Narcissistic Personality Disorder

Narcissism is a term used to describe a focus on the self and self-admiration that is taken to an extreme. The word “narcissism” comes from a Greek myth in which a handsome young man named Narcissus sees his reflection in a pool of water and falls in love with it.

Narcissistic personality disorder is one of a group of conditions called dramatic personality disorders. People with these disorders have intense, unstable emotions and a distorted self-image. Narcissistic personality disorder is further characterized by an abnormal love of self, an exaggerated sense of superiority and importance, and a preoccupation with success and power. However, these attitudes and behaviors do not reflect true self-confidence. Instead, the attitudes conceal a deep sense of insecurity and a fragile self-esteem.

What Are the Symptoms of Narcissistic Personality Disorder?

In many cases, people with narcissistic personality disorder:

Are self-centered and boastful

Seek constant attention and admiration

Consider themselves better than others

Exaggerate their talents and achievements

Believe that they are entitled to special treatment

Are easily hurt but may not show it

Set unrealistic goals

May take advantage of others to achieve their goals

Other common traits of narcissistic personality disorder include the following:

Preoccupation with fantasies that focus on unlimited success, power, intelligence, beauty, or love

Belief that he or she is “special” and unique, and can only be understood by other special people

Expectation that others will automatically go along with what he or she wants

Inability to recognize or identify with the feelings, needs, and viewpoints of others

Envy of others or a belief that others are envious of him or her

Hypersensitivity to insults (real or imagined), criticism, or defeat, possibly reacting with rage, shame, and humiliation

Arrogant behavior and/or attitude

What Causes Narcissistic Personality Disorder?

The exact cause of narcissistic personality disorder is not known. However, many mental health professionals believe it results from extremes in child rearing. For example, the disorder might develop as the result of excessive pampering, or when a child’s parents have a need for their children to be talented or special in order to maintain their own self-esteem. On the other end of the spectrum, narcissistic personality disorder might develop as the result of neglect or abuse and trauma inflicted by parents or other authority figures during childhood. The disorder usually is evident by early adulthood.

How Is Narcissistic Personality Disorder Diagnosed?

If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical exam. Although there are no lab tests to specifically diagnose personality disorders, the doctor might use various diagnostic tests, such as X-rays and blood tests, to rule out a physical illness as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder.