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Diagnostic Criteria 301.81 (F60.81)
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
  1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
  2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
  3. Believes 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).
  4. Requires excessive admiration.
  5. Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).
  6. Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).
  7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
  8. Is often envious of others or believes that others are envious of him or her.
  9. Shows arrogant, haughty behaviors or attitudes.

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Diagnostic Features
The essential feature of narcissistic personality disorder is a pervasive pattern of grandiosity, need for admiration, and lack of empathy that begins by early adulthood and is present in a variety of contexts.
Individuals with this disorder have a grandiose sense of self-importance (Criterion 1). They routinely overestimate their abilities and inflate their accomplishments, often appearing boastful and pretentious. They may blithely assume that others attribute the same value to their efforts and may be surprised when the praise they expect and feel they deserve is not forthcoming. Often implicit in the inflated judgments of their own accomplishments is an underestimation (devaluation) of the contributions of others. Individuals with narcissistic personality disorder are often preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love (Criterion 2). They may ruminate about "'long overdue" admiration and privilege and compare themselves favorably with famous or privileged people.
Individuals with narcissistic personality disorder believe that they are superior, special, or unique and expect others to recognize them as such (Criterion 3). They may feel that they can only be understood by, and should only associate with, other people who are special or of high status and may attribute "unique," "perfect," or "gifted" qualities to those with whom they associate. Individuals with this disorder believe that their needs are special and beyond the ken of ordinary people. Their own self-esteem is enhanced (i.e., "mirrored") by the idealized value that they assign to those with whom they associate. They are likely to insist on having only the "top" person (doctor, lawyer, hairdresser, instructor) or being affiliated with the "best" institutions but may devalue the credentials of those who disappoint them.
Individuals with this disorder generally require excessive admiration (Criterion 4). Their self-esteem is almost invariably very fragile. They may be preoccupied with how well they are doing and how favorably they are regarded by others. This often takes the form of a need for constant attention and admiration. They may expect their arrival to be greeted with great fanfare and are astonished if others do not covet their possessions. They may constantly fish for compliments, often with great charm. A sense of entitlement is evident in these individuals' unreasonable expectation of especially favorable treatment (Criterion 5). They expect to be catered to and are puzzled or furious when this does not happen. For example, they may assume that they do not have to wait in line and that their priorities are so important that others should defer to them, and then get irritated when others fail to assist "in their very important work." This sense of entitlement, combined with a lack of sensitivity to the wants and needs of others, may result in the conscious or unwitting exploitation of others (Criterion 6). They expect to be given whatever they want or feel they need, no matter what it might mean to others. For example, these individuals may expect great dedication from others and may overwork them without regard for the impact on their lives. They tend to form friendships or romantic relationships only if the other person seems likely to advance their purposes or otherwise enhance their self-esteem. They often use special privileges and extra resources that they believe they deserve because they are so special.
Individuals with narcissistic personality disorder generally have a lack of empathy and have difficulty recognizing the desires, subjective experiences, and feelings of others (Criterion 7). They may assume that others are totally concerned about their welfare. They tend to discuss their own concerns in inappropriate and lengthy detail, while failing to recognize that others also have feelings and needs. They are often contemptuous and impatient with others who talk about their own problems and concerns. These individuals may be oblivious to the hurt their remarks may inflict (e.g., exuberantly telling a former lover that "I am now in the relationship of a lifetime!"; boasting of health in front of someone who is sick). When recognized, the needs, desires, or feelings of others are likely to be viewed disparagingly as signs of weakness or vulnerability. Those who relate to individuals with narcissistic personality disorder typically find an emotional coldness and lack of reciprocal interest.
These individuals are often envious of others or believe that others are envious of them (Criterion 8). They may begrudge others their successes or possessions, feeling that they better deserve those achievements, admiration, or privileges. They may harshly devalue the contributions of others, particularly when those individuals have received acknowledgment or praise for their accomplishments. Arrogant, haughty behaviors characterize these individuals; they often display snobbish, disdainful, or patronizing attitudes (Criterion 9). For example, an individual with this disorder may complain about a clumsy waiter's "rudeness" or "stupidity" or conclude a medical evaluation with a condescending evaluation of the physician.
Associated Features Supporting Diagnosis
Vulnerability in self-esteem makes individuals with narcissistic personality disorder very sensitive to "injury" from criticism or defeat. Although they may not show it outwardly, criticism may haunt these individuals and may leave them feeling humiliated, degraded, hollow, and empty. They may react with disdain, rage, or defiant counterattack. Such experiences often lead to social withdrawal or an appearance of humility that may mask and protect the grandiosity. Interpersonal relations are typically impaired because of problems derived from entitlement, the need for admiration, and the relative disregard for the sensitivities of others. Though overweening ambition and confidence may lead to high achievement, performance may be disrupted because of intolerance of criticism or defeat. Sometimes vocational functioning can be very low, reflecting an unwillingness to take a risk in competitive or other situations in which defeat is possible. Sustained feelings of shame or humiliation and the attendant self-criticism may be associated with social withdrawal, depressed mood, and persistent depressive disorder (dysthymia) or major depressive disorder. In contrast, sustained periods of grandiosity may be associated with a hypomanie mood. Narcissistic personality disorder is also associated with anorexia nervosa and substance use disorders (especially related to cocaine). Histrionic, borderline, antisocial, and paranoid personality disorders may be associated with narcissistic personality disorder.
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This is ASPD:
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Antisocial Personality Disorder
Kristy A. Fisher; Manassa Hany.
 Author Information
Last Update: June 24, 2020.Go to:
Introduction
Antisocial personality disorder (ASPD) is a deeply ingrained and rigid dysfunctional thought process that focuses on social irresponsibility with exploitive, delinquent, and criminal behavior with no remorse. Disregard for and the violation of others' rights are common manifestations of this personality disorder, which displays symptoms that include failure to conform to the law, inability to sustain consistent employment, deception, manipulation for personal gain, and incapacity to form stable relationships.[1]
The Diagnostic and Statistical Manual of Mental Disorders (DSM 5) classifies all ten personality disorders into three clusters (A, B, and C). Antisocial personality disorder falls into 1 of 4 cluster-B disorders, which also includes borderline, narcissistic, and histrionic. All of these disorders characteristically present with dramatic, emotional, and unpredictable interactions with others.[2] Antisocial personality disorder is the only personality disorder that is not diagnosable in childhood. Before the age of 18, the patient must have been previously diagnosed with conduct disorder (CD) by the age of 15 years old to justify diagnostic criteria for ASPD.[1]
Many researchers and clinicians argue this diagnosis, with concerns of significant overlap with other disorders, including psychopathy. However, others counter that psychopathy is simply a subtype of antisocial personality disorder, with a more severe presentation. Recent literature states that although a heterogeneous construct that can subdivide into multiple subtypes that share many similarities and are often comorbid but not synonymous, individuals with ASPD must be characterized biologically and cognitively to ensure more accurate categorization and appropriate treatment.[3]
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Etiology
Although the precise etiology is unknown, both genetic and environmental factors have been found to play a role in the development of ASPD. Various studies in the past have shown differing estimations of heritability, ranging from 38% to 69%. Environmental factors that correlate to the development of antisocial personality disorder include adverse childhood experiences (both physical and sexual abuse, as well as neglect) along with childhood psychopathology (CD and ADHD).[4]
Other studies stress the importance of both shared and non-shared environmental factors, including both family dynamics and peer relations on the development of ASPD. Research has focused on establishing the exact gene contributing to ASPD, and much evidence is pointing toward the 2p12 region of chromosome 2 and variation within AVPR1A. Interactions of specific genes with the environment have been an area of study as well, with evidence of variation in the oxytocin receptor gene (OXTR) contributing to the broad ranges of behavior elicited in antisocial personality disorder due to its effect on the influence of deviant peer affiliation.[5]
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Epidemiology
The estimated lifetime prevalence of ASPD amongst the general population falls within 1 to 4%.[6][7] Due to the predicting factor of the initial diagnosis of conduct disorder before the age of 15, this assumption can be quite broad as CD does not always get adequately evaluated.[8] Gender distribution tends to be skewed towards males, with 3 to 5 times more likelihood of being diagnosed with ASPD than females, with 6% men and 2% women within the general population.[9] Substance abuse has been found to show a significant correlation to the diagnosis of antisocial personality disorder,[10] while education and intelligence displays a negative correlation,[9][11] with a higher prevalence of ASPD amongst those with lower IQs and reading levels.[12] Research has shown reductions in the prevalence rate with increasing age in criminal populations,[13] as well as epidemiological samples.[9] Changes in personality traits with age and increased mortality with the behavior of antisocial personality disorder have been hypothesized to justify this age-dependent alteration.[14]
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History and Physical
Before performing a comprehensive psychiatric assessment of the patient, a careful history and physical examination is necessary. "The DSM-5 diagnostic criteria for Antisocial Personality Disorder

