Whenever we tell anyone about the NPI study we administered to celebrities while researching this book, their first question is: "Can I take the test?" The answer is yes. Before you do, however, you should understand a thing or two about how the test is structured and what it's intended to evaluate.

The most important thing to know is that the NPI is not a diagnostic instrument for a personality disorder. It will not tell you if you have narcissistic personality disorder; what this test documents is the taker's levels of various narcissistic traits.

You should also be aware that there is ongoing debate within the scientific community about the validity of measuring narcissism on the NPI or any other scale. Nor is everyone convinced that tests using this scale prove the existence of a trend toward increasing narcissism in our society. However, other studies have offered further independent evidence that the trend is increasing, and this conforms with our own experiences in the field.

Taking the NPI is in no way a substitute for a diagnostic workup by a trained professional. If you're experiencing symptoms such as depression, anxiety, uncontrolled use of substances, or any other behaviors that affect your functioning, please see a professional. Symptoms that may seem psychiatric or psychological can actually be signs of a medical condition. In any such circumstances, always begin by having a thorough medical evaluation; if necessary, your doctor can then give you an appropriate referral to a mental health professional.

Narcissism has become such a pervasive issue today that it will be natural for most readers to identify with at least some of the issues discussed in the book and to wonder where they fall on the narcissism spectrum. Again, if you're having chronic feelings of emptiness, or difficulty with your interpersonal functioning, simply knowing where you are on this spectrum won't change things. Narcissism is the result of longstanding behavioral patterns that reflect fixed brain functioning. It requires a lot of motivation to change these patterns. In chapter 10, we suggest ways to start changing in a healthy direction, but these suggestions won't be enough for everyone, and you might need professional help to sustain whatever changes you make.

In taking this test, you'll notice that it's sometimes difficult to choose between the two choices offered to you. You may feel that neither, or both, apply. This is what social scientists call a forced choice. Although you may feel ambivalent about the choices available to you, the one you do choose has meaning. There are no time constraints for the evaluation, but you should take it in a single sitting, without asking anyone for help or clarification. There's no such thing as a good or bad result on this test. Scoring high on the narcissism inventory, or high on any of the component categories, doesn't mean you have a disorder, or that you're a good or bad person. Narcissism is an adaptive strategy, one that can be useful in certain areas of human functioning. Narcissism can be a source of immense creative energy that fuels an individual's need to make a difference in the world. It can certainly be important in extraordinarily dangerous or stressful careers, such as being a fighter pilot, for instance.

Narcissistic traits are often a liability when it comes to interpersonal functioning. When a narcissistic individual's emotions become unregulated, and the people around him or her don't comply with his or her needs, the going can get a little tough. If you can't quite empathize with the needs of others, conflict is inevitable. And narcissists tend to meet conflict with rigid unwillingness to change and an inability to see any perspective other than their own. Add in the aggressive reactive tendencies of a narcissist, and it's quite clear that an extremely narcissistic person, and those with whom he or she is involved, are headed for unpleasantness.

If you take this test and get a high score, and you're experiencing emotional distress or interpersonal conflict, you should consider seeking professional help. What do we mean by high? Remember that the average score for the population is 15.3. In statistics, we use a concept called a standard deviation to explain the spread of the scores are the mean, or average. One standard deviation above the mean accounts for 68 percent of the entire population; two standard deviations accounts for 95 percent of the population. In the general population NPI data, one standard deviation is equal to 6.8 points and two standard deviations are 13.6 points. Thus, if you took the survey and got a score that is two standard deviations above the mean, your total would be 29.9 (15.3 + 13.6). This means that you scored higher than 95 percent of the population that has taken the NPI.
Although we can't stress enough that this test alone is not a screening tool and not specifically meant to uncover genuine pathology or need for treatment, we do believe that knowledge of one's traits can create opportunities for change. If you score 20 or higher on the test, it's highly likely that there will be one or two components on the inventory that are predominant in explaining your score. If you find that most or all of the answers that earned you points pertained to one or two specific personality traits, consider focusing some attention on these characteristics, which are likely, at the very least, to be dominant aspects of your personality.

