Narcissistic Personality Disorder 671
others who talk about their ow n problems and concerns. These individuals may be oblivious
to the hurt their remarks may in flict (e.g., exuberantly telling a former lover that “I am now
in the relationship of a lifetime !”; boasting of health in front of someone who is sick). When
recognized, the needs, desires, or feelings of others are likely to be viewed disparagingly as
signs of weakness or vulnerability. Those who re late to individuals with narcissistic person-
ality disorder typically find an emotional coldness and lack of reciprocal interest.
These individuals are often envious of others or believe that others are envious of them
(Criterion 8). They may begrudge others their su ccesses or possessions, fe eling that they better
deserve those achievements, admiration, or priv ileges. They may harshly devalue the contri-
butions of others, particularly when those individuals have received acknowledgment or
praise for their accomplishments. Arrogant, haug hty behaviors characterize these individuals;
they often display snobbish, disdainful, or patr onizing attitudes (Criterion 9). For example, an
individual with this disorder may complain about  a clumsy waiter’s “rudeness” or “stupidity”
or conclude a medical evaluation with a condescending evaluation of the physician.
Associated Features Supporting Diagnosis
Vulnerability in self-esteem makes individuals with narcissistic personality disorder very
sensitive to “injury” from criticism or defe at. Although they may not show it outwardly,
criticism may haunt these individuals and ma y leave them feeling humiliated, degraded,
hollow, and empty. They may react with disdain, rage, or defiant counterattack. Such ex-
periences often lead to social withdrawal or an appearance of humility that may mask and