Last reviewed: November 14, 2010.
Narcissistic personality disorder is a condition in which people have an inflated sense of self-importance and an extreme preoccupation with themselves. Causes, incidence, and risk factors
The causes of this disorder are unknown. An overly sensitive personality and parenting problems may affect the development of this disorder. Symptoms
A person with narcissistic personality disorder may:
* React to criticism with rage, shame, or humiliation
* Take advantage of other people to achieve his or her own goals * Have excessive feelings of self-importance
* Exaggerate achievements and talents
* Be preoccupied with fantasies of success, power, beauty, intelligence, or ideal love * Have unreasonable expectations of favorable treatment
* Need constant attention and admiration
* Disregard the feelings of others, and have little ability to feel empathy * Have obsessive self-interest
* Pursue mainly selfish goals
Signs and tests
Like other personality disorders, narcissistic personality disorder is diagnosed based on a psychological evaluation and the history and severity of the symptoms. Treatment
Psychotherapy (for example, talk therapy) may help the affected person relate to other people in a more positive and compassionate way. Expectations (prognosis)
The outcome depends on the severity of the disorder.
* Alcohol or other drug dependence
* Relationship, work, and family problems
1. Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and personality disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Clinical Psychiatry. 1st ed. Philadellphia, Pa: Mosby Elsevier;2008:chap 39
The Diagnostic and Statistical Manual of Mental Disorders fourth edition, DSM IV-TR, a widely used manual for diagnosing mental disorders, defines narcissistic personality disorder (in Axis II Cluster B) as: 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 five (or more) 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 others are envious of him or her 9. Shows arrogant, haughty behaviors or attitudes
It is also a requirement of DSM-IV that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria. Etiology
The etiology of this disorder is unknown.
Researchers have identified childhood developmental factors and parenting behaviors that may contribute to the disorder: * An oversensitive temperament at birth
* Overindulgence and overvaluation by parents
* Valued by parents as a means to regulate their own self-esteem * Excessive admiration that is never balanced with realistic feedback * Unpredictable or unreliable caregiving from parents
* Severe emotional abuse in childhood
* Being praised for perceived exceptional looks or talents by adults * Learning manipulative behaviors from parents...