To Merovingian's point, I'm very leery of non-specialists offering psychological diagnoses. Yet, as more and more time goes on, I think that diagnosis fits Trump to a T. More to the point, it perfectly explains many of Trump's puzzling words, actions, and -- especially -- Tweets.
Practice EssentialsNarcissistic personality disorder (NPD) is a cluster B personality disorder defined as comprising
a pervasive pattern of grandiosity (in fantasy or behavior), a constant need for admiration, and a lack of empathy.Signs and symptomsIn the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), NPD is defined as comprising a pervasive pattern of grandiosity (in fantasy or behavior), a constant need for admiration, and a lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by the presence of
at least 5 of the following 9 criteria:
- A grandiose sense of self-importance
- A preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
- A belief that he or she is special and unique and can only be understood by, or should associate with, other special or high-status people or institutions
- A need for excessive admiration
- A sense of entitlement
- Interpersonally exploitive behavior
- A lack of empathy
- Envy of others or a belief that others are envious of him or her
- A demonstration of arrogant and haughty behaviors or attitudes
In a proposed alternative model cited in DSM-5, NPD is characterized by moderate or greater impairment in personality functioning, manifested by characteristic difficulties in 2 or more of the following 4 areas:
- Identity
- Self-direction
- Empathy
- Intimacy
In addition, NPD is characterized by the presence of both grandiosity and attention seeking.
NPD is not associated with any specific defining physical characteristics; however, physical consequences of substance abuse, with which NPD is often associated, may also be apparent on examination. Mental status examination may reveal depressed mood. Patients in the throes of narcissistic grandiosity may display signs of hypomania or mania.