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9 Facts to Know About Narcissistic Personality Disorder Before Calling Someone a Narcissist

Narcissism, Narcissistic

1. Narcissism is a personality trait that centers around being self-involved, and it exists on a spectrum.

Just as people vary in how spontaneous, independent, thoughtful, or protective they are, people can also vary in how narcissistic—meaning how selfish, self-absorbed, or obsessed with themselves—they are. “Healthy self-esteem and pride in one’s accomplishments [are] a good thing,” psychologist Angela Grace, Ph.D., tells SELF. “However, further along the spectrum of narcissism can be a sense of exaggerated self-importance, grandiosity to the point of exploitation, and lack of empathy for others.”

2. Narcissistic personality disorder revolves around a prolonged, inflated sense of self, lack of empathy for others, and related symptoms.

NPD is listed as a personality disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Per the Merck Manual, people who have NPD persistently exhibit at least five of the following symptoms by early adulthood: 

  • An overwhelming sense of self-importance 
  • An obsession with fantasies about being incredibly successful, powerful, intelligent, attractive, or loved 
  • A belief that they are more special and unique than others 
  • A need for excessive admiration 
  • A strong sense of entitlement 
  • A habit of constantly taking advantage of other people 
  • A lack of empathy toward others 
  • An envy of others 
  • A haughty attitude 

3. Experts believe NPD’s characteristic outsized self-esteem is rooted in a person’s low opinion of themselves.

“An inflated sense of self … is actually a protection people with NPD use to cover up extreme hurt they are embarrassed or feel guilty about,” psychiatrist Laura Dabney, M.D., tells SELF.

4. It’s not entirely clear how common NPD is.

Since there’s a pretty significant dearth of research on the subject, there are no solid numbers on how prevalent NPD is. The DSM-5 says that estimates range from 0 to 6.2 percent of the population having NPD, which is kind of confusing. Here’s the deal.

5. It does seem as though narcissistic traits and NPD are more common in men than in women.

A massive 2014 review in Psychological Bulletin investigated the gender differences in narcissism to interesting results. After examining 31 years of narcissism research that included 470,846 participants, the study authors concluded that, on average, men were more likely to exhibit narcissistic traits such as entitlement and a quest for power.For instance, the outdated societal expectation is that men are more likely to be natural leaders, so they may be more inclined to seek power. More research is necessary to fully delve into possible social and biological factors behind gender differences in narcissism and NPD.

Narcissism, Narcissistic

6. Experts are not sure exactly what causes NPD.

“Little is known about narcissistic personality disorder’s causal factors,” Anthony DeMaria, Ph.D., a clinical psychologist and assistant professor of psychiatry at Mount Sinai Hospital, tells SELF.

7. NPD can be tough to diagnose because there aren’t easy tests for it, and it shares symptoms with other disorders.

Even though NPD symptoms can appear in adolescence, experts typically wait until adulthood to make a diagnosis, DeMaria says. This helps make sure those “symptoms” aren’t just due to a person being self-involved as they grow up then becoming better adjusted as an adult. There’s no lab test that can provide a diagnosis of NPD. Instead, a mental health professional can use interviews or questionnaires to see if someone is showing the NPD symptoms listed in the DSM-5, the Cleveland Clinic explains.

8. Therapy can help someone with NPD, but only if they’re willing to put in the work.

DeMaria says that NPD is “one of the hardest-to-treat psych conditions.”

Still, you don’t have to assume all hope is lost if you think a loved one has NPD. In Dabney’s experience, people with NPD seek treatment due to the ways their difficulty relating to people can manifest, like repeatedly getting fired, losing contact with their grown children, or struggling to maintain intimate relationships.

9. NPD is widely misunderstood, so educating yourself and others about what narcissism really means is important.

Mayer says that people often conflate NPD with someone who is “spoiled” or poorly socialized, but it’s much more than that. Unfortunately, the “narcissist” label is still persistently “overstated, overused and misapplied,” he says.


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