Narcissistic Personality Disorder

Full description of Narcissistic Personality Disorder (NPD). Definition, signs, symptoms, causes of Narcissistic Personality Disorder.

Full description of Narcissistic Personality Disorder (NPD). Definition, signs, symptoms, and causes of Narcissistic Personality Disorder.

Description of Narcissistic Personality Disorder (NPD)

Narcissistic Personality Disorder usually begins by early adulthood and is marked by disregard for the feelings of others, grandiosity (an exaggerated belief in their own value or importance), obsessive self-interest, and the pursuit of primarily selfish goals. It affects about 1% of the general population and 50-75% of those with NPD are men. Narcissistic Personality Disorder typically occurs in high achievers, although it may also occur in people with few achievements.

People with Narcissistic Personality Disorder demonstrate an apparently paradoxical combination of self-centeredness and worthlessness. Their sense of self-importance is generally extravagant, and they demand attention and admiration. Concern or empathy for others is typically absent. They often appear arrogant, exploitative, and entitled. However, despite their inflated sense of self, below their brittle facade lies low self-esteem and intense envy of those whom they regard as more desirable, worthy, or able.

The Merck Manual states that people with narcissistic personality "may be extremely sensitive to failure, defeat, or criticism. When confronted by a failure to fulfill their high opinion of themselves, they can easily become enraged or severely depressed."

Diagnostic Criteria for Narcissistic Personality Disorder (NPD)

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:

  • has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
  • 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 sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
  • is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
  • lacks empathy: 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
  • shows arrogant, haughty behaviors or attitudes

Causes of Narcissistic Personality Disorder (NPD)

The exact cause of Narcissistic Personality Disorder is unknown, but researchers have identified childhood developmental factors and parenting behaviors that may contribute to NPD:

  • 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

For comprehensive information on narcissism and other personality disorders, visit the Personality Disorders Community.

Sources: 1. American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association. 2. Merck Manual, Home Edition for Patients and Caregivers, last revised 2006. 3. "Narcissistic Personality Disorder", Armenian Medical Network (2008). Leonard C. Groopman, M.D., Arnold M. Cooper, M.D.

APA Reference
Writer, H. (2009, January 2). Narcissistic Personality Disorder, HealthyPlace. Retrieved on 2019, August 20 from

Last Updated: July 5, 2019

Medically reviewed by Harry Croft, MD

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