Let's say your overall score is an 18, but your high score is largely the product of your higher results in the superiority category. You might consider monitoring this trait in your daily life by paying attention to your feelings of superiority, how you tend to express them, and what effect they seem to have on other people. Then, try to let go of your feelings of superiority, and see whether other feelings, such as fear or anger, emerge in their place. Own these feelings, but try to stay aware of what the other people in the conversation are experiencing in that moment. What are their motivations? Are their points of view in any way valid? Does acknowledging their feelings somehow make you feel diminished? (This is common; you might consider it the flip side of envy.) Understand that what you're experiencing is just your feelings; they don't necessarily reflect reality, or even what the other person is experiencing.

As you move past any of the feelings represented by the categories in the NPI, you'll generally experience a certain amount of anxiety or discomfort. You may feel vulnerable or even attacked by the other person with whom you're interacting. Hang on; usually, this will pass. However, be aware that any time you're dealing with narcissistic tendencies, aggression is always right around the corner. You may actually start feeling exactly the opposite of the feeling you're working on. For example, as you work on acknowledging your feelings of superiority, you may find feelings of inferiority creeping in. You're not going to like these feelings, but stay with it. The object is to start creating a more realistic appraisal of reality without the distortions created by your narcissistic traits. The fact is that, no matter what you're feeling, you, yourself, is neither superior nor inferior to the other person. Even if you're actually in a position of authority, your feelings are not superior to anyone else's. In reality, other people probably have some valid points and some feelings you could easily relate to if you gave them a chance. Slowly, you'll begin to develop the capacity to process interpersonal experiences more realistically and without triggering feelings of emptiness, envy, or rage. Though there's no conclusive evidence in the area, we've seen people who are strongly motivated change their behaviors in areas like superiority simply by increasing their awareness of the trait and how it affects them and their relationships. Of course, such personal development requires a great deal of motivation and a willingness to change. And such change is difficult for those who are highly narcissistic because their narcissistic perceptions and interpretations of themselves allow no alternative explanation. Nevertheless, if you're concerned that you have narcissistic tendencies, and you've documented this quantitatively with the NPI, you would appear to possess at least the self-awareness necessary to effect real change.

Learning to identify and assess your feelings and motivations accurately may come more easily to people who have spent time in therapeutic counseling. Individuals who have been in therapy are often aware of their narcissistic traits and are able to moderate them in their personalities. You might be surprised by what your scores, or the scores of your friends, reflect. Even when we administered the test to celebrities we found some scores that might seem surprising.

After word of our study got around, the producers of Howard Stern's Sirius Radio show asked Mark to administer the NPI to Howard, Robin, and Artie Lange. When Mark called in to the show to discuss the results, he cautioned the cast that they might feel embarrassed if he revealed private information about their psychological makeup on the air.

Howard, of course, didn't see it that way at all. "No, you don't understand, [any of us] would be proud if we were the biggest narcissist on the show," he told Mark. If you've ever heard Howard on the radio, you might expect his narcissism score to be off the charts. In fact, when Mark revealed the scores, Howard's was a modest 15, actually slightly below the national average, and considerably below that of most of the celebrities we tested.

In contrast, his cohost Robin Quivers scored a 34, one of the highest of anyone we tested. And, indeed, Robin's reaction confirmed her highly narcissistic traits. First, she tried to defend her performance by complaining about the test: "I didn't know how to answer any of those questions." Then, she tried to deny the results: "Oh, stop it! That's ridiculous!" Then she tried to shift the blame to others: "You cheated! I think that you must have switched our tests." Underlying her response was a level of aggression typical of a narcissistic personality who has been provoked. When Mark pointed out that Howard's score put him right in the average population in terms of narcissism, Stern immediately credited his years of therapy for his balanced performance. "I can tell you that therapy helped me, and I am way more together than all of you." (He couldn't resist getting in one last dig at Quivers, though: "So I won, and you lost. You're crazy and I'm not!")

