Narcissistic Personality Disorder: Pathogenesis and Clinical Findings

 • Arrogant, Haughty Behaviors or Attitude - Often display snobbish, disdainful, or patronizing attitudes

 • Need for Admiration - Constant need to be the center of attention, feel mistreated when they are not

 • Entitlement & Envy - Needing the best of something/expect favorable treatment and recognition AND feel they deserve achievements of others / devalue those who disappoint them

 • Superficial and Exploitive Relationships - Relationships based on surface attributes and valued because they are viewed as beneficial for personal gain and used as tools to build up positive self-states and self-definition

 • Grandiosity - Exaggerated sense of self-importance, with private fantasies of unlimited success, beauty, brilliance, power, or love

 • Identity Disturbance - Sense of self is relatively superficial, rigid, and often fragile, sustained only by constant feedback of superiority. Try hard for affection, are sensitive to criticism/failure and are often depressed

 • Vulnerable to Life Transitions - Difficulty maintaining reality-based personal and professional goals. Requirements / compromises of work seem intolerable, causing a withdrawal to protect their feelings of specialness

 • Lack of Empathy - Difficulty recognizing the desires, subjective experiences, and feelings of others. Tend to discuss their own concerns in inappropriate detail, impatient with problems of others

NPD Mnemonic: SPEEECIAL

Dx: 25 Of the below, beginning in early adulthood, and present in a variety of contexts

 - Special feelings of importance

 - Preoccupied with fantasies (success, power, beauty, love)

 - Entitlement, Excess admiration, Envious of others (or believes others are of them)

 - Conceited (grandiose)

 - Interpersonal exploitation

 - Arrogant

 - Lacks empathy



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