October 4, 2011

Life and Health

Clinical Narcissism:
Narcissistic Personality Disorder

Gina Stepp

Although most of us exhibit some “narcissistic” behaviors at times, a specific set of personality traits must be habitual for someone to be clinically diagnosed with narcissistic personality disorder, or NPD. At least, this has been true under the current standards set by the fourth edition of the widely-used Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

According to the DSM-IV, in addition to satisfying certain criteria general to personality disorders, a diagnosis of NPD requires:

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following. The individual:

  • Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
  • Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  • 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)
  • Requires excessive admiration
  • Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
  • Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
  • Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
  • Is often envious of others or believes others are envious of him or her
  • Shows arrogant, haughty behaviors or attitudes 


Studies of narcissistic traits often focus on nonclinical narcissism that has been assessed using common personality inventories such as the Narcissistic Personality Inventory (NCI) or others, and do not necessarily suggest that the study subjects have been clinically diagnosed.