The Narcissistic Personality Disorder

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The Cleveland Clinic

Mental Health: Narcissistic Personality Disorder

* What are the symptoms of narcissistic personality disorder?
* What causes narcissistic personality disorder?
* How is narcissistic personality disorder diagnosed?
* How is narcissistic personality disorder treated?
* What complications are associated with narcissistic personality disorder?
* What is the outlook for people with narcissistic personality disorder?
* Can narcissistic personality disorder be prevented?

Narcissism is a term used to describe a focus on the self and self-admiration that is taken to an extreme. The word "narcissism" comes from a Greek myth in which a handsome young man named Narcissus sees his reflection in a pool of water and falls in love with it.

Narcissistic personality disorder is one of a group of conditions called dramatic personality disorders. People with these disorders have intense, unstable emotions and a distorted self-image. Narcissistic personality disorder is further characterized by an abnormal love of self, an exaggerated sense of superiority and importance, and a preoccupation with success and power. However, these attitudes and behaviors do not reflect true self-confidence. Instead, the attitudes conceal a deep sense of insecurity and a fragile self-esteem.

What Are the Symptoms of Narcissistic Personality Disorder?

In many cases, people with narcissistic personality disorder:

* Are self-centered and boastful


* Seek constant attention and admiration


* Consider themselves better than others


* Exaggerate their talents and achievements


* Believe that they are entitled to special treatment


* Are easily hurt but may not show it


* Set unrealistic goals


* May take advantage of others to achieve their goals

Other common traits of narcissistic personality disorder include the following:

* Preoccupation with fantasies that focus on unlimited success, power, intelligence, beauty, or love


* Belief that he or she is "special" and unique, and can only be understood by other special people


* Expectation that others will automatically go along with what he or she wants


* Inability to recognize or identify with the feelings, needs, and viewpoints of others


* Envy of others or a belief that others are envious of him or her


* Hypersensitivity to insults (real or imagined), criticism, or defeat, possibly reacting with rage, shame and humiliation


* Arrogant behavior and/or attitude

What Causes Narcissistic Personality Disorder?

The exact cause of narcissistic personality disorder is not known. However, many mental health professionals believe it results from extremes in child rearing. For example, the disorder might develop as the result of excessive pampering, or when a child's parents have a need for their children to be talented or special in order to maintain their own self-esteem. On the other end of the spectrum, narcissistic personality disorder might develop as the result of neglect or abuse and trauma inflicted by parents or other authority figures during childhood. The disorder usually is evident by early adulthood.

How Is Narcissistic Personality Disorder Diagnosed?

If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose personality disorders, the doctor might use various diagnostic tests, such as X-rays and blood tests, to rule out a physical illness as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder.

How Is Narcissistic Personality Disorder Treated?

There is no known cure for narcissistic personality disorder, but psychotherapy (a type of counseling) might help the person learn to relate to others in a more positive and rewarding way. Psychotherapy tries to provide the person with greater insight into his or her problems and attitudes in the hope that this will change behavior. The goal of therapy is to help the person develop a better self-esteem and more realistic expectations of others. Medication might be used to treat the distressing symptoms, such as behavioral problems, that might occur with this disorder.

What Complications Are Associated With Narcissistic Personality Disorder?

People with narcissistic personality disorder might abuse drugs and/or alcohol as a way of coping with their symptoms. The disorder also might interfere with the development of healthy relationships with others.

What Is the Outlook for People With Narcissistic Personality Disorder?

The prognosis depends on the severity of the disorder.

Can Narcissistic Personality Disorder Be Prevented?

There is no known way to prevent narcissistic personality disorder.

Reviewed by the doctors at The Cleveland Clinic Department of Psychiatry and Psychology.

Reviewed by Cynthia Dennison Haines, MD

Edited by Cynthia Dennison Haines, MD, on March 1, 2005

Portions of this page © The Cleveland Clinic 2000-2005

Last Editorial Review: 9/22/2008
Narcissistic Personality Disorder (NPD) Causes, Symptoms, Diagnosis and Treatment on MedicineNet.com (29 June 2009)
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