What Are the Hallmarks of Narcissistic Personality Disorder?
Narcissistic Personality Disorder (NPD) is a personality disorder. People with this condition think unrealistically highly of themselves and crave attention – rather than connection – from other people. Although narcissism is a trait by itself, it is important to note that narcissism is a spectrum, so not everyone who is narcissistic has narcissistic personality disorder. The journal Current Opinion Psychiatry estimates the prevalence of NPD to be between 0.5% and 5% in the US population.
The three hallmarks of narcissistic personality disorder are:
- A lack of empathy
- A need for admiration
Grandiosity is an unrealistic feeling or sense of superiority, and it is the defining characteristic of narcissistic personality disorder. A lack of empathy, or the ability to understand and share another person’s feelings, causes people with narcissistic personality disorder to have extreme self-involvement and ignore other people around them. This can lead to relationship problems with friends and family.
What Are the Two Types of Narcissism?
There are two main types of narcissism – grandiose and vulnerable – both of which have self-centeredness as a core feature.
- Grandiose narcissism (or overt narcissism) is characterized by extraversion, aggression, and obvious entitlement. People with grandiose narcissism often exaggerate their importance and continuously crave attention and validation. These people tend to brag about themselves and their lives.
- Vulnerable narcissism (or covert narcissism) is characterized by introversion, negative emotions, and hypersensitivity to criticism. Contrary to grandiose narcissism, they fear attention and criticism. Their narcissism helps protect them from feeling inadequate, as they crave reassurance.
Traits and Symptoms Of Narcissistic Personality Disorder
According to the DSM-5, a diagnosis of narcissist personality disorder has five or more symptoms that are present by early adulthood and across settings. The symptoms include:
- A belief that one is special or important
- A sense of entitlement
- A need for excessive admiration
- Preoccupation with fantasies of success (e.g., beauty, love)
- Grandiose sense of self-importance
- A lack of empathy
- Envy or belief of being the object of envy
- Arrogant behavior or attitudes
- Exploitation of others
What Causes Someone to Develop a Narcissistic Personality Disorder?
Although the causes of narcissistic personality disorder are not well understood, researchers believe environmental and biological factors play a role. Parenting styles, childhood experiences, and social & cultural environments all influence how the disorder presents itself. Examples of this are:
- Parenting that focuses intensely on competition and success can breed narcissism. Parents who are neglectful or abusive can also breed vulnerable narcissism characterized by introversion and sensitivity. Alternatively, treating children as superior or “above” others can cause grandiose narcissism.
- Narcissism is more common in individualistic cultures than in collective ones. It is also more common in competitive environments, such as New York or other major cities.
Treatment of Narcissistic Personality Disorder
It is difficult for people with narcissistic personality disorder to acknowledge their problems so treatment can be difficult. People with NPD are often defensive, aggressive, and have a big ego, so the key is finding a therapist or clinician who is specifically trained to work with patients with NPD.
Therapy can help people with narcissistic personality disorder learn to relate with themselves and others, leading them to have healthier relationships with self and others. Successful treatment for NPD typically involves identifying unhealthy coping strategies, learning adaptive coping skills, unpacking childhood experiences, and learning to empathize with other people’s feelings. The goal of therapy is to develop a healthy self-image and connection with others.
Frequently Ask Questions
Yes, narcissistic people can change. This change can be difficult, but not impossible. It depends on how willing and open-minded the person is to accept treatment and change.
Having relationships with people with narcissistic personality disorder can be challenging. One of the core features of the disorder is a lack of empathy, and this can affect relationships. If you are in a relationship with someone who has NPD, it is important to take care of yourself. To do this, you may consider:
- Setting boundaries
- Not taking what they say personally
- Looking for support and connection with other people
- Looking for other sources of fulfillment in your life
Living with NPD can cause issues with work and relationships, so it is important to seek and engage in treatment (counseling). If you have NPD, giving up treatment may seem more straightforward. Here are some tips for continuing therapy:
- Keep an open mind
- Focus on your goals and the rewards to come
- Follow advice of doctors and other loved ones
- Be honest about any other mental health issues
The information on this page, or elsewhere on this site, is not intended to take the place of diagnosis, treatment or informed advice from a qualified mental health professional. You should not take or avoid any action without consultation with the latter.
If you would like to talk to a counselor, please click here.
Brummelman E., Gürel Ç., Thomaes S., Sedikides C. (2018). What Separates Narcissism from Self-esteem? A Social-Cognitive Perspective. In: Hermann A., Brunell A., Foster J. (eds) Handbook of Trait Narcissism. Springer, Cham. https://doi.org/10.1007/978-3-319-92171-6_5
Koepernik, T., Jauk, E. & Kanske, P. Lay theories of grandiose and vulnerable narcissism. Curr Psychol (2021). https://doi.org/10.1007/s12144-020-01296-w
Mitra, P., & Fluyau, D. (2022). Narcissistic Personality Disorder. In StatPearls. StatPearl Publishing. http://www.ncbi.nlm.nih.gov/books/NBK556001/
Psychology Today. (n.d.). Narcissistic Personality Disorder. https://www.psychologytoday.com/us/conditions/narcissistic-personality-disorder
Ronningstam E. (2013). An update on narcissistic personality disorder. Current opinion in psychiatry, 26(1), 102–106. https://doi.org/10.1097/YCO.0b013e328359979c
WebMD. (n.d.). Narcissistic Personality Disorder. https://www.webmd.com/mental-health/narcissistic-personality-disorder