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You probably know some people who are really full of themselves.
你可能认识一些人，他们真的很自我。
You know, when they're not just proud of their accomplishments,
他们不仅仅自己为成就感到自豪，
they also need to remind you of them regularly.
还经常提醒你他们取得了多大成就。
That might indicate a high degree of narcissism:
这可能暗示着一种高度自恋：
grandiose ideas about oneself or an exaggerated sense of self-importance.
夸大自己的想法或夸大自己的重要性。
But it also could just be a lot of confidence.
但这也可能是信心十足。
An ego can indicate a healthy level of self-esteem, or it can be part of a diagnosable disorder,
自我意识可以表明一种健康的自尊水平，但也可能是可诊断障碍的一部分，
like Narcissistic Personality Disorder, also called NPD.
比如自恋型人格障碍（NPD）。
It turns out it's hard to make that judgment, for most of us, and even for psychologists.
事实证明，我们大多数人，甚至是心理学家们也很难判断这种障碍。
Psychologists define personality traits as characteristic thoughts, emotions,
心理学家将人格特征定义为典型的思想、情感
and behaviors that seem to be stable across time.
和长期稳定的行为。
Narcissism is one of many that psychologists can test for, and we all fall somewhere on the spectrum.
自恋是心理学家测试的众多问题之一，我们都有不同程度的表现。
Some people are just a little more vain, and have a little more of an inflated, grand view of themselves than others do.
有些人只是有点儿自负，比其他人更自我膨胀，自视甚高一点儿。
This makes them less likely to respond well to negative feedback,
这使得他们不太可能对负面反馈做出良好反应，
and more likely to show less empathy and have a harder time maintaining relationships.
更有可能较少得表现出同理心，也更难维持关系。
But being a bit narcissistic isn't all bad.
但有点儿自恋也不全是坏事。
Some studies have shown that more narcissism is associated with more happiness and less anxiety, and even more creativity.
一些研究表明，越自恋的人越快乐，越不焦虑，越有创造力。
And determining if someone scores high on the narcissism spectrum is actually quite easy: just ask them.
判断一个人是否高度自恋其实很容易：问问他们就知道了。
A 2014 study involving over 2000 people found that
2014年，一项涉及2000多人的研究发现，
a "single item narcissism scale", aka just asking how well the definition applied to them, on a scale of 1 to 11,
“单项自恋”，即人们如何在1~11等级范围内定义自恋的调查结果显示，
turned out to be about as accurate as much longer surveys that tried to, like try to dance around the issue a little more.
调查越长，比如对问题迂回着多问些东西，结果就越准确。
Surprise! Narcissists aren't really that ashamed.
令人惊奇的是，自恋者并没有那么羞愧。
After all, they think they're great, why shouldn't they be a little narcissistic about it?
毕竟，他们认为自己很优秀，为什么他们不应该自恋点儿呢？
But scoring high on this trait isn't the same as having a disorder.
但这个特质得分高并不等同于他们有障碍。
Your personality traits are things that are generally true about you whether you're at home, at school, or at work.
无论你是在家里、学校，还是在工作中，你的性格特点通常都是真实的。
But they don't determine everything about how you act.
但它们并不能决定你的行为。
Even the most extroverted people tend to act quiet and somber at a funeral, for example.
例如，最外向的人在葬礼上也往往表现得安静而忧郁。
It's only when traits get really rigid and people become inflexible in their behaviors
只有当性格变得非常刻板，人们的行为变得不可转变时，
that psychologists start to draw the line between a trait and a disorder.
心理学家才开始在特质和障碍之间划清界限。
Though how people develop personality disorders is still somewhat of a mystery.
不过人们如何形成人格障碍仍然是一个谜。
There's some evidence that how narcissistic you are, like other personality traits, comes from your genes.
一些证据表明，你的自恋和其他人格特征一样，都是基因决定的。
But just like having a familial history of alcoholism doesn't make you an alcoholic,
但正如家族酗酒史不会让你成为酒鬼一样，
not everyone with super narcissistic parents develops NPD.
不是每个有高度自恋父母的人都会形成自恋型人格障碍。
So psychologists think that environmental factors,
于是心理学家认为环境因素，
particularly during adolescence, influence whether a trait becomes a disorder.
尤其是青春期的环境因素能影响一个特质是否成为一种障碍。
And still, what pushes people over that line is unclear.
然而，究竟是什么促使人们越过这条界线仍不清楚。
Like, you might have heard that spoiling kids will turn them into narcissists.
比如，你可能听说过宠溺孩子可能会让他们成为自恋狂。
And some case studies do suggest that narcissists had overly-indulgent and praising parents, or ones that were too permissive.
而且一些案例研究确实表明，自恋者的父母过分纵容和赞扬他们或者是过于宽容。
The problem is, some studies show the opposite,
但问题是，有些研究结果恰好相反，
that parents of diagnosed patients were cold, authoritarian, or even lacked empathy.
它们表明确诊患者的父母冷漠、专制，甚至缺乏同情心。
Trying to look at case studies to find risk factors is also difficult because you can't determine cause and effect.
试图通过案例研究来发现风险因素也很困难，因为你无法确定因果关系。
Even if most NPD patients were raised the same way,
即使大多数NPD患者被抚养的方式相同，
that wouldn't prove that the way their parents raised them gave them the disorder.
