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Narcissistic Personality Disorder 
American Description 

Diagnostic Criteria
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: 
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 that others are envious of him or her 
shows arrogant, haughty behaviors or attitudes 

Associated Features
Depressed Mood 
Dramatic/Erratic/Antisocial Personality 

Differential Diagnosis
Histrionic Personality Disorder; Antisocial Personality Disorder; Borderline Personality Disorder; Obsessive-Compulsive Personality Disorder; Schizotypal Personality Disorder; Paranoid Personality Disorder; Manic Episodes; Hypomanic Episodes; Personality Change Due to a General Medical Condition; symptoms that may develop in association with chronic substance use. 

Internet Mental Health (www.mentalhealth.com) copyright © 1995-2000 by Phillip W. Long, M.D. 

 

 

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