Narcissistic personality disorder is one of 10 clinically recognized personality disorders. Although narcissistic personality disorder is only one official diagnosis, doctors classify the condition into two types.
Healthcare professionals use the term “narcissism” to describe a focus or preoccupation with oneself or one’s own needs or desires. A person with narcissism may have an exaggerated sense of their importance and may lack empathy for others.
Narcissistic personality disorder is one of 10 types of personality disorders identified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). Read on for more information about the two types of narcissistic personality disorder.
What Are the Two Types of Narcissism?
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), published by the American Psychiatric Association (APA), lists narcissistic personality disorder as one disorder. However, experts generally agree that there are two subtypes of narcissism: grandiose narcissism and vulnerable narcissism. Both types can exist in a single individual.
These types share several core traits, including:
Selfishness
A sense of entitlement
A lack of empathy for others
These traits can manifest in different ways depending on the type of narcissism.
What is grandiose narcissism?
Grandiose narcissism is also referred to as overt narcissism. It’s what many people think of when they think of narcissism.
Some characteristics of grandiose narcissism may include:
Extroversion
Self-esteem
A bold or domineering personality
Vanity, pretense, or charm
Exaggerated abilities
Ideas of perfection or superiority
Attention-seeking or show-off behaviors
Aggression
A tendency toward exploitative behavior
Individuals with grandiose narcissism generally enjoy admiration and seek to reinforce positive perceptions of themselves and their abilities.
They may deny or reject information that conflicts with their self-image. They may also aggressively seek to assert dominance or superiority in settings such as work, school, or their relationships. This may occur especially when they feel their status or image is threatened.
What is Vulnerable Narcissism?
Vulnerable narcissism, also called covert narcissism, may include the following characteristics:
Introversion
Low self-esteem or insecurity
A sensitive or defensive personality
Envy or passive aggression
Distrustful or avoidant behavior
Neuroticism
Difficulty regulating emotions
Vulnerable narcissism is more internalized than grandiose narcissism. The individual may appear shy or reserved, yet may have internal feelings of superiority or entitlement.
They may seek admiration in less obvious ways, such as being passive or belittling themselves to seek admiration from others to boost their feelings of self-worth.
Individuals with vulnerable narcissism can also be extremely sensitive to perceived slights or criticisms. They may compare themselves to others a lot. As a result, they may display envy or schadenfreude (secretly feeling happy about someone else’s misfortune).
People with vulnerable narcissism may be more prone to lashing out in narcissistic rages. This may be because they may have lower self-esteem than people with grandiose narcissism, leading to anger or aggression.
How is narcissism diagnosed?
Diagnosing narcissistic personality disorder involves a physical and psychological evaluation. There are no specific laboratory tests that can diagnose personality disorders.
It is important to note that the traits of narcissistic personality disorder are similar to those of other personality disorders. Because of this, it is possible to receive a diagnosis of more than one personality disorder.
A physical exam can help rule out physical causes for your symptoms. A psychological evaluation can also help. This is when a professional conducts a comprehensive exploration of your personality through your history, questionnaires, and performance-based instruments.
Evaluating narcissistic traits or narcissistic personality disorder is a complex diagnostic process that can be performed by a licensed psychologist or psychiatrist.
Mental health professionals also use the DSM-5-TR to diagnose the condition. It includes a set of standardized criteria for diagnosing mental disorders.
What are the DSM-5 criteria for narcissistic personality disorder?To receive a diagnosis of narcissistic personality disorder, an individual must have:
Significant impairment in interpersonal and interpersonal functioning: This can include issues with identity, personal motivations, showing empathy, or maintaining intimacy.
Pathological personality traits: These may include things like covert or overt entitlement or selfishness, as well as attention-seeking or admiration-seeking behavior.
Consistency: The level of functioning and expression of pathological personality traits must be consistent across different times and situations.
There is no other explanation for their behavior: For example, factors such as age, culture, or socioeconomic status cannot explain the person’s behavior. Additionally, other medical conditions or substance abuse cannot explain the condition.
What is the treatment for narcissistic personality disorder?
People with narcissistic personality disorder have an inflated sense of themselves and may see the causes of their problems as external rather than internal and may not seek treatment.
Psychotherapy, also known as talk therapy, is used to treat narcissistic personality disorder. The goals of treatment are to:
Help you understand the causes of your emotions, feelings, and attitudes
Develop improved interpersonal relationships where you can accept and relate to others better
Develop a less inflated view of yourself, more achievable goals, and more realistic expectations of those around you
There are no medications that can specifically treat narcissistic personality disorder. However, if you have other conditions such as anxiety or depression, you may be prescribed medications, such as anti-anxiety medications or antidepressants, to control them.
What is the outlook for people with narcissistic personality disorder?
The outlook for people with narcissistic personality disorder depends on several factors. These may include things like the severity of the condition as well as the individual’s commitment to their treatment goals.
In general, seeking treatment is very important for managing narcissistic personality disorder. Those who seek and stick to a treatment plan can help improve their quality of life and level of functioning.
Conclusion
Narcissistic personality disorder is characterized by an elevated sense of self and a disregard for or lack of empathy for others. While the American Psychiatric Association (APA) defines narcissistic personality disorder as a single narcissistic disorder, it includes two subtypes.
Grandiose narcissism is associated with extroversion, high self-esteem, and exaggeration of abilities or accomplishments. Meanwhile, vulnerable narcissism is associated with introversion, low self-esteem, and insecurity or avoidance.
People with narcissistic personality disorder and those in relationships with them may benefit from treatment and adherence to a treatment plan. Both can help improve the quality of life for the person with narcissistic personality disorder and their friends, family, and loved ones.
