Narcissistic Personality Disorder Diagnostic Criteria

Narcissistic Personality Disorder

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:

Criterion 1

(1) has a grandiose sense of self-importance (exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

Grandiosity (criterion 1) fuels many behaviors

• Assertion that problems lie within the company, not him

• Ignoring the fact that his relationships at work are strained to a breaking point

– Others might take time to reflect on the reasons for this

Criterion 2

(2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

– Much of NPD is manifested in one’s own mind in the form of fantasies

These fantasies (criterion 2)

• Support and protect a superior image of the self against intrusions from an above-average but much less stellar reality

• Are indulged upon

• Are resilient

• Are reinforcing

Criterion 3

(3) 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)

Often times these individuals from criterion 3 are

above average

• This does not preclude their perceptions from distorting and magnifying their aptitude

– i.e., Michael Jordan is the greatest basketball player of all time...and still narcissistic

Criterion 4

(4) requires excessive admiration

–Often elicited via a boastful and haughty presentation

– Often times will not present themselves in an average light

• i.e., will only go out if they look fabulous

• Kanye: “And I can’t even go to the grocery store without some ones thats clean and a shirt with a team...”

Criterion 5

(5) has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations

–

The idea that the rules do not/should not apply to them

• Examples:

– Show up late with little regard for its effect on others

– Skirt legal responsibilities (e.g. paying taxes, tickets)

– Refusal to go through “hoops” that we all have to

– Cheat on husbands and wives

Criterion 6

(6) is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

– Others are seen as a means to and end

– Often times as an obstacle to an end

Criterion 7

(7) lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

– This ties very closely with the 6th criterion

• Lack of empathy allows for the exploitation of others

– Their “self” is the most important “self”

– There is a refusal to be “shown up”

• When cannot be avoided, leads to a “narcissistic injury”

– Refusal to be “shown up”

• If “shown up” someone will be sacrificed in order to restore order

Criterion 8

(8) is often envious of others or believes that others are envious of him or her

– It’s not just that they be great, but that they be great in comparison to others

– As a result, they are acutely aware of the abilities and possessions of others

• When others have more, they are envious and attribute it to external causes (e.g. luck, nepotism, privilege)

• When others have less, they assume that these others view them as they would (i.e. with envy

Criterion 9

(9) shows arrogant, haughty behaviors or attitudes

– Central theme of self-aggrandizement Frank T. J. Mackey from the movie “Magnolia”