What is Narcissistic Personality Disorder?NPD is a type of psychological personality disorder characterized primarily by grandiosity, need for admiration, and lack of empathy. Narcissism occurs in a spectrum of severity, but the pathologically narcissistic tend to be extremely self-absorbed, intolerant of others’ perspectives, insensitive to others’ needs and indifferent to the effect of their own egocentric behavior.
It is not uncommon for persons with this disorder to frequently compare themselves to the accomplished, well-known and well-to-do. They feel entitled to great praise, attention, and deferential treatment by others.
Those with NPD crave the limelight and are quick to abandon situations in which they are not the center of attention. Defects of empathy may cause narcissists to misperceive other people's speech and actions, causing them to believe that they are well-liked and respected despite a history of negative personal interactions.
Those with Narcissistic Personality Disorder are often ambitious and capable, but are unable to cope with setbacks, disagreements or criticism. These emotional limitations, along with lack of empathy, make it difficult for such individuals to work well with others and to build a successful career (Kernberg 2003, 2004, APA 2000).
Diagnosis of Narcissistic PDConsiderable overlap between the characteristics of different personality disorders makes diagnosis of NPD a challenge. Grandiosity, lack of empathy and exploitative interpersonal relations are not unique to NPD, nor is the need to be seen as special or unique. The differential diagnosis of Narcissistic Personality Disorder is typically made based on the absence of certain behaviors. Borderline Personality Disorder has several conspicuous similarities, but unlike NPD, is characterized by self-injury, whereas narcissists are rarely physically self-injurious. The need for constant attention is also found in Histrionic Personality Disorder, but HPD and BPD are both relationship oriented, whereas NPD is characterized by the avoidance of intimacy. Psychopathy, or Antisocial Personality Disorder is differentiated from NPD by the psychopaths' willingness to use physical violence whereas narcissists rarely commit crimes Kernberg 2003, Vaknin 2007).
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), a patient must exhibit five or more of the following traits in order to be diagnosed with NPD: