Narcissistic Personality Disorder Symptoms, Early Warning Signs, & Ways to Cope

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the standard reference manual used worldwide to diagnose mental health conditions. For NPD, it specifies the following nine symptoms that clinicians look for when making a diagnosis.²

1. Grandiose Sense of Self-Importance

Grandiosity means acting “larger than life.” Specifically, the DSM-5 describes grandiosity as “exaggerating achievements and talents” and “expecting to be recognized as superior without actual achievements to match.” For example, people with NPD often insist on being treated as special, even when the facts don’t back this type of treatment up. 

Grandiosity seems to do two main jobs for the person who displays it: 

1. It protects a fragile self to keep shame at bay. 
2. It functions as a social strategy of projecting high status to secure admiration, resources, or influence.³

As you may expect, people with narcissism who show signs of grandiosity are typically very outgoing and bold. They often love attention and may step into the spotlight to charm a room, but this charisma tends to hide a sense of entitlement.

2. Preoccupation With Fantasies of Success, Power, or Beauty

People with NPD spend real mental space (daydreams and internal narratives) imagining themselves in exceptional roles – beyond what’s realistic. In close relationships, people around them might notice how conversations keep circling back to grandeur or future glory. 

In fact, intimate partners of those with NPD often report that pathological narcissism isn’t about simply being boastful; fantasies become part of the person’s emotional life. These reports came from a study interviewing partners and family of people with narcissism, as they described how these people retreated into imagined versions of themselves when criticised.⁴

In addition, these fantasies aren’t plausible. Based on findings, researchers judged grandiose fantasies as more ambitious and less realistic than regular positive future thinking.⁵

Some ways this preoccupation with fantasizing may show up in behaviors and conversations include: 

• Curating social media to reflect the version of themselves they believe is their rightful legacy
• Setting extremely ambitious and unrealistic goals (for example, “I’ll write a book that reshapes culture”) without grounding in feasible steps
• Stockpiling material items, such as extravagant cars or flashy clothes
• Hinting at or openly asserting that they are destined for greatness

3. Beliefs of Being Special and Unique

Another striking sign of NPD is the strong conviction of being special. This means believing that they can only be understood by, or should only associate with, other high-status people. 

A person with this trait typically dismisses the opinions of others whom they view as less accomplished. They may also actively seek out connections with people or organizations that improve their image of prestige. Examples of such organizations include elite schools, exclusive social circles, and high-profile workplaces.

Additionally, a large review on pathological narcissism notes that “special and unique” beliefs fuel entitlement. They also typically make people hypersensitive to others not recognizing their supposed exceptional status.⁴

Further, studies using narcissism assessment tools, such as the Five-Factor Narcissism Inventory, have also found that these beliefs are strongly tied to interpersonal problems, particularly arrogance toward peers.⁶

4. Need for Excessive Admiration

People with narcissistic traits often expect more attention and validation than others, and they behave in ways to secure it. 

They might fish for compliments or set up situations where admiration is almost guaranteed (like social media posts meant to impress). They may also have a tendency to show off accomplishments in exaggerated terms. 

Moreover, they may expect others to point out their strengths even when nothing special has happened. When they don’t get admiration, their default response is often to feel hurt and unnoticed. They may even interpret neutral feedback as criticism. 

In a large sample of undergraduates, admiration scores on the Narcissistic Admiration and Rivalry Questionnaire (NARQ) predicted how socially charming someone with NPD can appear initially. However, later, higher scores also predicted problems when admiration was not sustained.⁷

5. Sense of Entitlement

A “sense of entitlement” means believing one deserves special treatment without earning it in the usual way. It is a stable belief that others should bend to one’s needs and help them automatically.

The Narcissistic Personality Inventory (NPI) is another NPD assessment tool that has an “Exploitiveness/Entitlement” subscale. Studies using this tool show how people who score high on entitlement tend to have more mood swings when they don’t feel they are being treated “correctly.”⁸ Further, a recent study also found that entitlement is closely linked to being disagreeable (less warm and cooperative) and having problematic relationships.⁹

Both grandiose and vulnerable narcissism share signs of entitlement, but they show up differently. Grandiose narcissists believe they are inherently superior, so they think they deserve more because “they just do.” 

In contrast, vulnerable narcissists typically feel that they’ve been disadvantaged, so their sense of being owed comes from a feeling of unfairness. 

6. Exploitative Behavior in Relationships

Exploitative behavior refers to using other people to get what you want without regard for their feelings.

People with this trait might treat others more like tools than partners. For example, they may demand emotional support, money, favors, and admiration from others while expecting them to adjust to their schedule. When these expectations are challenged, there can be anger, blame, gaslighting, and withdrawal rather than acknowledgement.

Unfortunately, a study looked at people in intimate relationships with someone scoring high in narcissistic traits and found that many reported emotional, verbal, and financial exploitation.¹⁰

7. Lack of Empathy

The unwillingness or inability to recognize the feelings and needs of others is a major sign of NPD. Research classifies empathy into two types:

1. Cognitive empathy, which is understanding what someone else is thinking or feeling
2. Emotional empathy, which is feeling with others and sharing their suffering or joy 

People with NPD tend to have pretty good cognitive empathy but trouble with emotional empathy.¹¹ For example, they might correctly identify sadness in someone’s behavior (cognitive empathy), yet fail to respond with genuine warmth and concern (emotional empathy).

Research describes empathy in NPD as “dysfunctional,” not simply “absent.” This means the empathy someone with NPD has may come on inconsistently, depending on whether it serves a purpose for themselves.¹²

8. Envy of Others or Belief Others Envy Them

The DSM-5 also mentions that people with NPD display two types of envious behaviors:

1. Envying what others have, like success, status, appearance, and relationships
2. Believing that others are envious of them for the same reasons

Vulnerable narcissists tend to report higher dispositional envy (which is a baseline tendency to envy others). In contrast, grandiose narcissists may downplay envy unless threatened, though they might strongly believe others envy them.

In research experiments where people see a peer getting high monetary benefits, vulnerable narcissists were visibly envious. However, grandiose ones reacted with dismissive and hostile behaviors – they also maintained that they were the ones who deserved more admiration.¹³

Additionally, feeling entitled could amplify envy in people with narcissism. This is because, when someone believes they deserve special treatment or success, seeing someone else get it might feel unfair.

9. Arrogant and Haughty Attitudes

According to criteria, people with NPD tend to show visibly arrogant behaviors. For example, they could: 

• Subtly or blatantly belittle others
• Dismiss contributions
• Correct people condescendingly
• Act as though they need not follow norms

Put simply, they may behave as if only their perspective matters. Such a sense of arrogance is also often projected through self-promoting behaviors. For instance, showing off talents, seeking attention in public, choosing tasks where they can be admired, and performing helpful acts only when it enhances their image. 

In addition, research finds that narcissists are more willing to verbally demean others when their own status feels threatened.¹⁴