How Is a Narcissistic Personality Disorder Diagnosed?

The latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) lists nine characteristics that define persons with NPD:

  1. An exaggerated sense of self-importance; feelings of grandiosity, omnipotence and infallibility.
  2. A belief that he or she is somehow “special” and should only associate with people who are at the same level.
  3. A tendency to fantasize frequently about achieving great success and gaining public recognition.
  4. A desire to be praised, flattered and admired by everyone around them.
  5. A willingness to exploit others (even friends and family members) for personal gain.
  6. A sense of entitlement, a firm conviction that they are more deserving of fame and fortune than others.
  7. An inability to empathize with other people or accurately perceive their feelings.
  8. An inclination to feel envious about the success of others, and to respond with resentment when asked to acknowledge it.
  9. A reluctance to treat others with kindness, courtesy and respect in most social encounters.

If an individual displays five or more of these traits, a diagnosis of narcissistic personality disorder can be made by a psychologist or psychiatrist.

Hostility and Rage in Men With NPD

Narcissistic personality disorder is found in both men and women. But there is an anger and aggressiveness in the actions and behavior of men who suffer from the disorder that is quite distinctive.

Men with NPD react (or more accurately, overreact) with anger, defensiveness, sarcasm and hostility when subject to any type of criticism or dissent. Believing they’re always right, they see hidden agendas behind differences of opinion and will frequently accuse others of acting in bad faith.

For reasons that aren’t entirely clear, their rage is more often directed at women than other men, and domestic abuse is not uncommon among men who suffer from this disorder. Their attitudes and behaviors make it difficult for men with NPD to form lasting, rewarding relationships, and even those who stick with them the longest often give up in the end.

Finding Hope in the Contradictions of NPD

Despite their self-absorption and apparent self-love, men with NPD actually lack healthy self-esteem and are constantly overcompensating for a poor self-image.

Ironic as it sounds, this is important to understand, because it is this surprising fact that gives friends and family members an opening. If they can somehow break through the walls men with NPD erect to protect themselves, and get them to admit that they aren’t nearly as self-assured as they pretend to be, they might be able to convince them to seek professional help.

Men who agree to participate in a recovery program at a men’s treatment center could find the support and understanding they need to come to terms with their narcissism. By opening their hearts and minds and becoming more thoughtful and reflective, they could learn to manage their NPD so it no longer rules their lives.


BPD Central: Narcissistic Traits

The Narcissistic Life: Dealing with Narcissistic Men in Relationships


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