The Diagnostic and Statistical Manual of Mental Disorders fourth edition, DSM IV-TR, a widely used manual for diagnosing mental disorders, defines narcissistic personality disorder (in Axis II Cluster B) as:
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
Requires excessive admiration
Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
Is often envious of others or believes others are envious of him or her
Shows arrogant, haughty behaviors or attitudes
It is also a requirement of DSM-IV that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.
People who are diagnosed with narcissistic personality disorder use splitting (black and white thinking) as a central defense mechanism. They do this to preserve their self-esteem, by seeing the self as purely good and the others as purely bad. The use of splitting also implies the use of other defense mechanisms, namely devaluation, idealization and denial.
http://en.wikipedia.org/wiki/Narcissist ... y_disorder
You can read more about it in that wikipedia link.
I'll be honest i've met a lot of fellow Americans like this. I'll even go as far as to say that Winston appears to exhibit standard NPD traits according to the DSM IV.