I think you are being too restrictive with the concept of "distress". The description in the image is about such distress.

Vulnerability in self-esteem makes individuals with narcissistic personality disorder very sensitive to criticism or defeat. Although they may not show it outwardly, such experiences may leave them feeling ashamed, humiliated, degraded, hollow, and empty. They may react with disdain, rage, or defiant counterattack. However, such experiences can also lead to social withdrawal or an appearance of humility that may mask and protect the grandiosity. Interpersonal relations are typically impaired because of problems related to self-preoccupation, entitlement, need for admiration, and relative disregard for the sensitivities of others. Individuals with narcissistic personality disorder can be competent and high functioning with professional and social success, while others can have various levels of functional impairment.

Extracted from the DSM-5-TR (2022); emphases are mine. Their distress revolves around self-esteem. As you can see, NPD can manifest in different ways too.

A person can suffer from NPD while, unrelated to it, they might hold questionable political views. Those two things are not mutually exclusive; if they were, all people with NPD would be irreproachable.

The sad part is that they are assholes, as you put it, but perhaps in some cases we failed them helping them not become who they became.