Selfishness is also on a spectrum, like narcissism. Severe forms of selfishness ought to be included in the DSM-6. It could be called Selfish Personality Disorder, SPD.
All narcissists are selfish but all selfish assholes are not narcissistic.
Selfish people hide their selfishness behind an agreeable mask. They are also hiding their selfishness for themselves. They don't even know that they are selfish. Some of them even believe that they have always been too nice and kind.
They lie both to themselves and to others, they slander, talk bullshit, and believe that they are completely innocent. Feelings of anxiety, guilt, and shame will be the result. They don't understand why they have these feelings so they stuff themselves with antidepressants, anti-anxiety medications, and junk food. They try to hypnotize themselves with "positive thinking and self-affirmations". They are completely stuck in the mud of lies and self-deception.