也不能证明这种抚养方式给了他们这种障碍。
The only thing everyone seems to agree on is that risk factors for NPD need to be studied more.
大家似乎只同意一点，NPD的风险因素需要更多研究。
But even that's not so straightforward, because NPD is especially tricky to diagnose.
但这也不是那么简单，因为NPD很难确诊。
That's because psychologists don't diagnose personality disorders based on trait scores.
这是因为心理学家不会根据特征分数来诊断人格障碍。
Technically, you could score 40 out of 40 on the narcissism scale and still not be diagnosed with NPD
理论上讲，你可能在自恋量表上得到40分满分，但仍不能被确诊为自恋型人格障碍，
because diagnoses for personality disorders hinge on the trait being a problem.
因为人格障碍的诊断取决于这一特征是不是问题。
You have to be distressed by your behavior, it has to be causing some kind of impairment.
你必须为你的行为感到痛苦，它必须引起某种伤害。
And that makes diagnosing NPD tougher than other personality disorders
这使得诊断NPD比诊断其他人格障碍更困难，
because it's basically someone who thinks they're too great, which isn't usually a distressing feeling.
因为它基本上是人们觉得自己太过优秀导致的，通常不是痛苦的感觉。
So when NPD diagnoses do occur, they're usually in conjunction with another issue the person sought help for,
所以当NPD诊断出现时，他们通常与人们求助的另一个问题有关，
like substance use, or bipolar disorder.
比如药物滥用或躁郁症。
To be diagnosed, you need to show at least 5 of a list of 9 more severe symptoms of narcissism
你要想确诊，除了膨胀的自我重要性之外，需要表现出9个更严重的自恋症状中至少5个症状，
in addition to the inflated self-importance, things like demanding special treatment, manipulativeness,
比如特殊待遇的要求、控制欲、
and the belief that you can only be understood or appreciated by particularly special people.
和你只能被特殊人群理解或欣赏的信念。
These can take a toll on relationships and otherwise reduce a person's well-being,
这些症状会对人际关系产生负面影响，从而降低一个人的幸福感，
even if they don't realize the disorder is at the root of their troubles.
尽管他们没有意识到障碍是他们麻烦的根源。
And diagnosis is especially tricky if someone has what psychologists call high functioning narcissism.
如果一个人有心理学家所说的高功能自恋，那么诊断就显得尤为棘手了。
Say, they're holding down a job and meeting most responsibilities… they're just really, really narcissistic.
比如说，他们有工作，并且承担大部分责任，他们只是非常非常的自恋。
In one published case, for example, a man housed and supported several mistresses
例如，在一个公开案例中，一名男子养了几名情妇，
while still believing it had no effect on his relationship with his wife.
然而他仍然相信这对他和妻子的关系没有影响。
He only went to a psychologist because he was wondering whether to stay in his marriage,
他去找心理医生是因为他想知道是否要继续他的婚姻，
but the therapist felt that the effects of his narcissism on his personal life were enough to warrant a diagnosis.
但治疗师认为，他的自恋对其个人生活的影响足以被诊断出来。
Such patients don't always come to the attention of psychologists,
这样的病人并不总能引起心理学家的注意，
and occasionally, the lack of broad impairment means doctors may disagree that a diagnosis is appropriate.
某些时候，缺乏广泛的损害意味着医生可能不同意这种诊断是适当的。
But even when clearly diagnosable, NPD is notoriously hard to treat,
即使诊断明确了，NPD也是出了名的难以治疗，
since patients with inflated opinions of themselves are less likely to think they have a problem that needs resolution.
因为那些自我膨胀的患者不太可能认为他们有问题需要解决。
They're also more likely to drop out of treatment for whatever else they initially came in for.
他们也更有可能放弃治疗，不管他们的初衷是什么。
And because NPD is so rarely diagnosed alone,
因为NPD很少单独诊断，
almost no studies have tested treatments of patients with just NPD, so it's hard to say what works.
所以几乎没有研究对仅患NPD的病人治疗进行测试，因此很难说什么是有效的。
But research to date suggests that plain ol' therapy might be the best strategy.
但迄今为止的研究表明，单纯的疗法可能是最好的策略。
One study that looked at 142 NPD patients getting treatment for depressive disorder
一项研究观察了142个NPD患者治疗抑郁症的方法，
found that they were more likely to respond to a treatment of just talk therapy,
发现他们更有可能响应谈话疗法，
instead of therapy plus meds, perhaps because they felt more autonomy.
而不是治疗加药物的疗法，也许是因为他们觉得这样更有自主性。
So your friend who always interrupts your story to tell you a better one might be a little narcissistic.
所以一个总是打断你的故事，告诉你另一个更好故事的朋友可能有点儿自恋。
But that doesn't mean they have NPD.
但这不意味着他们患有自恋型人格障碍。
If you're genuinely worried about them, you could try to convince them to talk to someone.
如果你真得担心他们，可以试着说服他们和别人交谈。
But it's best to leave diagnosis to the professionals.
但最好还是把诊断留给专业人士。
Thanks for watching this episode of SciShow Psych!
感谢您收看本期的心理科学秀！
If you want to learn more about the science of psychology
如果你想了解更多心理科学，
or gain a better understanding of how these big narcissists of our work,
或者更好地理解我们这些极度自恋的人是如何工作的，
stick around by clicking that subscribe button.
点击那个订阅按钮就可以了。
