The symptoms of narcissistic personality disorder can be similar to the traits of individuals with strong self-esteem and confidence; differentiation occurs when the underlying psychological structures of these traits are considered pathological. Narcissists have such an elevated sense of self-worth that they value themselves as inherently better than others. Yet, they have a fragile self-esteem and cannot handle criticism, and will often try to compensate for this inner fragility by belittling or disparaging others in an attempt to validate their own self-worth. It is this sadistic tendency that is characteristic of narcissism as opposed to other psychological conditions affecting level of self-worth.

Symptoms of this disorder include:

Reacting to criticism with anger, shame, or humiliation
Taking advantage of others to reach their own goals
Exaggerating their own importance, achievements, and talents
Imagining unrealistic fantasies of success, beauty, power, intelligence, or romance
Requiring constant attention and positive reinforcement from others
Becoming jealous easily
Lacking empathy and disregarding the feelings of others
Being obsessed with oneself
Pursuing mainly selfish goals
Trouble keeping healthy relationships
Becoming easily hurt and rejected
Setting goals that are unrealistic
Wanting "the best" of everything
Appearing unemotional

He may not always be as good at everything as he thinks, including politics. While Mr. Obama has given himself high grades for his tenure in the White House — including a “solid B-plus” for his first year — many voters don’t agree, citing everything from his handling of the economy to his unfulfilled pledge that he would be able to unite Washington to his claim that he would achieve Israeli-Palestinian peace.
Those were not the only times Mr. Obama may have overestimated himself: he has also had a habit of warning new hires that he would be able to do their jobs better than they could.
“I think that I’m a better speechwriter than my speechwriters,” Mr. Obama told Patrick Gaspard, his political director, at the start of the 2008 campaign, according to The New Yorker. “I know more about policies on any particular issue than my policy directors. And I’ll tell you right now that I’m going to think I’m a better political director than my political director.”
Though he never ran a large organization before becoming president, he initially dismissed internal concerns about management and ended up with a factionalized White House and a fuzzier decision-making process than many top aides wanted.

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But the differences between people of upper and lower-classes seems to be the product of the cultural environment, not ingrained traits. Studies have found that as people rise in the classes, they become less empathetic.

Keltner speculates that people of lower-classes are more empathetic because they need to rely on others more often to be successful. Those who can’t afford daycare service for their children, for example, turn to neighbors or relatives to watch the kids.

“If you don’t have resources and education, you really adapt to the environment, which is more threatening, by turning to other people,” he explained. “People who grow up in lower-class neighborhoods, as I did, will say,’ There’s always someone there who will take you somewhere, or watch your kid. You’ve just got to lean on people.’”

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"Politicians are different," says Pepper Schwartz, a sociologist at the University of Washington in Seattle who's writing a book about narcissistic men. "How many of us would have the desire, much less the ability, to promote ourselves ceaselessly? You have to do that as a politician. It's an amazing level of self-love … and a need for affirmation."

Most recently in the news was Gov. Mark Sanford of South Carolina, whose extramarital romance with a woman in Argentina spurred investigations into his spending habits. And remember Eliot Spitzer? He was forced to resign as governor of New York last year; his extramarital dalliance involved a prostitution ring. James McGreevey, former governor of New Jersey, resigned in 2004 after revealing his adultery with a male aide.

"Ambition and narcissism are occupational hazards for all political leaders," says Stanley Renshon, a political psychologist at City University of New York and author of books dealing with psychological issues and political behavior. "Infidelity is a byproduct of narcissism."
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Feeling invincible and having no regard for the consequences your actions may have, is not uncommon for men who fill powerful posts, several psychologists told ABCNews.com, and are common attributes of narcissists.

"There is something about a lot of the people in power that they think the rules no longer apply to them or they're above the rules," said Wendy Behary, an expert specializing in narcissism and the author of "Disarming the Narcissist."

"They have a sense of entitlement that comes with their prestige or place in the political sphere," Behary said.
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When Barack Obama was elected to the U.S. Senate, he obtained a $1 million earmark for the University of Chicago Hospital--and his wife’s salary as Vice President for Community Affairs jumped from $121,910 to $316,962. Her job: pushing poor, uninsured patients to other hospitals.