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Narcissistic Personality Disorder The Diagnostic and Statistical Manual of Mental Disorders Fourth Edition describes Narcissistic Personality Disorder 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 as indicated by five or more of the following has a grandiose sense of self-importance eg exaggerates achievements and talents expects to be recognized as superior without commensurate achievements is preoccupied with fantasies of unlimited success power brilliance beauty or ideal love 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 requires excessive admiration has a sense of entitlement ie unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations is interpersonally exploitive ie takes advantage of others to achieve his or her own ends lacks empathy is unwilling to recognize or identify with the feelings and needs of others is often envious of others or believes that others are envious of him or her shows arrogant haughty behaviors or attitudes Two forms of narcissism Michael H Stone neatly contrasts the supposed etiologies of the two narcissistic personality disorders the Narcissistic and the Compensatory Narcissistic Narcissistic traits can develop curiously when there are deviations from ideal rearing on either side pampering or neglecting expecting too much or too little Excessive praise of a child whether the child is unusually talented or not can give rise to what Tartakoff 1966 called the Nobel Prize complex Feelings of superiority of being destined for greatness may arise in this situation But compensatory feelings of a similar kind can arise where there has been parental indifference and neglect for in this situation a child may develop an exaggerated desire for greatness by way of shoring up a sense of self-worth in the absence
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