A 30-year-old man is repeatedly fired because he believes he deserves special treatment, takes advantage of colleagues, lacks empathy, and is preoccupied with fantasies of unlimited success. He reacts with rage when criticized. Which personality disorder cluster and SPECIFIC diagnosis fits BEST?

• A Cluster A; Schizoid Personality Disorder
• B Cluster B; Narcissistic Personality Disorder ✓
• C Cluster C; Obsessive-Compulsive Personality Disorder
• D Cluster B; Antisocial Personality Disorder

Explanation

Narcissistic Personality Disorder (NPD, Cluster B) requires at least 5 of 9 criteria: grandiosity, preoccupation with unlimited success/power, belief in special uniqueness, need for admiration, sense of entitlement, interpersonal exploitation, lack of empathy, envy, and arrogant behavior. The key distinguishing features from Antisocial PD: NPD involves grandiosity, need for admiration, and hypersensitivity to criticism (narcissistic rage), while Antisocial PD involves a pervasive pattern of violating others' rights, deceitfulness, and criminal behavior with callous indifference—not necessarily grandiosity.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.