Narcissistic Personality Disorder

Alternate Names
NPD
narcissism
self-centeredness

Definition of Narcissistic Personality Disorder

Someone with narcissistic personality disorder (NPD) has an exaggerated estimate of him or herself, and is self-centered and self-absorbed. The person is unable to empathize with the effects of his or her behavior on others.

What is going on in the body?

Everyone has characteristic patterns of perceiving and relating to other people and events. These are called personality traits. Someone with a personality disorder is not aware that his or her behavior or thought patterns are inappropriate. The individual often believes that his or her patterns are normal and right. A person with a narcissistic personality disorder has a sense of superiority and an exaggerated belief in his or her own value or importance.

What are the signs and symptoms of the condition?

A person with narcissistic personality disorder may:

• desire constant attention and admiration
• lack empathy
• exaggerate achievements and talents
• react to criticism with feelings of rage, shame, or humiliation
• be impulsive, anxious, or envious of others
• take advantage of others to achieve his or her own goals
• expect special treatment
• be preoccupied with ideas of unlimited success, power, brilliance, strength, and beauty
• become quickly dissatisfied with others

Many of these traits are relatively common. During adolescence, they are to be expected to some extent, and do not indicate NPD.

What are the causes and risks of the condition?

The cause of narcissistic personality disorder is unknown. One theory is that the parents of people who develop NPD need their children to be talented or special in order to maintain their own self-esteem.

What can be done to prevent the condition?

There is no known prevention for narcissistic personality disorder.

How is the condition diagnosed?

A psychological evaluation is performed, and the diagnosis of narcissistic personality disorder is based on the pattern of symptoms. Psychological testing is sometimes used to help diagnose NPD.

What are the long-term effects of the condition?

A person with narcissistic personality disorder tends to have stormy, and often unsuccessful, relationships. He or she may have a lot of trouble adjusting to the normal limitations of aging.

What are the risks to others?

Narcissistic personality disorder is not contagious, so there are no risks to others.

What are the treatments for the condition?

As in most personality disorders, NPD is made more difficult to treat by the fact that the person does not see him- or herself as ill. Treatments that can be helpful if a person can be persuaded to take them include cognitive behavioral therapy, group therapy, and individual psychotherapy.

Therapy may help the person relate to others in a more positive and rewarding way. Medication is commonly used only as an adjunct to counseling and therapy. Antidepressants can help stabilize moods and treat any depression.

What are the side effects of the treatments?

Side effects to medications vary, but may include drowsiness and allergic reactions.

What happens after treatment for the condition?

In many cases, a person with narcissistic personality disorder does not comply with treatment.

How is the condition monitored?

A person with narcissistic personality disorder should be followed closely by the healthcare professional. If medications are used, blood levels should be checked periodically. Any new or worsening symptoms should be reported to the healthcare professional.