- The essential feature of Narcissistic Personality Disorder is a pervasive pattern of grandiosity, need for admiration, and lack of empathy that begins by early adulthood and is present in a variety of contexts. These individuals routinely overestimate their abilities and inflate their accomplishments, often appearing boastful and pretentious. The may blithely assume that others attribute the same value to their efforts and may be surprised when the praise they expect and feel they deserve is not forthcoming. These individuals may feel that they can only be understood by, and should only associate with, other people who are special or of high status and may attribute "unique", "perfect", or "gifted" qualities to those with whom they associate. They believe that their needs are special and beyond the understanding of ordinary people. Their own self-esteem is enhanced by the idealized value that they assign to those with whom they associate. They are likely to insist on having only the "top" person (doctor, lawyer hairdresser, instructor) or being affiliated with the "best" institutions, but may devalue the credentials of those who disappoint them.
- The self-esteem of these individuals is almost invariably very fragile. They may be preoccupied with how well they are doing and how favorably they are regarded by others. This often takes the form of a need for constant attention and admiration. They may expect their arrival to be greeted with great fanfare and are astonished if others do not covet their possessions. They may constantly fish for compliments, often with great charm. They also expect to be catered to and are puzzled or furious when this does not happen. For example, they may assume that they do not have to wait in line and that their priorities are so important that others should defer to them, and then get irritated when others fail to assist "in their very important work". They expect to be given whatever they want or feel they need, no matter what it might mean to others. They tend to form friendships or romantic relationships only if the other person seems likely to advance their purposes or otherwise enhance their self-esteem.
- Vulnerability in self-esteem makes individuals with this disorder very sensitive to "injury" from criticism or defeat. Although they may not show it outwardly, criticism may haunt these individuals and may leave them feeling humiliated, degraded, hollow and empty. They may react with disdain, rage, or defiant counterattack. Interpersonal relations are typically impaired due to problems derived from entitlement, the need for admiration, and the relative disregard for the sensitivities of others. Though overweening ambition and confidence may lead to high achievement, performance may be disrupted due to intolerance of criticism or defeat.
Criteria for Narcissistic Personality Disorder:
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has a grandiose sense of self-importance (e.g., exaggerates achievements and 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 needs 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 - The self-esteem of these individuals is almost invariably very fragile. They may be preoccupied with how well they are doing and how favorably they are regarded by others. This often takes the form of a need for constant attention and admiration. They may expect their arrival to be greeted with great fanfare and are astonished if others do not covet their possessions. They may constantly fish for compliments, often with great charm. They also expect to be catered to and are puzzled or furious when this does not happen. For example, they may assume that they do not have to wait in line and that their priorities are so important that others should defer to them, and then get irritated when others fail to assist "in their very important work". They expect to be given whatever they want or feel they need, no matter what it might mean to others. They tend to form friendships or romantic relationships only if the other person seems likely to advance their purposes or otherwise enhance their self-esteem.