoccupation with fantasies of outstanding brilliance or power, or perfect beauty or love
- A sense of entitlement; expecting compliance or favor unreasonably or automatically
- Often envies others and/or thinks that others envy him or her
- Believes that they are “unique” or “special”, and feels the need to stick with other people, organizations, or situations that have a similar “high status” or special importance
(Adapted from American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC, American Psychiatric Association, 1994)
Among mental health professionals, it is quite widely accepted that the behaviors of NPD usually compensate for conscious or unconscious insecurity, or fears about inadequate performance. They are an attempt to hold up a shaky brand of self-esteem - one which depends on feeling superior, on achieving some ideal of “success”, or on the perceptions of others.
The NPD personality may have elaborate internal or external defenses against any humiliation or damage to their self-esteem. Reactions to real or perceived criticism or failure are often minimization, denial, shock, contempt, or disdain; in other cases the reaction may be pronounced anger, depression, or embarrassment – whether displayed or hidden.
People with narcissistic personality disorder often do not recognize it in themselves, and rarely seek treatment for this disorder on their own account.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC, American Psychiatric Association, 1994
Michael B. First & Allan Tasman: Clinical Guide to the Diagnosis and Treatment of Mental Disorders, John Wiley and Sons, 2010