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What Is Narcissistic Personality Disorder?

Symptoms and Treatments


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According to a study published in the Journal of Clinical Psychiatry, approximately 30 million American adults are affected by at least one personality disorder. The DSM-IV reports that narcissistic personality disorder affects an estimated 1-percent of these individuals.

What is Narcissistic Personality Disorder?

Narcissistic personality disorder is a pervasive disorder characterized by self-centeredness, lack of empathy, and an exaggerated sense of self-importance. As with other personality disorders, this disorder is an enduring and persistent pattern of behavior that negatively impacts many different life areas including social, family, and work relationships.

Narcissistic personality disorder is thought to be less common than other personality disorders such as borderline personality disorder, antisocial personality disorder, and histrionic personality disorder. Narcissistic personality disorder is estimated to affect 1-percent of the adult population in the United States and is more common among men than women.

Symptoms of Narcissistic Personality Disorder

Narcissism is a term commonly used to describe those who seem more concerned with themselves than with others. It is important to distinguish between those who have narcissistic personality traits and those suffering from narcissistic personality disorder. Those with narcissistic personalities are often seen as arrogant, confident, and self-centered, but they do not have the exaggerated or grandiose view of their own abilities that characterizes narcissistic personality disorder.

The DSM-IV identifies the following symptoms:

  • 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

An official diagnosis can be made by a qualified mental health professional, and requires that the individual exhibit 5 of the 9 symptoms identified in the DSM-IV. Practitioners must also rule out other psychiatric disorders in order to make a diagnosis.

People with narcissistic personality disorder are typically described as arrogant, conceited, self-centered, and haughty. Because they imagine themselves as superior to others, they often insist on possessing items that reflect a successful lifestyle. Despite this exaggerated self-image, they are reliant on constant praise and attention to reinforce their self-esteem. As a result, those with narcissistic personality disorder are usually very sensitive to criticism, which is often viewed as a personal attack.

Causes of Narcissistic Personality Disorder

While the exact cause is unknown, researchers have identified some factors that may contribute to the disorder. Childhood experiences such as parental overindulgence, excessive praise, unreliable parenting, and a lack of realistic responses are thought to contribute to narcissistic personality disorder.

Treatments for Narcissistic Personality Disorder

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 that insurance companies are focused on short-term treatments that minimize symptoms such as depression and anxiety, but ignore the underlying problems.

Cognitive-behavioral therapy is often effective to help individual's change destructive thought 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.

Further Reading:
Overview of Personality Disorders

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