Narcissistic personality disorder (NPD) is an extensive pattern of distorted regard for self and others. Although it is normal and healthy to take a positive attitude toward oneself, narcissistic persons exhibit an inflated view of self as special and superior. Rather than strong self-confidence, however, narcissism reflects aggrandizing self-preoccupation. The narcissist is very active and competitive in seeking status, as outward signs of status are used as the measure of personal worth. When others fail to validate the special status of the narcissistic person, he or she is apt to view this as intolerable mistreatment and become angry, defensive, and depressed. The failure to be superior or regarded as special ac- tivates underlying beliefs of inferiority, unimportance, or powerlessness and the compensatory strategies of self-protection and self-defense.

Narcissistic individuals take pride in their social standing yet show some startling lacunae in adhering to norms and expectations of social reciprocity. Self-centered and inattentive to the feelings of others, the narcissist can turn a friendly exchange into an irritating display of selfpreoccupation. A deceptively warm demeanor may be marred by arro- gant outbursts, heartless remarks, or insensitive actions. Attention to the needs and feelings of others is lacking, whether in simple matters such as recognizing the contributions of others or in respecting more complex and deeply meaningful emotions. They may begrudge the successes of others and jealously judge or discredit those they view as encroaching competitors. The narcissist can also be masterful in twisting confrontations toward attributing blame and fault to other people.