Narcissistic Personality Disorder is characterized by a long-standing pattern of grandiosity (either in fantasy or actual behavior), an overwhelming need for admiration, and usually a complete lack of empathy toward others. People with this disorder often believe they are of primary importance in everybody’s life or to anyone they meet. While this pattern of behavior may be appropriate for a king in 16th Century England, it is generally considered inappropriate for most ordinary people today.
People with narcissistic personality disorder often display snobbish, disdainful, or patronizing attitudes. For example, an individual with this disorder may complain about a clumsy waiter’s “rudeness” or “stupidity” or conclude a medical evaluation with a condescending evaluation of the physician.
In laypeople terms, someone with this disorder may be described simply as a “narcissist” or as someone with “narcissism.” Both of these terms generally refer to someone with narcissistic personality disorder.
A personality disorder is an enduring pattern of inner experience and behavior that deviates from the norm of the individual’s culture. The pattern is seen in two or more of the following areas: cognition; affect; interpersonal functioning; or impulse control. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. It typically leads to significant distress or impairment in social, work or other areas of functioning. The pattern is stable and of long duration, and its onset can be traced back to early adulthood or adolescence.
Symptoms of Narcissistic Personality Disorder
In order for a person to be diagnosed with narcissistic personality disorder (NPD) they must meet five or more of the following symptoms:
- Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
- Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
- 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)
- Requires excessive admiration
- Has a very strong sense of entitlement, e.g., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
- Is exploitative of others, e.g., takes advantage of others to achieve his or her own ends
- Lacks empathy, e.g., is unwilling to recognize or identify with the feelings and needs of others
- Is often envious of others or believes that others are envious of him or her
- Regularly shows arrogant, haughty behaviors or attitudes
Because personality disorders describe long-standing and enduring patterns of behavior, they are most often diagnosed in adulthood. It is uncommon for them to be diagnosed in childhood or adolescence, because a child or teen is under constant development, personality changes and maturation. However, if it is diagnosed in a child or teen, the features must have been present for at least 1 year.
Narcissistic personality disorder is more prevalent in males than females, and is thought to occur in up to 6.2 percent of the general population.
Like most personality disorders, narcissistic personality disorder typically will decrease in intensity with age, with many people experiencing few of the most extreme symptoms by the time they are in the 40s or 50s.
How is Narcissistic Personality Disorder Diagnosed?
Personality disorders such as narcissistic personality disorder are typically diagnosed by a trained mental health professional, such as a psychologist or psychiatrist. Family physicians and general practitioners are generally not trained or well-equipped to make this type of psychological diagnosis. So while you can initially consult a family physician about this problem, they should refer you to a mental health professional for diagnosis and treatment. There are no laboratory, blood or genetic tests that are used to diagnose personality disorder.
Many people with narcissistic personality disorder don’t seek out treatment. People with personality disorders, in general, do not often seek out treatment until the disorder starts to significantly interfere or otherwise impact a person’s life. This most often happens when a person’s coping resources are stretched too thin to deal with stress or other life events.
A diagnosis for narcissistic personality disorder is made by a mental health professional comparing your symptoms and life history with those listed here. They will make a determination whether your symptoms meet the criteria necessary for a personality disorder diagnosis.
Causes of Narcissistic Personality Disorder
Researchers today don’t know what causes narcissistic personality disorder. There are many theories, however, about the possible causes of narcissistic personality disorder. Most professionals subscribe to a biopsychosocial model of causation — that is, the causes of are likely due to biological and genetic factors, social factors (such as how a person interacts in their early development with their family and friends and other children), and psychological factors (the individual’s personality and temperament, shaped by their environment and learned coping skills to deal with stress). This suggests that no single factor is responsible — rather, it is the complex and likely intertwined nature of all three factors that are important. If a person has this personality disorder, research suggests that there is a slightly increased risk for this disorder to be “passed down” to their children.
Treatment of Narcissistic Personality Disorder
Treatment of narcissistic personality disorder typically involves long-term psychotherapy with a therapist that has experience in treating this kind of personality disorder. Medications may also be prescribed to help with specific troubling and debilitating symptoms. For more information about treatment, please see narcissistic personality disorder treatment.
Narcissistic Personality Disorder Resources
Psych Central. (2014). Narcissistic Personality Disorder Symptoms. Psych Central. Retrieved on March 11, 2014, from http://psychcentral.com/disorders/narcissistic-personality-disorder-symptoms/
Symptom criteria summarized from:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Washington, DC: American Psychiatric Association.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
Last reviewed: By John M. Grohol, Psy.D. on 5 Feb 2014
Published on PsychCentral.com. All rights reserved.