What are the DSM-5 diagnostic criteria for narcissistic personality disorder (NPD)?

Updated: May 16, 2018
  • Author: Sheenie Ambardar, MD; Chief Editor: David Bienenfeld, MD  more...
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Answer

In the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), [1] NPD is defined as comprising a pervasive pattern of grandiosity (in fantasy or behavior), a constant need for admiration, and a lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by the presence of at least 5 of the following 9 criteria:

  • A grandiose sense of self-importance

  • A preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love

  • A belief that he or she is special and unique and can only be understood by, or should associate with, other special or high-status people or institutions

  • A need for excessive admiration

  • A sense of entitlement

  • Interpersonally exploitive behavior

  • A lack of empathy

  • Envy of others or a belief that others are envious of him or her

  • A demonstration of arrogant and haughty behaviors or attitudes

In a proposed alternative model cited in DSM-5, NPD is characterized by moderate or greater impairment in personality functioning, manifested by characteristic difficulties in 2 or more of the following 4 areas [2] :

  • Identity

  • Self-direction

  • Empathy

  • Intimacy

In addition, NPD is characterized by the presence of both grandiosity and attention seeking.


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