Narcissistic personality disorder is a condition in which a person acts in a grandiose manner and puts himself on a pedestal. Narcissistic personality disorder causes people with the disorder to put their own needs above the needs of others. It is characterized by the DSM-IV as a “Cluster B” personality disorder–characterized by dramatic behavior and similar to antisocial and borderline personality disorders.
Diagnosing narcissistic personality disorder can be difficult. People with this disorder often think too highly of themselves to realize that there is anything wrong with their behavior. Often, narcissists are successful professionally and function well socially, so treatment does not appear necessary.
If they do seek treatment, narcissists may have trouble developing a relationship with a therapist and can be difficult to work with. Aditionally, signs of narcissism are often mistaken for other disorders, including borderline personality disorder, antisocial personality disorder, substance abuse or post-traumatic stress disorder.
A person must exhibit several of the following signs of narcissism in order to be diagnosed with narcissistic personality disorder:
- Arrogant behavior
- Exaggerated sense of self-importance
- Jealousy of others
- Lack of empathy; inability to recognize the needs and emotions of others
- Need for constant attention and admiration
- Preoccupation with fantasies about beauty, power or success
- Sense of being special
- Sense of entitlement
- Tendency to take advantage of others.
As is the case with all personality disorders, a person must be at least 18 years old to be officially diagnosed with narcissistic personality disorder. However, narcissistic behavior may first appear much earlier, often in adolescence.
Narcissistic Personality Disorder Assesments and Diagnosis
Diagnosis of this disorder typically comes after several narcissistic personality disorder assessments. First, a physical exam is administered to rule out any medical causes of narcissistic behavior. Next, the patient is referred to a mental health expert for a psychological evaluation, during which the patient is typically interviewed and asked to complete a questionnaire.
The most common narcissism test is the Narcissistic Personality Inventory (NPI), a questionnaire consisting of questions about the patient’s history of narcissistic behavior. The NPI was first published in 1979 and presents the patient with 223 pairs of statements, each reflecting one narcissistic and one non-narcissistic behavior. The patient is asked which one more closely reflects his patterns of thinking.
It’s not uncommon for another mental disorder to be diagnosed at the same time as narcissistic personality disorder. Narcissism often appears alongside other personality disorders, depression and/or anxiety. People with this disorder may also have problems with eating disorders and substance abuse.
Encyclopedia of Mental Disorders. (n.d.). Narcissistic personality disorder. Retrieved September 7, 2010, from http://www.minddisorders.com/Kau-Nu/Narcissistic-personality-disorder.html
Mayo Clinic Staff. (2009). Narcissistic personality disorder. Retrieved September 7, 2010, from http://www.mayoclinic.com/health/narcissistic-personality-disorder/DS00652
The Cleveland Clinic Foundation. (2009). Narcissistic personality disorder. Retrieved September 7, 2010, from http://my.clevelandclinic.org/disorders/personality_disorders/hic_narcissistic_personality_disorder.aspx