You might be surprised to find that you score relatively high on the NPI's narcissistic scale, which doesn't necessarily mean you're in denial (others in your life can tell you whether you are), but that you might not have the overt narcissistic characteristics we've been discussing.

If this is the case, you may have a personality style that James F. Masterson calls the closet narcissist and Elsa Ronningstam identifies as the shy narcissist. Narcissists who fit this profile may actually be very focused on other people, but have difficulty giving others' feelings the same importance as their own. This kind of narcissist is very sensitive to criticism or slights from others and will respond with harsh self-criticism. They may seem humble or unassuming and avoid being the center of attention. They may also feel guilt or shame for their ambitions or accomplishments, although they may relentlessly pursue them without genuine regard for others. They may also hide their strivings or accomplishments for fear of triggering envy in others. Closet narcissists know envy well; they suffer intensely from it, even as they fiercely disavow it. They can be difficult to identify, because they're not arrogant and openly aggressive, but may manifest their narcissistic traits with overattentiveness and exceeding vulnerability. Nevertheless, such narcissists suffer from a lack of self-esteem and a deep sense of shame; their attentiveness should not be taken for empathy, as it's as difficult for them to connect emotionally as it is for the classic narcissist.

My friend and longtime Loveline cohost Adam Carolla is a good example of this type of narcissistic personality. In fact, he openly identifies himself as a narcissist. However, when he found out about his high NPI results, he immediately protested: "Drew, how could that be? You know I hate to be the center of attention. No one talks about his accomplishments less than you or I."

And he's right. Full disclosure: I scored 16 on the NPI, and I do have some of the dynamic of the closet narcissist in my own personality. And, just as Howard Stern credited his years in therapy with his reduced narcissistic strivings, I, too, have done a great deal of personal work in order to function effectively in my daily professional capacity in the field of mental health. For me, an accurate understanding and the ability to acknowledge my personality traits is essential to my ability to effectively help my patients. Several of the celebrities from our study have graciously consented to allow us to publish their scores to give you some context in judging your own results. Understand that these results don't necessarily imply a need for treatment or change. However, if you're higher up the scale and wonder why your relationships never seem to work out, or you have difficulty with aggression, particularly if you have trauma in your childhood, check in with people in your life who genuinely care about you for an assessment of these results. Very narcissistic people are usually the last to be aware of the source of their troubles.

If you are having symptoms, regardless of whether you rate well above average on the NPI scale, there are plenty of mental health professionals out there who are well trained to help you. If your score is higher than thirty, I suggest you consider a professional assessment. Of course, even a score that high isn't a concrete sign that anything is direly wrong, and treatment is not mandated. Adam Carolla didn't run for help after hearing his result, and he has great success and satisfaction in his career, a stable relationship with a wonderful woman, and two beautiful kids (although, one day we'll have to talk to them about what it was like having Adam as their father).

Measuring yourself against the celebrities on our scale may be reassuring. You may find that your results are similar to those of someone you admire or for whom you have great affection. Remember, though, that your attraction to a celebrity may be an attraction to the pseudo-self that star puts forth, rather than to his or her true personality. Matching your favorite star's level of narcissism shouldn't necessarily be reassuring; nor should it be considered a healthy goal.

The celebrities we surveyed were a diverse group of people, but they all shared one thing: the specific dynamic of narcissism. If you are having significant distress in your own life, and believe it may be linked to narcissistic tendencies in your personality, you can take solace in the fact that people on our list are working them out in ways that at least seem to allow them to thrive. But registering the same score as one of our celebrities doesn't mean you're likely to be as successful as that individual, or even that you're fundamentally similar people. It does mean you're struggling with a similar dynamic, but one that can manifest differently from person to person. Having read this book, you should understand that narcissism can be a significant liability. If your answers show a trend toward narcissism, it's up to you to understand your behavior and work to change in a healthy direction.

Take the test!