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- National Center for Biotechnology Information - Narcissistic Personality Disorder (Oct. 31, 2026)
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What is narcissism in psychology?
In psychology, narcissism is characterized by an inflated sense of self-importance, a persistent need for admiration, and a lack of empathy. It can manifest as narcissistic personality disorder, diagnosed through clinical evaluation, marked by grandiosity, attention-seeking, and impaired empathy.
Narcissists often seek positive feedback to maintain their self-esteem and may manipulate others to gain admiration. Though narcissists report high self-esteem, it's often insecure and based on distorted perceptions. This can lead to disturbed relationships, as narcissists prioritize admiration over genuine connection, becoming hostile when challenged.
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What are some traits of a narcissistic person?
Narcissistic Personality Disorder (NPD) is characterized by grandiosity, a persistent need for admiration, and a lack of empathy. People with NPD often display arrogance, a sense of superiority, and aggressiveness. They are preoccupied with maintaining positive self-concepts, seeking admiration, and manipulating others to solicit praise.
Narcissists have inflated self-images, overestimate their attractiveness and intelligence, and take credit for positive outcomes, even when due to luck. Their self-esteem is fragile, leading to anger when threatened, which contributes to disturbed relationships. They brag and put others down, initially appearing competent but eventually viewed as arrogant and hostile.
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How does narcissism affect a person's relationships?
Narcissism can significantly impair a person's relationships due to impaired empathy and a need for admiration. Narcissists often manipulate others to coerce admiration, reflecting a chronic need to regulate self-esteem interpersonally. While they may initially appear attractive and competent, their arrogance and hostility eventually strain relationships.
Narcissists use their relationships to feel good about themselves, constantly seeking attention and admiration to support their positive, yet fragile, self-image. They are highly sensitive to perceived disrespect, reacting with anger and aggression, which further damages their interpersonal connections. This self-enhancement at the expense of others ultimately costs them friendships.
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What is narcissistic personality disorder (NPD)?
Narcissistic personality disorder (NPD) is characterized by grandiosity and attention-seeking behaviors, along with impairments in personality functioning. These include seeking external validation for self-esteem, a sense of exceptionalism, lack of empathy, and superficial relationships. These traits are generally stable and not due to medical conditions or developmental stages. People with NPD often seek admiration and manipulate others to get it, reflecting issues with self-esteem regulation.
NPD shares traits with antisocial personality disorder, such as lack of empathy and high self-opinion, but differs in impulsivity, aggressiveness, and deceitfulness.
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How do psychologists diagnose narcissistic personality disorder?
Psychologists typically diagnose narcissistic personality disorder (NPD) through clinical evaluations, as detailed in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
Diagnosis is based on identifying enduring personality traits, such as grandiosity and attention-seeking, alongside significant impairments in personality functioning. These impairments include relying on others for self-esteem regulation, a sense of exceptionality, lack of empathy, and superficial relationships. Assessments like the Narcissistic Personality Inventory (NPI) may be used, presenting individuals with statements to determine which best describes them. Although NPD is more common in men, the mere presence of narcissistic traits does not constitute a disorder; the traits must also cause distress to the individual or society.
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What are some ways narcissism can be treated or managed?
Narcissistic personality disorder is typically diagnosed through clinical evaluation, focusing on traits like grandiosity, attention-seeking, and impaired empathy. Cognitive behavior therapy (CBT), a common psychotherapy, can help individuals become aware of and change inaccurate or negative thinking patterns.
CBT focuses on how thinking patterns affect emotions and behaviors, helping individuals manage emotions, alter behaviors, and deal with problems and stresses more effectively. Narcissists often seek admiration to support positive self-images, reacting negatively to perceived disrespect. Over time, others may view them as arrogant and hostile, which ultimately costs them friendships.
