An exaggerated view of personal importance, abilities or achievements.
DSM-5-TR · Cluster B · personality disorder
Could I have narcissistic personality disorder?
Narcissistic personality disorder is characterised by a persistent pattern of grandiosity, need for admiration and lack of empathy. Having some of these traits does not mean that someone has a personality disorder: DSM-5-TR requires an enduring, pervasive and clinically significant pattern.
Cluster BDramatic, emotional or erratic patterns
5/9
DSM-5-TR
What are the DSM-5-TR features?
DSM-5-TR requires at least 5 of the 9 specific features, together with the general requirements for a personality disorder.
Specific criteria — paraphrased
Strong preoccupation with fantasies of success, power, beauty, intelligence or ideal love.
Believing oneself to be especially unique or understandable only by high-status people or institutions.
A strong need for admiration.
A sense of entitlement to special treatment or automatic fulfilment of expectations.
Using other people to achieve personal goals.
Marked difficulty recognising or taking account of other people’s feelings and needs.
Frequently envying others or believing that others envy them.
Arrogant or haughty attitudes and behaviours.
Diagnostic reference: DSM-5-TR (American Psychiatric Association, 2022). The wording above is intentionally concise and paraphrased.
The specific criteria are not sufficient on their own
- The pattern is enduring, inflexible and present across different contexts — not only during a crisis or in one particular relationship.
- It causes significant distress or impairment in social, occupational or other important areas of functioning.
- The pattern is stable over time and can be traced back at least to adolescence or early adulthood.
- It is not better explained by another mental disorder, a substance/medication effect or a medical condition.
Differential diagnosis
Narcissistic traits or narcissistic personality disorder?
Ambition, enjoying recognition or having some narcissistic traits is not enough. Diagnosis requires an enduring, pervasive pattern with significant consequences. Differential diagnosis notably includes bipolar disorder, antisocial personality disorder and histrionic personality disorder.
Clinical assessment
How is the diagnosis made?
Diagnosis is not based on a checklist or a single questionnaire. It requires clinical interviewing, review of the person’s long-term pattern and functional impact across settings, and differential diagnosis. Personality questionnaires and tests can support that assessment.
The 10 specific DSM-5-TR personality disorders
Explore the other personality disorders
Personality disorders can share features and sometimes overlap, making differential diagnosis essential.
Are you wondering about your personality functioning?
An emotional and personality assessment can compare several hypotheses, clarify the overall pattern and avoid drawing conclusions from a few isolated traits.
