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Diagnostic Criteria
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Home
Contents
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| 1. | has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
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| 2. | is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
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| 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)
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| 4. | requires excessive admiration
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| 5. | has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
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| 6. | is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
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| 7. | lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
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| 8. | is often envious of others or believes that others are envious of him or her
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| 9. | shows arrogant, haughty behaviors or attitudes."
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| The narcissist strives to maintain and protect his concocted self-image at all cost. The pathological narcissistic syndrome may be likened to a wheel in which the grandiose false self is the hub, to which are affixed spokes. The spokes have a specific purpose, which is to maintain, protect, and sustain the "hub" of the grandiose false self. Attributes 3-9 of the DSM-IV checklist constitute some of the spokes.
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| To begin with, the pathological narcissist uses people as tools of self-aggrandizement to affirm and maintain his false self -- others are used for a perverse kind of "mirroring" to reflect the narcissist's ostentatious self-regard. This accounts for why the narcissist "requires excessive admiration" (DSM-IV attribute 4), seeks to associate with "special or high-status people or institutions" (DSM-IV attribute 3), and is "interpersonally exploitative, i.e., takes advantage of others to achieve his own ends" (DSM-IV attribute 6). Like a vampire who must feed on others' blood in order to live, the narcissist basks in the admiration, love, approval, and compliments he elicits from others. If the other person ceases to provide him with "narcissistic supply," he no longer has much use for that person and the relationship will markedly cool, if not end altogether.
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| To lure people into his web, the skillful narcissist puts on an attractive social mask. The narcissist not only has a counterfeit self-image, he literally dons a false façade of physical appearance and demeanor. He can be charming, gracious, and socially adept. He must also be a consummate actor, skilled at simulating the whole range of human emotions, especially those of love and kindness. The more successful he is at simulation, the greater the circle of friends and acquaintances who can be his primary and secondary feeding sources.
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| — Maria Chang, A Study in Evil
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| · | Depressed Mood
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| · | Dramatic/Erratic/Antisocial Personality
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| Most observers regard grandiosity as the most important single trait of a narcissistic personality. It is important to note that grandiosity implies more than boasting or prideful display as such—it signifies self-aggrandizement that is not borne out by reality. For example, a person who claims that he or she was the most valuable player on a college athletic team may be telling the truth about their undergraduate sports record. Their claim may be bad manners but is not grandiosity. On the other hand, someone who makes the same claim but had an undistinguished record or never even made the team is being grandiose. Grandiosity in NPD is related to some of the diagnostic criteria listed by DSM-IV-TR, such as demanding special favors from others or choosing friends and associates on the basis of prestige and high status rather than personal qualities. In addition, grandiosity complicates diagnostic assessment of narcissists because it frequently leads to lying and misrepresentation of one's past history and present accomplishments.
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| Other symptoms of NPD include:
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| · | a history of intense but short-term relationships with others; inability to make or sustain genuinely intimate relationships
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| · | a tendency to be attracted to leadership or high-profile positions or occupations
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| · | a pattern of alternating between unrealistic idealization of others and equally unrealistic devaluation of them
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| · | assessment of others in terms of usefulness
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| · | a need to be the center of attention or admiration in a working group or social situation
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| · | hypersensitivity to criticism, however mild, or rejection from others
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| · | an unstable view of the self that fluctuates between extremes of self-praise and self-contempt
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| · | preoccupation with outward appearance, "image," or public opinion rather than inner reality
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| · | painful emotions based on shame (dislike of who one is) rather than guilt (regret for what one has done)
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