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Diagnostic Features of Narcissistic Personality Disorder

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) provides the criteria for diagnosing NPD. According to the DSM-5, a person must meet at least five of the following nine criteria for a diagnosis of NPD:

  1. Grandiosity with expectations of superior treatment: Individuals with NPD often display an exaggerated sense of self-importance and expect others to recognize their superiority without evidence.
  2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love: They often fantasize about achieving greatness, success, or perfection, and may believe they deserve special treatment.
  3. Believing they are “special” and unique: Narcissistic individuals often perceive themselves as exceptional, and they may feel they can only be understood by other extraordinary or high-status people.
  4. Requiring excessive admiration: A strong need for attention and admiration is characteristic. They seek out constant validation and praise to maintain their self-esteem.
  5. Sense of entitlement: Individuals with NPD often have unreasonable expectations of favorable treatment or automatic compliance with their desires, believing that they are entitled to special privileges.
  6. Exploiting others: Narcissistic individuals may take advantage of others to achieve their own goals or maintain their self-image, showing a lack of concern for the feelings or needs of others.
  7. Lack of empathy: One of the hallmark features of NPD is a lack of empathy, which means they struggle to understand or care about the emotions and needs of others.
  8. Being frequently envious of others or believing others are envious of them: Those with NPD may exhibit envy towards others’ successes or believe that others are jealous of them.
  9. Arrogant, haughty behaviors or attitudes: Narcissistic individuals may display arrogance and a sense of superiority, often belittling others to elevate their own status.

Individuals with NPD typically have a fragile self-esteem that requires constant reinforcement. While they may appear confident and self-assured, they often feel deep insecurity and vulnerability. They may react with rage or withdrawal if their self-image is threatened or challenged.

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