NPD means Narcissistic Personality Disorder, an axis II, Cluster B personality disorder in the DSM IV (Diagnostic and Statistical Manual of Mental Disorders). This site will give you some valuable information on how the DSM IV classifies and defines certain psychological disorders: DSM, Axis II, Cluster B.
Last year (2011) it was announced that Narcissistic Personality Disorder, among others, was going to be removed from the DSM V, but apparently this met with some serious opposition. Instead, the disorder was redefined for inclusion in the new edition and as of June 2011, was as follows:
The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose narcissistic personality disorder, the following criteria must be met:
A. Significant impairments in personality functioning manifest by:
-1. Impairments in self functioning (a or b):
--a. Identity: Excessive reference to others for self-definition and self-esteem regulation; exaggerated self-appraisal may be inflated or deflated, or vacillate between extremes; emotional regulation mirrors fluctuations in self-esteem.
--b. Self-direction: Goal-setting is based on gaining approval from others; personal standards are unreasonably high in order to see oneself as exceptional, or too low based on a sense of entitlement; often unaware of own motivations.
AND
-2. Impairments in interpersonal functioning (a or b):
--a. Empathy: Impaired ability to recognize or identify with the feelings and needs of others; excessively attuned to reactions of others, but only if perceived as relevant to self; over- or underestimate of own effect on others.
--b. Intimacy: Relationships largely superficial and exist to serve self-esteem regulation; mutuality constrained by little genuine interest in others’ experiences and predominance of a need for personal gain.
B. Pathological personality traits in the following domain:
-1. Antagonism, characterized by:
--a. Grandiosity: Feelings of entitlement, either overt or covert; self-centeredness; firmly holding to the belief that one is better than others; condescending toward others.
--b. Attention seeking: Excessive attempts to attract and be the focus of the attention of others; admiration seeking.
C. The impairments in personality functioning and the individual’s personality trait expression are relatively stable across time and consistent across situations.
D. The impairments in personality functioning and the individual’s personality trait expression are not better understood as normative for the individual’s developmental stage or socio-cultural environment.
E. The impairments in personality functioning and the individual’s personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).
The DSM IV characterized NPD thus:
Narcissistic Personality Disorder
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, as indicated by five (or more) of the following:
(1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
(2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
(3) believes 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)
(4) requires excessive admiration
(5) has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
(6) is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
(7) lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
(8) is often envious of others or believes that others are envious of him or her
(9) shows arrogant, haughty behaviors or attitudes
One of the best translations this psychobabble into plain English was written by the late Joanna Ashmun on her site. In it, she takes each of the nine points above and carefully provides examples of what they mean. Until reading Ashmun’s illustration, for example, I would not have called my personality disordered mother “grandiose” because my definition of the word didn’t seem to describe any of her attributes. But after reading “...in their own view, they are the star, and they give the impression that they are bearing heroic responsibility for their family or department or company, that they have to take care of everything because their spouses or co-workers are undependable, uncooperative, or otherwise unfit. They ignore or denigrate the abilities and contributions of others and complain that they receive no help at all; they may inspire your sympathy or admiration for their stoicism in the face of hardship or unstinting self-sacrifice for the good of (undeserving) others. But this everyday grandiosity is an aspect of narcissism that you may never catch on to unless you visit the narcissist's home or workplace and see for yourself that others are involved and are pulling their share of the load and, more often than not, are also pulling the narcissist's share as well…” I nearly fell out of my chair—this so accurately described my mother that it was creepy!
The Mayo Clinic describes NPD thus: Narcissistic personality disorder is characterized by dramatic, emotional behavior, which is in the same category as antisocial and borderline personality disorders.
Narcissistic personality disorder symptoms may include:
• Believing that you're better than others
• Fantasizing about power, success and attractiveness
• Exaggerating your achievements or talents
• Expecting constant praise and admiration
• Believing that you're special and acting accordingly
• Failing to recognize other people's emotions and feelings
• Expecting others to go along with your ideas and plans
• Taking advantage of others
• Expressing disdain for those you feel are inferior
• Being jealous of others
• Believing that others are jealous of you
• Trouble keeping healthy relationships
• Setting unrealistic goals
• Being easily hurt and rejected
• Having a fragile self-esteem
• Appearing as tough-minded or unemotional
Although some features of narcissistic personality disorder may seem like having confidence or strong self-esteem, it's not the same. Narcissistic personality disorder crosses the border of healthy confidence and self-esteem into thinking so highly of yourself that you put yourself on a pedestal. In contrast, people who have healthy confidence and self-esteem don't value themselves more than they value others. (Emphasis mine.)
When you have narcissistic personality disorder, you may come across as conceited, boastful or pretentious. You often monopolize conversations. You may belittle or look down on people you perceive as inferior. You may have a sense of entitlement. And when you don't receive the special treatment to which you feel entitled, you may become very impatient or angry. You may insist on having "the best" of everything — the best car, athletic club, medical care or social circles, for instance.
But underneath all this behavior often lies a fragile self-esteem. You have trouble handling anything that may be perceived as criticism. You may have a sense of secret shame and humiliation. And in order to make yourself feel better, you may react with rage or contempt and efforts to belittle the other person to make yourself appear better.
Narcissists carry with them a bag of tricks, tools of their disorder, designed to bring them what the layperson likes to call “strokes.” There are good strokes and there are bad strokes, but the narcissist doesn’t care—any stroke is better than no stroke at all. Hence there are narcissists who self-aggrandize, who puff themselves up to look supremely important and elicit admiration (or fear) in others…and there are narcissists who present themselves as pathetic victims of others, old ladies whose mean children (who suffered a lifetime of abuse at their hands) neglect them, people who feel picked on because the law or the rules of the home, school, workplace or social interaction shouldn’t be applied to them because they are somehow special and above the rest of us mere mortals, or the pathetically abused who flit from one abuser to another whining “why me?” but who garner an endless supply of sympathy and even well-intentioned outrage on their behalf, to stroke their egos. Strokes are strokes, whether they feel good or bad—they are attention and if good attention is not available, bad attention will suffice.
Narcissist’s tricks include (but are not limited to) manipulation, twisting the truth, and outright lying. They use “gaslighting,” (see Glossary) triangulation, projection and misdirection, feigned hurt feelings, intimidation, even towering rages to get what they want from their victims. Through all of this, the narcissist seeks to have control of his/her surroundings and all who are in it, and can be ruthless, even violent, in bending others to their will. The narcissist is the centre of the universe and the rest of the world revolves around him/her, the rest of us exist merely to supply the narcissist with attention and we simply do not exist to the narcissist outside that paradigm.
Some narcissists can be subtle, even charming, especially when first met. But the narcissist’s agenda is always his/her own selfish gratification and you are merely a means to that end. Malignant narcissists are the punitive ones, the ones who think nothing of wreaking violence on those who do not accede to their demands. The violence may be covert and psychological or it can be overt and physical, but in all cases, the violence is intentionally inflicted in a bid to control the victim and give the narcissist that desperately craved feeling of power.
NPD is a terrible thing to have to live with, especially if you are a child and have no avenue of escape.
