Narcissistic Personality Disorder

  • Medical Author:
    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

What are causes and risk factors for narcissistic personality disorder?

As with most mental-health disorders, narcissistic personality disorder does not have one single definitive cause. Rather, people with this illness tend to have biological, psychological, and environmental risk factors that contribute to its development. Biologically, narcissists are thought to have a tendency to have a smaller part of the brain that is related to having empathy for others.

Psychologically, individuals with narcissistic personality disorder tend to have trouble having opposing self-images of excessive admiration and devaluing in their minds and in their relationships. They are thought to be excessively emotionally sensitive.

Early psychoanalytic theory on the emotional motivations for the development of narcissistic personality disorder focused on the relationship between mothers and sons. Specifically, it was thought that men develop this disorder as the result of having an excessively close relationship with their mother that is contingent upon always doing what she wants, with a resulting paranoid fear of being retaliated against by their father and humiliated or abandoned by their mother. Since those early theories, the social risk factors for developing NPD have been expanded to include excessive admiration or neglect by either parent.

In addition to receiving excessive, unrealistic admiration, praise, and overindulgence, or excessive criticism for misbehavior during childhood, theories about other social risk factors of narcissistic personality disorder include emotional abuse, unpredictable parental care, and learning manipulation from caregivers.

What are narcissistic personality disorder symptoms and signs?

In order to be assessed with the diagnosis of narcissistic personality disorder, an individual must demonstrate a pervasive pattern of significantly inflated self esteem (grandiosity), a need to be admired and lack of empathy for others that begins by early adulthood and is present in a number of different aspects of their life. Specific symptoms and signs of this illness can include the following:

  • An excessive sense of self importance, with an expectation of being seen as superior for no reason
  • Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or love
  • Excessive belief that he or she is special or unique
  • A need for excessive admiration
  • A sense of entitlement to special treatment or compliance with their wishes
  • A tendency to take advantage of others to achieve their own goals
  • Lacking empathy for the needs and feelings of others
  • Frequently envious of others or thinking others are envious of him or her
  • Exhibits arrogant thoughts or behaviors

Individuals who have some symptoms of narcissistic personality disorder but not enough for the diagnosis to be assigned are often described as having narcissistic traits.

Medically Reviewed by a Doctor on 11/19/2015

Subscribe to MedicineNet's Depression Newsletter

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

Health Solutions From Our Sponsors