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You probably know some people who are really full of themselves.
你可能認識一些人，他們真的很自我。
You know, when they're not just proud of their accomplishments,
他們不僅僅自己為成就感到自豪，
they also need to remind you of them regularly.
還經常提醒你他們取得了多大成就。
That might indicate a high degree of narcissism:
這可能暗示著一種高度自戀：
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.
但這也可能是信心十足。
An ego can indicate a healthy level of self-esteem, or it can be part of a diagnosable disorder,
自我意識可以表明一種健康的自尊水平，但也可能是可診斷障礙的一部分，
like Narcissistic Personality Disorder, also called NPD.
比如自戀型人格障礙（NPD）。
It turns out it's hard to make that judgment, for most of us, and even for psychologists.
事實證明，我們大多數人，甚至是心理學家們也很難判斷這種障礙。
Psychologists define personality traits as characteristic thoughts, emotions,
心理學家將人格特征定義為典型的思想、情感
and behaviors that seem to be stable across time.
和長期穩定的行為。
Narcissism is one of many that psychologists can test for, and we all fall somewhere on the spectrum.
自戀是心理學家測試的眾多問題之一，我們都有不同程度的表現。
Some people are just a little more vain, and have a little more of an inflated, grand view of themselves than others do.
有些人只是有點兒自負，比其他人更自我膨脹，自視甚高一點兒。
This makes them less likely to respond well to negative feedback,
這使得他們不太可能對負面反饋做出良好反應，
and more likely to show less empathy and have a harder time maintaining relationships.
更有可能較少得表現出同理心，也更難維持關系。
But being a bit narcissistic isn't all bad.
但有點兒自戀也不全是壞事。
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，越自戀的人越快樂，越不焦慮，越有創造力。
And determining if someone scores high on the narcissism spectrum is actually quite easy: just ask them.
判斷一個人是否高度自戀其實很容易：問問他們就知道了。
A 2014 study involving over 2000 people found that
2014年，一項涉及2000多人的研究發現，
a "single item narcissism scale", aka just asking how well the definition applied to them, on a scale of 1 to 11,
“單項自戀”，即人們如何在1~11等級范圍內定義自戀的調查結果顯示，
turned out to be about as accurate as much longer surveys that tried to, like try to dance around the issue a little more.
調查越長，比如對問題迂回著多問些東西，結果就越準確。
Surprise! Narcissists aren't really that ashamed.
令人驚奇的是，自戀者并沒有那么羞愧。
After all, they think they're great, why shouldn't they be a little narcissistic about it?
畢竟，他們認為自己很優秀，為什么他們不應該自戀點兒呢？
But scoring high on this trait isn't the same as having a disorder.
但這個特質得分高并不等同于他們有障礙。
Your personality traits are things that are generally true about you whether you're at home, at school, or at work.
無論你是在家里、學校，還是在工作中，你的性格特點通常都是真實的。
But they don't determine everything about how you act.
但它們并不能決定你的行為。
Even the most extroverted people tend to act quiet and somber at a funeral, for example.
例如，最外向的人在葬禮上也往往表現得安靜而憂郁。
It's only when traits get really rigid and people become inflexible in their behaviors
只有當性格變得非常刻板，人們的行為變得不可轉變時，
that psychologists start to draw the line between a trait and a disorder.
心理學家才開始在特質和障礙之間劃清界限。
Though how people develop personality disorders is still somewhat of a mystery.
不過人們如何形成人格障礙仍然是一個謎。
There's some evidence that how narcissistic you are, like other personality traits, comes from your genes.
一些證據表明，你的自戀和其他人格特征一樣，都是基因決定的。
But just like having a familial history of alcoholism doesn't make you an alcoholic,
但正如家族酗酒史不會讓你成為酒鬼一樣，
not everyone with super narcissistic parents develops NPD.
不是每個有高度自戀父母的人都會形成自戀型人格障礙。
So psychologists think that environmental factors,
于是心理學家認為環境因素，
particularly during adolescence, influence whether a trait becomes a disorder.
尤其是青春期的環境因素能影響一個特質是否成為一種障礙。
And still, what pushes people over that line is unclear.
然而，究竟是什么促使人們越過這條界線仍不清楚。
Like, you might have heard that spoiling kids will turn them into narcissists.
比如，你可能聽說過寵溺孩子可能會讓他們成為自戀狂。
And some case studies do suggest that narcissists had overly-indulgent and praising parents, or ones that were too permissive.
而且一些案例研究確實表明，自戀者的父母過分縱容和贊揚他們或者是過于寬容。
The problem is, some studies show the opposite,
但問題是，有些研究結果恰好相反，
that parents of diagnosed patients were cold, authoritarian, or even lacked empathy.
它們表明確診患者的父母冷漠、專制，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.
試圖通過案例研究來發現風險因素也很困難，因為你無法確定因果關系。
Even if most NPD patients were raised the same way,
即使大多數NPD患者被撫養的方式相同，
that wouldn't prove that the way their parents raised them gave them the disorder.
也不能證明這種撫養方式給了他們這種障礙。
The only thing everyone seems to agree on is that risk factors for NPD need to be studied more.
