Narcissistic Personality Disorder

About Narcissistic Personality Disorder

Narcissistic personality disorder is a pervasive pattern of grandiosity in fantasy or behavior, need for admiration and lack of empathy, beginning by early adulthood and present across contexts. DSM-5 criteria include an inflated sense of self importance, preoccupation with fantasies of unlimited success, power or brilliance, a belief of being special, a need for excessive admiration, a sense of entitlement, exploitation of others, lack of empathy, envy of others or a belief that others are envious, and arrogant behavior. Clinicians and researchers often distinguish a grandiose presentation from a vulnerable presentation marked by hypersensitivity to criticism, shame and fluctuating self esteem, and outward confidence can mask a fragile sense of self. The term draws on the Greek myth of Narcissus, who fell in love with his own reflection, and the concept was developed in psychoanalytic writing by figures such as Heinz Kohut and Otto Kernberg. The disorder is diagnosed more often in men. People with the condition often seek help for depression, relationship problems or work difficulties rather than for the personality traits themselves. There is no medication specifically for it. Psychotherapies such as transference focused psychotherapy, mentalization based treatment and schema therapy are used, although research on treatment outcomes remains limited.