A formal psychiatric diagnosis: pervasive grandiosity, need for admiration, and lack of empathy as defined in the DSM-5.
Narcissistic Personality Disorder (NPD) is a formal psychiatric diagnosis defined in the DSM-5 as a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts.
The DSM-5 diagnostic criteria require five or more of nine specific traits: a grandiose sense of self-importance; preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love; belief that they are special and unique; requirement for excessive admiration; a sense of entitlement; interpersonally exploitative behavior; lack of empathy; envy of others or belief that others are envious of them; and arrogant, haughty behaviors or attitudes.
NPD is estimated to affect approximately 1-6% of the general population, with higher rates in clinical samples. It is among the most treatment-resistant of the personality disorders.
Important caveat: the behavioral patterns described in this system are not limited to individuals with a formal NPD diagnosis. Many people who cause significant relational harm through narcissistic behavior do not meet the full diagnostic criteria. The behavioral tests described here are designed to identify harmful patterns, not to diagnose clinical conditions.
A subtype of narcissistic personality disorder characterized by hidden grandiosity, victimhood, and indirect manipulation.
The classic, visible form of narcissistic personality disorder — obvious grandiosity, entitlement, and rage responses to criticism.
A cluster of three overlapping traits — narcissism, Machiavellianism, and subclinical psychopathy — that together produce manipulative behavior.