Narcissistic personality disorder (NPD) is a mental condition in which people have an inflated sense of their own importance, a deep need for excessive attention and admiration, troubled relationships, and a lack of empathy for others.
But behind this mask of extreme confidence lies a fragile self-esteem that’s vulnerable to the slightest criticism.
The person may be generally unhappy and disappointed when they’re not given the special favours or admiration they believe they deserve.
They may find their relationships unfulfilling, and others may not enjoy being around them.
It is complex condition and frequently occurs alongside other mental health (axis I diagnoses) conditions for example:
It tends to occur from mid 20’s and onwards and tends to get worst by middle age or old age.
Two basic subtypes have been identified:
Grandiose subtype is associated with aggression and boldness.
Vulnerable subtype involves hypersensitivity and defensiveness, and it is often overlooked.
Some persons with NPD may exhibit parts of both subtypes.
NPD has a higher risk for death by suicide compared with other personality disorders.
Diagnosis Tests
NPD is typically made on the basis of a history of narcissistic symptoms from pertinent sources (such as the patient, their friends, family, and co-workers, and the observations of the clinician).
Psychiatric interview, the person with NPD will display a lack of concern for others, a sense of superiority, and an egocentric view of the world.
No signs of psychosis (i.e. hallucinations, delusions) are present.
They have full orientation to time, place, and person and memory is intact.
The following tests can also be used to facilitate diagnosis. however, this is not required, and debate surrounds their reliability and usefulness.
The total PDQ-4+ self- report score provides an index of overall personality disturbance: for scores under 20, PD is discarded; scores of 20-30 require further assessment; and scores above 30 indicate a probable PD diagnosis.
Millon clinical multiaxial inventory III (MCMI-III) test
International personality disorder examination (IPDE) test
Tests for high alcohol consumption
Tests for illicit drug use
NPD isn’t a personality flaw. It’s a mental health condition. When you have NPD, you do or say things that rub others the wrong way and damage relationships. Usually, this isn’t on purpose. It’s driven by deep-seated insecurity — feeling like you’re not good enough — and the need for people to think that you’re worthy
(Signs and symptoms of narcissistic personality disorder and the severity of symptoms vary)
Person with the disorder can:
Have an exaggerated sense of self-importance?
Have a sense of entitlement and require constant, excessive admiration?
Expect to be recognised as superior even without achievements that warrant it?
Exaggerate achievements and talents?
Be preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate?
Believe they are superior and can only associate with equally special people?
Monopolise conversations and belittle or look down on people they perceive as inferior?
Expect special favours and unquestioning compliance with their expectations?
Take advantage of others to get what they want?
Have an inability or unwillingness to recognise the needs and feelings of others?
Be envious of others and believe others envy them?
Behave in an arrogant or haughty manner, coming across as conceited, boastful and pretentious?
Insist on having the best of everything — for instance, the best car or office?
At the same time, people with narcissistic personality disorder have trouble handling anything they perceive as criticism, and they can:
Become impatient or angry when they don’t receive special treatment?
Have significant interpersonal problems and easily feel slighted?
React with rage or contempt and try to belittle the other person to make themselves appear superior?
Have difficulty regulating emotions and behaviour?
Experience major problems dealing with stress and adapting to change?
Feel depressed and moody because they fall short of perfection?
Have secret feelings of insecurity, shame, vulnerability and humiliation?
According to the DSM-5, a diagnosis of NPD requires five of the following nine criteria:
A belief that they are unique or special and can only associate with and be understood by others like them, such as people or institutions with high status that are special
A grandiose sense of self-importance
A lack of empathy
A preoccupation with fantasies of unlimited beauty, brilliance, power, success, or ideal love
A sense of entitlement
A need for excessive admiration
Inter-personally exploitative behaviour
Envy of others or a belief that others envy them
Arrogant and haughty attitudes or behaviours
Complications /Information to beware of/General tips:
Do not wait, phone for an ambulance if one have symptoms and/or develop:
Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice
Detailed Information
Please copy and paste any key words from the title: Narcissistic Personality Disorder in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).
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