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  1. A pervasive pattern of disregard for and violation of the rights of others, since age 15 years, as indicated by three (or more) of the following:
  2. Failure to conform to social norms concerning lawful behaviors, such as performing acts that are grounds for arrest.
  3. Deceitfulness, repeated lying, use of aliases, or conning others for pleasure or personal profit.
  4. Impulsivity or failure to plan.
  5. Irritability and aggressiveness, often with physical fights or assaults.
  6. Reckless disregard for the safety of self or others.
  7. Consistent irresponsibility, failure to sustain consistent work behavior, or honor monetary obligations.
  8. Lack of remorse, being indifferent to or rationalizing having hurt, mistreated, or stolen from another person.
  9. The individual is at least age 18 years.
  10. Evidence of conduct disorder typically with onset before age 15 years.
  11. The occurrence of antisocial behavior is not exclusively during schizophrenia or bipolar disorder."
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Evaluation
No current diagnostic modalities, such as tests including serology, are currently accepted standards in diagnosing antisocial personality disorder. However, genetic testing and neuroimaging have been used to evaluate potential causes and patterns, respectively, with ASPD (see Etiology section above). Patients with antisocial personality disorder are at a higher risk of contracting certain viral infections and sexually transmitted diseases associated with high-risk behavior, including hepatitis C and human immunodeficiency virus, as well as increased mortality rates due to accidents, traumatic injuries, suicides, and homicides.[15][16][17]
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Treatment / Management
Although there has been a multitude of interventions tested in the past, an appropriate algorithm fails to exist today. Literature suggests early treatment intervention with conduct disorder in children as the least costly and most effective with treating ASPD.[18] However, researchers have employed certain psychopharmacology and psychotherapy throughout literature, but due to the severity of potential harms in adulthood, intricate consideration are necessary when delineating a treatment course.[19]
NCBI Bookshelf
Antisocial Personality Disorder
Antisocial personality disorder (ASPD) is a deeply ingrained and rigid dysfunctional thought process that focuses on social irresponsibility with exploitive, delinquent, and criminal behavior with no remorse. Disregard for and the violation of others' rights are common manifestations of this personality disorder, which displays symptoms that include failure to conform to the law, inability to sustain consistent employment, deception, manipulation for personal gain, and incapacity to form stable relationships.[1]
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This is Delusional Disorder (which is not a personality disorder, it is more of a thought disorder)
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Delusional Disorder Symptoms
By John M. Grohol, Psy.D.
Last updated: 8 Jul 2020
~ 2 min read
Delusional disorder is characterized by the presence of either bizarre or non-bizarre delusions which have persisted for at least one month. Non-bizarre delusions typically are beliefs of something occurring in a person’s life which is not out of the realm of possibility. For example, the person may believe their significant other is cheating on them, that someone close to them is about to die, a friend is really a government agent, etc.
All of these situations could be true or possible, but the person suffering from this disorder knows them not to be (e.g., through fact-checking, third-person confirmation, etc.). Delusions are deemed bizarre if they are clearly implausible, not understandable, and not derived from ordinary life experiences (e.g., an individual’s belief that a stranger has removed his or her internal organs and replaced them with someone else’s organs without leaving any wounds or scars). 
Delusions that express a loss of control over mind or body are generally considered to be bizarre and reflect a lower degree of insight and a stronger conviction to hold such belief compared to when they are non-bizarre. Accordingly, if an individual has bizarre delusions, a clinician will specify “with bizarre content” when documenting the delusional disorder.
People who have this disorder generally don’t experience a marked impairment in their daily functioning in a social, occupational, or other important setting. Outward behavior is not noticeably bizarre or objectively characterized as out-of-the-ordinary.
The delusions can not be better accounted for by another disorder, such as schizophrenia, which is also characterized by delusions (which are bizarre). The delusions also cannot be better accounted for by a mood disorder, if the mood disturbances have been relatively brief. The lifetime prevalence of delusional disorder has been estimated at around 0.2%.
Specific Diagnostic Criteria
  1. Delusions lasting for at least 1 month’s duration.
  2. Criterion A for schizophrenia has never been met. Note: Tactile and olfactory hallucinations may be present in delusional disorder if they are related to the delusional theme. Criterion A of schizophrenia requires two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):
  3. delusions
  4. hallucinations
  5. disorganized speech (e.g., frequent derailment or incoherence)
  6. grossly disorganized or catatonic behavior
  7. negative symptoms, i.e., affective flattening, alogia, or avolition
  8. Note: Criteria A of schizophrenia requires only one symptom if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person’s behavior or thoughts, or two or more voices conversing with each other.
  9. Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired and behavior is not obviously odd or bizarre.
  10. If mood episodes have occurred concurrently with delusions, their total duration has been brief relative to the duration of the delusional periods.
  11. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.
Specify type (the following types are assigned based on the predominant delusional theme):

Psych Central
Schizophrenia Guide: Symptoms, Treatment & More  | Psych Central
Learn more about Schizophrenia causes, symptoms, resources, and treatment from Psych Central. Includes information about psychosis and a psychotic episode. Schizophrenia is characterized by delusions
Aug 29th, 2016
Psych Central
Schizophrenia Symptoms & Types  | Psych Central
A person with schizophrenia who is not receiving treatment will experience periods of time when they are disconnected from reality, usually experiencing a combination of hallucinations and delusions.
Jan 16th, 2017
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  • Erotomanic Type: delusions that another person, usually of higher status, is in love with the individual
  • Grandiose Type: delusions of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person
  • Jealous Type: delusions that the individual’s sexual partner is unfaithful
  • Persecutory Type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way
  • Somatic Type: delusions that the person has some physical defect or general medical condition
  • Mixed Type: delusions characteristic of more than one of the above types but no one theme predominates
  • Unspecified Type

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Now. all that being said. For example, my mother has persecutory delusions, especially having to do with paying taxes or healthcare or health insurance.
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My father has grandiose and persecutory delusions.

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