## Narcissistic Personality Disorder (NPD) **Key Point:** NPD is a Cluster B personality disorder defined by the DSM-5 triad of grandiosity, entitlement, and lack of empathy. ### Core Features | Feature | Description | |---------|-------------| | Grandiosity | Preoccupation with fantasies of unlimited success, power, or brilliance | | Need for admiration | Requires excessive admiration and interpersonal exploitation | | Lack of empathy | Unwilling to recognize or identify with others' feelings and needs | | Entitlement | Expects special treatment without reciprocal responsibilities | | Interpersonal exploitation | Takes advantage of others to achieve own goals | **High-Yield:** NPD is part of the **Dramatic Cluster (B)** — characterized by emotional instability, impulsivity, and interpersonal dysfunction. The hallmark distinguishing feature from other Cluster B disorders is the *defensive grandiosity* and *absence of guilt or remorse*. **Clinical Pearl:** Patients with NPD rarely seek treatment voluntarily; they typically present when external circumstances force them (legal issues, relationship breakdown, occupational failure). **Mnemonic: GRAN** — **G**randiosity, **R**equires admiration, **A**bsence of empathy, **N**eed for special treatment. ### Differentiation from Other Cluster B Disorders - **Histrionic PD:** Seeks attention through emotional expressiveness and seductiveness, but lacks the deep grandiosity and entitlement of NPD. - **Antisocial PD:** Shares lack of empathy but is defined by *conduct violations* and *criminal behavior*, not grandiosity. - **Borderline PD:** Characterized by fear of abandonment and emotional instability, not grandiosity. [cite:DSM-5 Diagnostic and Statistical Manual of Mental Disorders]
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