What is Narcissistic Personality Disorder & How to Spot

To understand what Narcissistic Personality Disorder is and how to spot it, we must first position the disorder within the larger context of mental disorders. Narcissistic Personality Disorder is housed within the Personality Disorders section of the Diagnostic and Statistically Manual of Mental Disorders (DSM-5), including Paranoid Personality Disorder, Antisocial Personality Disorder, Borderline Personality Disorder, and Obsessive-Compulsive Personality Disorder (for a fully comprehensive list, see the DSM-5).

A personality disorder is “…an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment” (DSM-5).

Although Narcissistic Personality Disorder and even the words “narcissistic” and “narcissism” have become widely sensationalized by mainstream media, it is essential to remember that there are critical criteria to meet the official diagnosis.

What Are the Diagnostic Criteria for Narcissistic Personality Disorder

According to the DSM-5, the diagnostic criteria for Narcissistic Personality Disorder require the presence of five or more of the following:

1. Grandiose sense of self-importance. For example, one might exaggerate their achievements to seem superior to those around.
2. Preoccupied with fantasies about unlimited power, success, brilliance, beauty, or ideal love. One can become hyper-focused on “long-overdue” admiration of their strength or privileges.
3. Believes that they are “special” and “unique and can only be “understood” by those with elite social status. For example, one may describe the people in their life as “ordinary.”
4. Requires excessive admiration. As a result, one may have fragile self-esteem.
5. Has a sense of entitlement. For example, one may become frustrated by waiting in line because “they should be allowed to skip to the front.”
6. Is interpersonally exploitative. Often, one may form friendships to advance their own needs or desires.
7. Lacks empathy. For example, one may be preoccupied with their concerns and have difficulty recognizing the needs or feelings of others.
8. Is often envious of others and believes others are envious of them. As a result, one may imagine everyone is always looking at them or wishing they could be just like them.
9. Shows arrogant behaviors. For example, one may complain about a retail worker being clumsy or stupid for making an understandable mistake or error.

Narcissistic Personality Disorder Quick Facts

• Those with Narcissistic Personality Disorder often have difficulty maintaining relationships, given their need for admiration and disregard for others.
• Narcissistic Personality Disorder is estimated to be prevalent between 1-6% of the population.
• Of those diagnosed with Narcissistic Personality Disorder, 50-75% are male.
• Although traits of Narcissistic Personality Disorder can appear in adolescence, that does not necessarily mean a person would be diagnosed. Given that individuals with Narcissistic Personality Disorder often struggle to adjust to the “aging process,” symptoms usually manifest and become clearer to identify as a person ages post-adolescence.
• Narcissistic Personality Disorder has diagnostic criteria similar to Histrionic, Antisocial, and Borderline Personality Disorders; however, the critical feature that separates Narcissistic Personality Disorder from the others is the grandiosity characteristic. In other words, someone with Narcissistic Personality Disorder will uniquely highlight their felt superiority over others. Additionally, individuals with Narcissistic Personality Disorder often have a stable self-image (even if distorted) and lack self-destructive behaviors, which separate the disorder from borderline.
• Very little is known about the “cause” of Narcissistic Personality Disorder, however, some research suggests that biological and environmental factors play a role. Some everyday childhood experiences of narcissistic personalities include neglect, abandonment, and physical abuse (White, 2021).
• Individuals with Narcissistic Personality Disorder rarely seek help given their generally low self-esteem and inflated ego.

Other GoodTherapy Blogs About Narcissism

Covert Narcissism: The Quiet Counterpart to Narcissistic Personality

Codependency and Narcissism May Have More in Common Than You Think

The Arduous Work of Treating Narcissism: A Therapist’s Guide

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References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental

disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

White, M. A. (2021). How to spot narcissistic behaviors. From:

https://psychcentral.com/disorders/how-to-spot-a-narcissist

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