The basis for a diagnosis is having a pervasive pattern of grandiosity(in behavior or fantasy), lack of empathy, and a need for admiration. These should begin by early adulthood and present in a variety of contexts as indicated by 5 or more of the following:

1. Has grandiose sense of self-importance
2. Is preoccupied with fantasies of unlimited success, power, beauty, brilliance, or ideal love
3. Believes that she/he is special and unique and can only be understood by, or should associate with higher-status people
4. Requires excessive attention
5. Has a sense of entitlement
6. Lacks empathy; unwilling to recognize the feelings of others
7. Is interpersonally exploitive
8. Often envious of others and/or believes others are envious of them
9. Shows arrogant behavior or attitude