301.81 Narcissistic Personality Disorder
(The official diagnostic manual used by mental health
The essential feature of this disorder is a
pervasive pattern of grandiosity (in fantasy or behavior),
hypersensitivity to the evaluation of others, and lack of empathy
that begins by early adulthood and is present in a variety of
People with this disorder have a grandiose
sense of self importance. They tend to exaggerate their
accomplishments and talents, and expect to be noticed as "special"
even without appropriate achievement.
They often feel that because of their
"specialness," their problems are unique, and can be understood only
by other special people. Frequently this sense of self-importance
alternates with feelings of special unworthiness. For example, a
student who ordinarily expects an A and receives a grade A minus may,
at that moment, express the view that he or she is thus revealed to
all as a failure. Conversely, having gotten an A, the student may
feel fraudulent, and unable to take genuine pleasure in a real
These people are preoccupied with fantasies
of unlimited success, power, brilliance, beauty, or ideal love, and
with chronic feeling of envy for those whom they perceive as being
more successful than they are.
Although these fantasies frequently
substitute for realistic activity, when such goals are actually
pursued, it is often with a driven, pleasureless quality and an
ambition that cannot be satisfied. Self-esteem is almost invariably
very fragile; the person may be preoccupied with how well he or she
is doing and how well he or she is regarded by others. This often
takes the form of an almost exhibitionistic need for constant
attention and admiration.
The person may constantly fish for
compliments, often with great charm. In response to criticism, he or
she may react with rage,shame, or humiliation, but mask these
feelings with an aura of cool indifference.
Interpersonal relationships are invariably
disturbed. A lack of empathy (inability to recognize and experience
how others feel) is common. For example, the person may be unable to
understand why a friend whose father has just died does not want to
go to a party. A sense of entitlement, an unreasonable expectation of
especially favorable treatment, is usually present. For example, such
a person may assume that he or she does not have to wait in line when
Interpersonal exploitativeness, in which
others are taken advantage of in order to achieve one's ends, or for
self-aggrandizement, is common.
Friendships are often made only after the
person considers- ers how he or she can profit from them. In romantic
relationships, the partner is often treated as an object to be used
to bolster the person's self-esteem.
Frequently, many of the features of
Histrionic, Borderline, and Antisocial Personality Disorders are
present; in some cases more than one diagnosis may be warranted.
Depressed mood is extremely common. Often the person is painfully
self-conscious and preoccupied with grooming and remaining youthful.
Personal deficits,defeats, or irresponsible behavior may be justified
by rationalization or lying. Feelings may be faked in order to
Some impairment in interpersonal relations
is inevitable, Occupational functioning may be impeded by depressed
mood,interpersonal difficulties, or the pursuit of unrealistic goals.
In other cases, occupational functioning may be enhanced by an
unquenchable thirst for success.
Dysthymia and psychotic disorders such as
Brief Reactive Psychosis are possible complications. Major Depression
can occur as the person approaches middle age and becomes distressed
by awareness of the physical and occupational limitations that become
apparent at this stage of life.
This disorder appears to be more common
recently than in the past, but this may be due only to more
professional interest in it. Predisposing factors, sex ratio, and
familial pattern. No information.
Borderline, Histrionic, and Antisocial
Personality Disorders are often also present; in such instances,
multiple diagnoses should be given. However, in comparison with
people with Antisocial Personality Disorder, people with Narcissistic
Personality Disorder tend to be less impulsive, and their
exploitation is more for the promotion of feelings of entitlement and
power than form material gain. They display less emotional
exaggeration than people with Histrionic Personality Disorder, and
are less intensely involved with, or dependent on, others. People
with Narcissistic Personality Disorder also tend to have a more
cohesive identity and to be less impulsive and emotional than people
with Borderline Personality Disorder.
links on the subject of narcissism: