Mental Health Issues Personality Disorders

Narcissism: The Basics

November 2, 2012
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This article explores the concept of narcissism and how it manifests in individuals. You will also be introduced to Narcissistic Personality Disorder (NPD), including its epidemiology, symptoms and diagnostic criteria.

Introduction

During the week of pre-wedding festivities and at the wedding itself, Clifford – the groom – was the life and soul of the party. He had agreed that the wedding could be held in the native country of his fiancé, Carlotta. His few family members and friends flew in for the week of gatherings. With a new ensemble each night, Clifford looked magnificent for all the events, and particularly so at the wedding itself, where he was resplendent in a kilt.

He flashed his beautiful smile and gave eloquent speeches, declaring his love for Carlotta with expressive words and gestures (although he was publicly critical of Carlotta’s sister: without reason, Carlotta thought). Carlotta’s nephew exclaimed that he wanted to be “just like Clifford” when he grew up. Both sets of parents looked on approvingly, happy that their children could look forward to a wonderful new life together.

But things seemed to change when Carlotta and Clifford returned, after their expensive honeymoon, to Australia. Clifford quickly seemed to lose awareness of his new wife and her feelings, doing things like bringing business associates home to dinner with no notice and overriding her wishes on nearly all household decisions, even though Carlotta brought in as much money as he did.

Clifford’s style of lovemaking seemed to be only for the purposes of satisfying himself, and he displayed increasingly sour moods, to the point that he would not even acknowledge the presence of Carlotta’s friends or her family members who came to visit. As Clifford insisted on “nothing but the best”, the couple was soon beset by huge debts, including the mortgage for their beautiful house in an exclusive suburb. As Clifford sank deeper into his ugly moods, began a series of affairs, and then withdrew completely, Carlotta wondered what happened to all the romantic promises he had made.

If Clifford’s behaviour seems similar to that of someone you know, you are probably already familiar with the personality disorder of narcissism.

Definition and a few facts

Narcissistic personality disorder (NPD) is a disorder in which individuals seem to have an inflated sense of their own importance and an unrealistically deep need for admiration. A person with NPD is majorly preoccupied with issues of power, personal adequacy, prestige, and vanity. He or she lacks empathy and exudes a sense of superiority, but beneath the mask of super-confidence rests an extremely fragile self-esteem.

Individuals with NPD are insensitive to others’ feelings, but crumple at the slightest hint of criticism to themselves. Heinz Kohut formulated the construct of narcissism in 1968; it was called “megalomania” before then. The condition is similar to egocentrism (Mayo Clinic, 2011; Wikipedia, 2012).

Epidemiology

The lifetime prevalence of NPD is estimated at 6.2 percent in the general population, 9.4 percent among people age 20 to 29 (Miller & Campbell, 2010), and up to 16 percent in clinical populations. Fifty to 75 percent of those with the NPD diagnosis are men (Groopman and Cooper, 2006). Studies conducted in 2009 (Twenge and Campbell) suggested that the incidence of NPD has more than doubled in the US in the last 10 years.

Symptoms/ Diagnostic criteria

The DSM – IV (replaced in 2013 with the DSM – V) talks about NPD as “a pervasive pattern of grandiosity (in fantasy or behaviour), 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:

  1. Has a grandiose sense of self-importance, exaggerating achievements and skills and expecting to be recognized as superior without commensurate achievements
  2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  3. Believes that he or she is “special” and unique and can only be understood by, or should associate with, other high-status people (or institutions)
  4. Requires excessive admiration
  5. Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
  6. Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
  7. Lacks empathy; is unwilling to recognize or identify with the feelings and needs of others
  8. Is often envious of others or believes that others are envious of him or her
  9. Shows arrogant, haughty behaviours or attitudes.” (American Psychiatric Association, 2000, p 294).

This article is an extract of Mental Health Academy’s “Narcissism: The Basics” course. The aim of this course is to acquaint you with the basics of narcissism as it is understood by clinicians and researchers. Click here for more information about this course.

References:

  • American Psychiatric Association. (2000). Quick reference to the diagnostic criteria from DSM – IV – TR. Washington, D.C.: American Psychiatric Association.
  • Groopman, L. C., and Cooper, A. M. (2006). Narcissistic personality disorder. Armenian Medical Network. Retrieved on 11 September, 2012, from: http://www.health.am/psy/narcissistic-personality-disorder/
  • Mayo Clinic. (2012). Narcissistic personality disorder. Mayo Clinic. Retrieved on 11 September, 2012, from: http://www.mayoclinic.com/health/narcissistic-personality-disorder/DS00652
  • Miller, J. D. & Campbell, K. (2010). The case for using research on trait narcissism as a building block for understanding Narcissistic Personality Disorder. Personality Disorders: Theory, Research and Treatment. 1 (3), 180 – 191.