Narcissistic Personality Disorder
An all-pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration or
adulation and lack of empathy, usually beginning by early adulthood and present in various
contexts. Five (or more) of the following criteria must be met:
• Feels grandiose and self-importance (e.g., exaggerates achievements and talents to the
point of lying, demands to be recognized as superior without commensurate
achievements);
• Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence,
unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the
somatic narcissist), or ideal, everlasting, all-conquering love or passion;
• Firmly convinced that he or she is unique and, being special, can only be understood by,
should only be treated by, or associate with, other special or unique, or high-status people
(or institutions);
• Requires excessive admiration, adulation, attention and affirmation - or, failing that,
wishes to be feared and to be notorious (narcissistic supply);
• Feels entitled. Expects unreasonable or special and favourable priority treatment.
Demands automatic and full compliance with his or her expectations;
• Is "interpersonally exploitative", i.e., uses others to achieve his or her own ends;
• Devoid of empathy. Is unable or unwilling to identify with or acknowledge the feelings
and needs of others;
• Constantly envious of others or believes that they feel the same about him or her;
• Arrogant, haughty behaviours or attitudes coupled with rage when frustrated,
contradicted, or confronted.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental
disorders, fourth edition, text revision (DSM IV-TR). Washington, DC: American Psychiatric
Association.
Skopje and Prague, 1999, 2001, 2003.