大家似乎只同意一點，NPD的風險因素需要更多研究。
But even that's not so straightforward, because NPD is especially tricky to diagnose.
但這也不是那么簡單，因為NPD很難確診。
That's because psychologists don't diagnose personality disorders based on trait scores.
這是因為心理學家不會根據特征分數來診斷人格障礙。
Technically, you could score 40 out of 40 on the narcissism scale and still not be diagnosed with NPD
理論上講，你可能在自戀量表上得到40分滿分，但仍不能被確診為自戀型人格障礙，
because diagnoses for personality disorders hinge on the trait being a problem.
因為人格障礙的診斷取決于這一特征是不是問題。
You have to be distressed by your behavior, it has to be causing some kind of impairment.
你必須為你的行為感到痛苦，它必須引起某種傷害。
And that makes diagnosing NPD tougher than other personality disorders
這使得診斷NPD比診斷其他人格障礙更困難，
because it's basically someone who thinks they're too great, which isn't usually a distressing feeling.
因為它基本上是人們覺得自己太過優秀導致的，通常不是痛苦的感覺。
So when NPD diagnoses do occur, they're usually in conjunction with another issue the person sought help for,
所以當NPD診斷出現時，他們通常與人們求助的另一個問題有關，
like substance use, or bipolar disorder.
比如藥物濫用或躁郁癥。
To be diagnosed, you need to show at least 5 of a list of 9 more severe symptoms of narcissism
你要想確診，除了膨脹的自我重要性之外，需要表現出9個更嚴重的自戀癥狀中至少5個癥狀，
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賞的信念。
These can take a toll on relationships and otherwise reduce a person's well-being,
這些癥狀會對人際關系產生負面影響，從而降低一個人的幸福感，
even if they don't realize the disorder is at the root of their troubles.
盡管他們沒有意識到障礙是他們麻煩的根源。
And diagnosis is especially tricky if someone has what psychologists call high functioning narcissism.
如果一個人有心理學家所說的高功能自戀，那么診斷就顯得尤為棘手了。
Say, they're holding down a job and meeting most responsibilities… they're just really, really narcissistic.
比如說，他們有工作，并且承擔大部分責任，他們只是非常非常的自戀。
In one published case, for example, a man housed and supported several mistresses
例如，在一個公開案例中，一名男子養了幾名情婦，
while still believing it had no effect on his relationship with his wife.
然而他仍然相信這對他和妻子的關系沒有影響。
He only went to a psychologist because he was wondering whether to stay in his marriage,
他去找心理醫生是因為他想知道是否要繼續他的婚姻，
but the therapist felt that the effects of his narcissism on his personal life were enough to warrant a diagnosis.
但治療師認為，他的自戀對其個人生活的影響足以被診斷出來。
Such patients don't always come to the attention of psychologists,
這樣的病人并不總能引起心理學家的注意，
and occasionally, the lack of broad impairment means doctors may disagree that a diagnosis is appropriate.
某些時候，缺乏廣泛的損害意味著醫生可能不同意這種診斷是適當的。
But even when clearly diagnosable, NPD is notoriously hard to treat,
即使診斷明確了，NPD也是出了名的難以治療，
since patients with inflated opinions of themselves are less likely to think they have a problem that needs resolution.
因為那些自我膨脹的患者不太可能認為他們有問題需要解決。
They're also more likely to drop out of treatment for whatever else they initially came in for.
他們也更有可能放棄治療，不管他們的初衷是什么。
And because NPD is so rarely diagnosed alone,
因為NPD很少單獨診斷，
almost no studies have tested treatments of patients with just NPD, so it's hard to say what works.
所以幾乎沒有研究對僅患NPD的病人治療進行測試，因此很難說什么是有效的。
But research to date suggests that plain ol' therapy might be the best strategy.
但迄今為止的研究表明，單純的療法可能是最好的策略。
One study that looked at 142 NPD patients getting treatment for depressive disorder
一項研究觀察了142個NPD患者治療抑郁癥的方法，
found that they were more likely to respond to a treatment of just talk therapy,
發現他們更有可能響應談話療法，
instead of therapy plus meds, perhaps because they felt more autonomy.
而不是治療加藥物的療法，也許是因為他們覺得這樣更有自主性。
So your friend who always interrupts your story to tell you a better one might be a little narcissistic.
所以一個總是打斷你的故事，告訴你另一個更好故事的朋友可能有點兒自戀。
But that doesn't mean they have NPD.
但這不意味著他們患有自戀型人格障礙。
If you're genuinely worried about them, you could try to convince them to talk to someone.
如果你真得擔心他們，可以試著說服他們和別人交談。
But it's best to leave diagnosis to the professionals.
但最好還是把診斷留給專業人士。
Thanks for watching this episode of SciShow Psych!
感謝您收看本期的心理科學秀！
If you want to learn more about the science of psychology
如果你想了解更多心理科學，
or gain a better understanding of how these big narcissists of our work,
或者更好地理解我們這些極度自戀的人是如何工作的，
stick around by clicking that subscribe button.
點擊那個訂閱按鈕就可以了。
