Narcissistic Personality Disorder Diagnostic Criteria (DSM IV-TR)

Uploaded 8/13/2010, approx. 3 minute read

My name is Sam Vaknin. I am the author of Malignant Self-Love, Narcissism Revisited.

The Narcissistic Personality Disorder, NPD for short, is hardly a new psychological construct. In previous centuries the same set of symptoms and problems was called egotism or megalomania.

Narcissistic personality disorder is an extreme form of pathological narcissism. It is one of four personality disorders in Cluster B, the Dramatic, Emotional or Eratic Cluster.

The Narcissistic Personality Disorder was first described in the Diagnostic and Statistical Manual, Edition 3, revised text in 1980.

By contrast, the International Classification of Diseases, Edition 10, published by the World Health Organization in Geneva in 1992, does not recognize the Narcissistic Personality Disorder at all. It regards NPD as a personality disorder that fits none of the specific rubrics and it lumps it together with other bizarre dysfunctions such as hulk loss, immature passive-aggressive and psychoneurotic personality disorders.

There is a catch-all category called other-specific personality disorders in the International Classification of Diseases in Narcissistic Personality Disorder is dumped in this trash bin.

The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, text revision, published by the American Psychiatric Association in Washington DC, the United States in the year 2000, provides a diagnostic criteria for Narcissistic Personality Disorder on page 717.

The Diagnostic and Statistical Manual, DSM for short, defines Narcissistic Personality Disorder thus, an all-convasive pattern of grandiosity in fantasy or behavior, need for admiration or adulation, a lack of empathy, usually beginning by early adulthood and present in various contexts such as family life or work.

Five or more of the DSM's nine diagnostic criteria must be met for a Diagnostic of Narcissistic Personality Disorder to be rendered.

I took the nine diagnostic criteria of the DSM and I augmented them with experience that I have accumulated over the last 15 years, interacting with narcissists and their nearest and dearest colleagues, neighbors, employers, bosses, friends and family.

So here are my diagnostic criteria based largely of course on the DSM.

Number one, the narcissist feels grandiose and self-important.

Example given, exaggerates accomplishments, talents, skills, contacts and personality traits to the point of lying, demands to be recognized as superior without commensurate achievements.

Number two, the narcissist is obsessed with fantasies of unlimited success, fame, fearsome power, omnipotence, unequal brilliance if he is a cerebral narcissist, ability of sexual performance if he is a somatic narcissist or both types ideal and everlasting all conquering love or passion.

Number three, the narcissist is firmly convinced that he or she is unique and being special can only be understood by, should only be treated by or associate with other special or unique or high status people or institutions.

Therefore, the narcissist requires excessive admiration, adulation, attention and affirmation or failing that wishes to be feared and to be notorious. This is known as narcissistic supply.

The narcissist feels entitled, demands automatic and full compliance with his or her unreasonable expectations for special and favourable priority treatment.

Number six, the narcissist is interpersonally exploitative. In other words, he uses others to achieve his or her own ends without any concern for the welfare of the people he so uses or abuses.

Number seven, the narcissist is devoid of empathy. He is unable or unwilling to identify with, acknowledge or accept the feelings, needs, preferences, priorities and choices of others.

Number eight, the narcissist is constantly envious of others. He seeks to hurt or to destroy the objects of his frustration. He suffers from persecutory, paranoid delusions as he or she believes that everyone feels the same about him or her and that everyone is likely to act similarly to the narcissist.

Finally, the narcissist behaves arrogantly and haughtily. He feels superior, omnipotent, omniscient, invincible, immune above the law and omnipresent, a collection of beliefs and fantasies known as magical thinking. The narcissist rages when frustrated, when contradicted, when confronted by people he or she considers inferior and unworthy.

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