WHAT IS NPD (Narcissistic Personality Disorder
pattern of grandiosity (in fantasy
), need for admiration
and lack of empathy
, usually beginning by early adulthood and present in various contexts. Five (or more) of the following criteria must be met:
(1) Feels grandiose
s achievements and talents to the point of lying, demands to be recognized as superior without commensurate
(2) Is obsessed
with fantasies of unlimited success, fame, fearsome power or omnipotence
, unequalled brilliance (the cerebral
narcissist), bodily beauty or sexual performance (the somatic
narcissist), or ideal, everlasting, all-conquering love or passion
(3) Firmly convinced that he or she is unique
and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institution
(4) Requires excessive admiration, adulation, attention and affirmation
- or, failing that, wishes to be feared and to be notorious
(5) Feels entitled. Expects unreasonable or special and favourable priority
treatment. Demands automatic and full compliance with his or her expectations
(6) Is "interpersonally exploitative
", i.e., uses others to achieve his or her own ends
(7) Devoid of empathy
. Is unable or unwilling to identify with or acknowledge the feelings and needs of others
(8) Constantly envious
of others or believes that they feel the same about him or her
behaviours or attitudes coupled with rage when frustrated, contradict
ed, or confront
The language in the criteria above is based on or summarized from:
American Psychiatric Association
. (1994). Diagnostic and statistical manual of mental disorders
, fourth edition (DSM IV
). Washington, DC: American Psychiatric Association
. (1999). Malignant Self Love - Narcissism Revisited, first edition. Prague and Skopje: Narcissus Publication.
s (75%) are men.
(=the Narcissistic Personality Disorder
) is one of a "family" of personality disorders (formerly known as "Cluster B").
Other members: Borderline PD
, Antisocial PD
and Histrionic PD
NPD is often diagnosed with other mental health disorders ("co-morbidity
") - or with substance abuse
, or impulsive and reckless behaviours ("dual diagnosis").
NPD is new (1980) mental health category in the Diagnostic and Statistics Manual
There is only scant research regarding narcissism
But what there is has not demonstrated any ethnic, social, cultural, economic, genetic, or professional predilection to NPD.
It is estimated that 0.7-1% of the general population suffer from NPD.
Pathological narcissism was first described in detail by Freud
. Other major contributors are: Klein, Horney, Kohut, Kernberg, Millon, Roningstam, Gunderson, Hare.
The onset of narcissism is in infancy, childhood and early adolescence. It is commonly attributed to childhood abuse and trauma inflicted by parents, authority figures, or even peers.
There is a whole range of narcissistic reactions -
from the mild, reactive and transient to the permanent personality disorder.
Narcissists are either "Cerebral" (derive their narcissistic supply
from their intelligence or academic achievements) - or "Somatic
" (derive their narcissistic supply from their physique, exercise, physical or sexual prowess and "conquests").
Narcissists are either "Classic" - see definition below -
or they are "Compensatory", or "Inverted".
NPD is treated in talk therapy
(psychodynamic or cognitive-behavioral
The prognosis for an adult narcissist is poor, though his adaptation to life and to others can improve with treatment.
Medication is applied to side-effects and behaviours (such as mood or affect disorders and obsession-compulsion) -
usually with some success.