Pathological narcissism
The other end of the continuum — narcissistic personality disorder — is a persistent inability to establish a realistic, stable self-image, therefore creating an overdependence on others to regulate their self-esteem. This unrealistic self-image affects how people with this disorder behave and interact with others.

Signs and symptoms of narcissistic personality disorder may include:

• Grandiose sense of one's own abilities or achievements
• Fantasies about having exceptional power, attractiveness or success
• Sense of belonging to an exclusive group of people who truly understand each other
• Need for constant praise
• Expectations of special treatment
• Exploitation of other people
• Lack of empathy for other people
• Envy of other people or a belief that you are the subject of other people's envy
• Haughty or arrogant behaviors

Individuals with narcissistic personality disorder may come across as conceited or snobbish. They often monopolize conversation. They may belittle or look down on people they perceive as inferior. When they don't receive the special treatment to which they feel entitled, they may become very impatient or angry.

People with narcissistic personality disorder tend to seek out individuals whom they perceive as equal to their own self-image or to whom they attribute the same special talents and qualities they see in themselves. They may insist on having "the best" of everything — car, athletic club or social circles.

Their personal relationships and interactions are driven by the need for admiration and praise. Consequently, people with narcissistic personality disorder value others primarily according to how well those individuals affirm their unrealistic self-image. This limited value of others usually means that people with the disorder aren't interested in or aren't capable of perceiving the feelings or needs of others. They may take advantage of other people to make themselves look as good as they imagine.