Narcissistic personality disorder

Narcissistic personality disorder

Description, Causes and Risk Factors:

Narcissistic personality disorder involves arrogant behavior, a lack of empathy for other people, and a need for admiration-all of which must be consistently evident at work and in relationships. People who are narcissistic are frequently described as cocky, self-centered, manipulative, and demanding. Narcissists may concentrate on unlikely personal outcomes (e.g., fame) and may be convinced that they deserve special treatment.

Narcissists tend to have high self-esteem. However, narcissism is not the same thing as self-esteem; people who have high self-esteem are often humble, whereas narcissists rarely are. It was once thought that narcissists have high self-esteem on the surface, but deep down they are insecure. However, the latest evidence indicates that narcissists are actually secure or grandiose at both levels. Onlookers may infer that insecurity is there because narcissists tend to be defensive when their self-esteem is threatened (e.g., being ridiculed); narcissists can be aggressive. The sometimes dangerous lifestyle may more generally reflect sensation-seeking or impulsivity (e.g., risky sex, bold financial decisions).

Causes are not yet well-understood. Genes play a significant role (approximately 50%), but the unique ways that environments shape people (e.g., peer interactions) also influence narcissism. Related hypotheses include:

    Heritable narcissistic traits emerged in part due to natural selection for promiscuous sexuality.

  • Some people develop into narcissists because of self-reflection on largely heritable traits-"I am attractive and therefore I deserve special treatment."

  • Cultural factors may bring-about narcissistic qualities (e.g., watching narcissistic role models on TV; adverse, war-torn environments).

Some factors that may contribute to the disorder may include childhood experiences such as parental overindulgence, excessive praise, unreliable parenting, and a lack of realistic responses are thought also contribute to narcissistic personality disorder.


A person with narcissistic personality disorder may:

    Take advantage of other people to achieve his or her own goals.

  • React to criticism with rage, shame, or humiliation.

  • Have excessive feelings of self-importance.

  • Exaggerate achievements and talents.

  • Be preoccupied with fantasies of success, power, beauty, intelligence, or ideal love.

  • Have unreasonable expectations of favorable treatment.

  • Need constant attention and admiration.

  • Disregard the feelings of others, and have little ability to feel empathy.

  • Have obsessive self-interest.

  • Pursue mainly selfish goals.


Diagnosis is made based on the following The DSM-IV criteria:

    An exaggerated sense of one's own abilities and achievements.

  • A constant need for attention, affirmation and praise.

  • A belief that he or she is unique or "special" and should only associate with other people of the same status.

  • Persistent fantasies about attaining success and power.

  • Exploiting other people for personal gain.

  • A sense of entitlement and expectation of special treatment.

  • A preoccupation with power or success.

  • Feeling envious of others, or believing that others are envious of him or her.

  • A lack of empathy for others.


Individual psychotherapy can be effectively used to treat narcissistic personality disorder, although the process can be difficult and time consuming. It is important to note that people with this disorder rarely seek out treatment. Individuals often begin therapy at the urging of family members or to treat symptoms that result from the disorder.

Therapy can be especially difficult because clients are often unwilling to acknowledge the disorder. This difficulty in treatment is often compounded by the fact the insurance companies are focused on short-term treatments that minimize symptoms such as depression and anxiety, but ignore the underlying problems.

Cognitive-behavioral therapy (CBT) is often effective to help individual's change destructive thinking and behavior patterns. The goal of treatment is to alter distorted thoughts and create a more realistic self-image. Psychotropic medications are generally ineffective for long-term change, but are sometimes used to treat symptoms of anxiety or depression.

NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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