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narcissism, pathological self-absorption, first identified as a mental disorder by the British essayist and physician Havelock Ellis in 1898. Narcissism is characterized by an inflated self-image and addiction to fantasy, by an unusual coolness and composure shaken only when the narcissistic confidence is threatened, and by the tendency to take others for granted or to exploit them. The disorder is named for the mythological figure Narcissus, who fell in love with his own reflection. According to Sigmund Freud, narcissism is a normal stage in child development, but it is considered a disorder when it occurs after puberty. In psychology and personality theory, narcissism refers to one element of the so-called âdark triadâ of related negative personality traitsâthe other two being Machiavellianism and psychopathy.
Definition and assessment
Narcissistic personality disorder is usually diagnosed through clinical evaluation. It is defined by the fifth edition (2013) of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in terms of the personality traits of grandiosity and attention-seeking and in terms of significant impairments in personality functioningâsuch as looking excessively to others for the regulation of self-esteem, viewing oneself as exceptional, having impaired empathy, and having mostly superficial relationships. Those qualities remain relatively stable over time and are not attributable primarily to a medical condition, the use of drugs, or the individualâs developmental stage. Researchers have also investigated a less-extreme form of narcissism that is termed the narcissistic personality type. Such individuals possess most or all of the characteristics of the narcissistic personality disorder but are considered within the normal range of personality.
Persons who display either narcissistic personality disorder or the narcissistic personality type are preoccupied with maintaining excessively positive self-concepts. They become overly concerned with obtaining positive, aggrandizing feedback from others and react with extreme positive or negative emotions when they succeed or fail to receive confirmation that others hold them in high regard. Narcissists want positive feedback about themsleves, and they actively manipulate others to solicit or coerce admiration from them. Accordingly, narcissism is thought to reflect a form of chronic interpersonal self-esteem regulation.
The narcissistic personality type is measured through self-report questionnaires such as the Narcissistic Personality Inventory (NPI), the most widely used such scale, which can also be used to assess narcissistic personality disorder. The NPI presents respondents with a set of forced-choice items in which they must decide which of two statements is most descriptive of them. For example, persons completing the NPI would be asked whether they are best described by âpeople always seem to recognize my authorityâ or by âbeing an authority doesnât mean that much to me.â People who score high on the NPI have been shown to display a wide variety of narcissistic behaviours, such as arrogance, feigned superiority, and aggressiveness. In addition, people with a clinical diagnosis of narcissistic personality disorder score higher on the NPI than do people with other psychiatric diagnoses or those in control groups.
Origins
Clinical theories of narcissism, such as those of the Austrian psychoanalysts Heinz Kohut and Otto Kernberg, posit that adult narcissism has its roots in early childhood experiences. Both Kohut and Kernberg focus on disturbances in early social (parental) relationships as the genesis of adult narcissistic personality disorder. Also, both view narcissism at its core as a defect in the development of a healthy self. According to Kohut, the childâs self develops and gains maturity through interactions with others (primarily the mother) that provide the child with opportunities to gain approval and enhancement and to identify with perfect and omnipotent role models. Parents who are empathic contribute to the healthy development of the childâs self in two ways. First, they provide mirroring that fosters a more realistic sense of self. Second, parents reveal limitations in themselves that lead the child to internalize or assume an idealized image that is realistic and possible to attain. Problems are introduced when the parent is unempathetic and fails to provide approval and appropriate role models. According to Kohut, narcissism is in effect developmental arrestâa halt in the childâs development at what was a normal and necessary stage, with the result that the childâs self remains grandiose and unrealistic. At the same time, the child continues to idealize others to maintain self-esteem through association.
In contrast, Kernbergâs theory maintains that narcissism is a defense. It results from the childâs reaction to coldness and lack of empathy on the parentsâ part, perhaps stemming from their own narcissism. According to Kernberg, the child becomes emotionally hungry and responds with rage to the parentsâ neglect. In this view the narcissistic defense reflects the childâs attempt to take refuge in some aspect of the self that evokes admiration in othersâa defense that ultimately results in a grandiose and inflated sense of self. Narcissists, in Kernbergâs view, are grandiose on the outside but vulnerable and questioning of their self-worth on the inside.
The theories of Kernberg and Kohut both characterize narcissists as individuals with a childhood history of unsatisfactory social relationships who as adults possess grandiose views of the self that foster a conflicted psychological dependence on others.

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