Misdiagnosing Narcissism – Asperger’s Disorder

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(The use of gender pronouns in this article reflects the clinical facts: most narcissists and most Asperger’s patients are male.)

Asperger’s Disorder is often misdiagnosed as Narcissistic Personality Disorder (NPD), though evident as early as age 3 (while pathological narcissism cannot be safely diagnosed prior to early adolescence).

In both cases, the patient is self-centered and engrossed in a narrow range of interests and activities. Social and occupational interactions are severely hampered and conversational skills (the give and take of verbal intercourse) are primitive. The Asperger’s patient body language – eye to eye gaze, body posture, facial expressions – is constricted and artificial, akin to the narcissist’s. Nonverbal cues are virtually absent and their interpretation in others lacking.

Yet, the gulf between Asperger’s and pathological narcissism is vast.

The narcissist switches between social agility and social impairment voluntarily. His social dysfunctioning is the outcome of conscious haughtiness and the reluctance to invest scarce mental energy in cultivating relationships with inferior and...

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