Narcissistic personality disorder

Narcissistic personality disorder (NPD) is a personality disorder with a long-term pattern of abnormal behavior characterized by exaggerated feelings of self-importance, excessive need for admiration, and a lack of empathy. Those affected often spend much time thinking about achieving power or success, or on their appearance. They often take advantage of the people around them. The behavior typically begins by early adulthood, and occurs across a variety of social situations. Narcissistic personality disorder (NPD) is a personality disorder with a long-term pattern of abnormal behavior characterized by exaggerated feelings of self-importance, excessive need for admiration, and a lack of empathy. Those affected often spend much time thinking about achieving power or success, or on their appearance. They often take advantage of the people around them. The behavior typically begins by early adulthood, and occurs across a variety of social situations. The cause of narcissistic personality disorder is unknown. It is a personality disorder classified within cluster B by the Diagnostic and Statistical Manual of Mental Disorders (DSM). Diagnosis is made by a healthcare professional interviewing the person in question. The condition needs to be differentiated from mania and substance use disorder. Treatments have not been well studied. Therapy is often difficult, as people with the disorder frequently do not consider themselves to have a problem. About one percent of people are believed to be affected at some point in their life. It appears to occur more often in males than females and affects young people more than older people. The personality was first described in 1925 by Robert Waelder, and the term NPD came into use in 1968. People with narcissistic personality disorder (NPD) are characterized by persistent grandiosity, excessive need for admiration, and a personal disdain and lack of empathy for others. As such, the person with NPD usually displays arrogance and a distorted sense of superiority, and they seek to establish abusive power and control over others. Self-confidence (a strong sense of self) is different from narcissistic personality disorder; people with NPD typically value themselves over others to the extent that they openly disregard the feelings and wishes of others, and expect to be treated as superior, regardless of their actual status or achievements. Moreover, the person with narcissistic personality disorder usually exhibits a fragile ego (self-concept), intolerance of criticism, and a tendency to belittle others in order to validate their own superiority. The DSM-5 indicates that persons with NPD usually display some or all of the following symptoms, typically without the commensurate qualities or accomplishments: Narcissistic personality disorder usually develops in adolescence or early adulthood. It is not uncommon for children and adolescents to display traits similar to those of NPD, but such occurrences are usually transient, and below the criteria for a diagnosis of NPD. True symptoms of NPD are pervasive, apparent in varied situations, and rigid, remaining consistent over time. The NPD symptoms must be sufficiently severe that they significantly impair the person's capabilities to develop meaningful human relationships. Generally, the symptoms of NPD also impair the person's psychological abilities to function, either at work, or school, or important social settings. The DSM-5 indicates that the traits manifested by the person must substantially differ from cultural norms, in order to qualify as symptoms of NPD. People with NPD tend to exaggerate their skills, accomplishments, and their level of intimacy with people they consider high-status. This sense of superiority may cause them to monopolize conversations or to become impatient or disdainful when others talk about themselves. When their own ego is wounded by a real or perceived criticism, their anger can be disproportionate to the situation, but typically, their actions and responses are deliberate and calculated. Despite occasional flare-ups of insecurity, their self-image is primarily stable (i.e., overinflated). To the extent that people are pathologically narcissistic, they can be controlling, blaming, self-absorbed, intolerant of others' views, unaware of others' needs and the effects of their behavior on others, and insist that others see them as they wish to be seen. Narcissistic individuals use various strategies to protect the self at the expense of others. They tend to devalue, derogate, insult, and blame others, and they often respond to threatening feedback with anger and hostility. Since the fragile ego of individuals with NPD is hypersensitive to perceived criticism or defeat, they are prone to feelings of shame, humiliation, and worthlessness over minor or even imagined incidents. They usually mask these feelings from others with feigned humility or by isolating themselves socially, or they may react with outbursts of rage, defiance, or by seeking revenge. The merging of the 'inflated self-concept' and the 'actual self' is seen in the inherent grandiosity of narcissistic personality disorder. Also inherent in this process are the defense mechanisms of denial, idealization and devaluation. According to the DSM-5: 'Many highly successful individuals display personality traits that might be considered narcissistic. Only when these traits are inflexible, maladaptive, and persisting and cause significant functional impairment or subjective distress do they constitute narcissistic personality disorder.' Due to the high-functionality associated with narcissism, some people may not view it as an impairment in their lives. Although overconfidence tends to make individuals with NPD ambitious, it does not necessarily lead to success and high achievement professionally. These individuals may be unwilling to compete or may refuse to take any risks in order to avoid appearing like a failure. In addition, their inability to tolerate disagreements or criticism, along with lack of empathy, make it difficult for such individuals to work cooperatively with others or to maintain long-term professional relationships with superiors and colleagues.