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Narcissistic personality disorder (NPD) is a form of mental illness listed in the Diagnostic and Statistical Manual of Mental Disorders IV-TR (DSM IV-TR)and the International Classification of Diseases. Manifest by a lack of empathy, an extreme sense of entitlement, and the need to be constantly worshiped and admired, it is often referred to as psychopathic narcissism. Falling under the realm of personality disorders, NPD also has a particularly deviant form frequently discussed as a syndrome, given the term malignant narcissism. It is the disease that many associate with individuals given the label of psychopath or sociopath.
Personality disorders are a category of psychological conditions in which the affected individual displays disturbing behavior patterns that present problematic issues in daily life functioning in at least two of several areas, including emotional, cognitive, social, or self-control. With respect to the narcissistic personality, for a true diagnosis of this disorder, a minimum of five manifestations must be present, the most prominent symptom being the propensity to have an all self-important, grandiose perspective of self, including a completely self-absorbed and arrogant attitude. Other behavioral characteristics include a remarkable belief that he or she is, in fact, unique, possessing an imagined special talent or quality. The difference between this and high self-esteem is that a psychopathic narcissistic person exhibits a faked, exaggerated success, one that is a superficial display, while underneath lies an insecure person with low self-esteem.
Individuals considered to be psychopaths or sociopathic actually suffer from a mental condition called antisocial personality disorder (ASD), one of three diagnoses encompassing malignant narcissism syndrome, an express psychological illness of which narcissism and paranoid personality disorders also play a part. Psychopathic narcissism ranges in its severity, with NPD on the lower end and its malignant version on the extreme. NPD also has differing levels of intensity within it and some theorists conclude that subtypes of it exist. Thought to be a more severe variation on antisocial personality disorder, malignant narcissism syndrome is often outlined as a profiling trait of serial murderers and other violent criminals.
Causes of psychopathic narcissism are not known for certain; it is largely considered to be a myriad of areas working together involving early childhood trauma, as well as child-rearing and biological aspects. Psychologists have theorized that severe traumas during the early years can prompt children to create a way of coping, developing another reality in which they maintain control. Physical or sexual abuse and emotional neglect, especially extreme cases, are thought to be examples of direct primary causes.
Prognosis is generally poor for psychopathic narcissism, notably NPD. For patients with the malignant form, certain parts of it are treatable such as the paranoia and antisocial effects. Some disorders do tend to co-exist along with personality disorders, like anxiety and depression, for example; for these, patients are effectively helped with medication and psychotherapy.