Pathological narcissism and narcissistic personality disorder

Living with pathological narcissism: a qualitative study

Background

Research into the personality trait of narcissism have advanced further understanding of the pathological concomitants of grandiosity, vulnerability and interpersonal antagonism. Recent research has established some of the interpersonal impacts on others from being in a close relationship with someone having such traits of pathological narcissism, but no qualitative studies exist. Individuals with pathological narcissism express many of their difficulties of identity and emotion regulation within the context of significant interpersonal relationships thus studying these impacts on others is warranted.

Method

We asked the relatives of people high in narcissistic traits (indexed by scoring above a cut-off on a narcissism screening measure) to describe their relationships (N = 436; current romantic partners [56.2%]; former romantic partners [19.7%]; family members [21.3%]). Participants were asked to describe their relative and their interactions with them. Verbatim responses were thematically analysed.

Results

Participants described 'grandiosity' in their relative: requiring admiration, showing arrogance, entitlement, envy, exploitativeness, grandiose fantasy, lack empathy, self-importance and interpersonal charm. Participants also described 'vulnerability' of the relative: contingent self-esteem, hypersensitivity and insecurity, affective instability, emptiness, rage, devaluation, hiding the self and victimhood. These grandiose and vulnerable characteristics were commonly reported together (69% of respondents). Participants also described perfectionistic (anankastic), vengeful (antisocial) and suspicious (paranoid) features. Instances of relatives childhood trauma, excessive religiosity and substance abuse were also described.

Conclusions

These findings lend support to the importance of assessing the whole dimension of the narcissistic personality, as well as associated personality patterns. On the findings reported here, the vulnerable aspect of pathological narcissism impacts others in an insidious way given the core deficits of feelings of emptiness and affective instability. These findings have clinical implications for diagnosis and treatment in that the initial spectrum of complaints may be misdiagnosed unless the complete picture is understood. Living with a person with pathological narcissism can be marked by experiencing a person who shows large fluctuations in affect, oscillating attitudes and contradictory needs.

Is Narcissism Associated with Heavy Work Investment? The Moderating Role of Workload in the Relationship between Narcissism, Workaholism, and Work Engagement

This study aimed to investigate the association between narcissism and two forms of heavy work investment, namely, workaholism and work engagement. More specifically, it was hypothesized that narcissism is positively associated with both workaholism and work engagement, with workload moderating these relationships, which are expected to be stronger when the workload is high. Overall, 217 workers completed a self-report questionnaire, and the hypothesized relationships were tested using moderated multiple regression. Results partially supported our predictions. Narcissism was positively associated with workaholism and its dimensions of working excessively and working compulsively only in individuals facing a high workload. Furthermore, narcissism was positively associated with work engagement and its dimensions of vigor and dedication (but no absorption) in employees with average levels of workload. Finally, the workload exacerbated the relationship between narcissism and work engagement and its dimensions so that these associations were stronger when the workload was high. Overall, our study suggested that in a work environment characterized by moderate levels of demand, individuals with strong narcissistic components might inherently feel energetic and dedicated (i.e., engaged) at work. Differently, in a demanding work environment, workers with high narcissism might experience higher work engagement, but they could also be at risk of workaholism.

The Pathological Narcissism Inventory: Measurement Invariance Across Serbian and USA Samples and Further Validation

Abstract. The aim of this research was to explore measurement invariance across samples from Serbia and the USA (Study 1) and to further validate the Serbian adaptation of the Pathological Narcissism Inventory – PNI (Study 2). The results supported the original seven-factor first-order structure as well as the hierarchical structure of the PNI with Narcissistic grandiosity and vulnerability as the second-order factors. Further, scalar invariance between the two versions of the PNI was achieved. Relations between Narcissistic grandiosity and vulnerability and other measures of grandiose and hypersensitive narcissism supported the validity of their scores. Among HEXACO traits, both Narcissistic grandiosity and vulnerability showed substantial negative correlations with Honesty-Humility. The main distinctions between the two aspects of narcissism lie in the positive relations with Neuroticism and negative relations with self-esteem, both of which are higher for Narcissistic vulnerability. The results support good psychometric properties of the PNI scores and add to the PNI’s cross-cultural validity.

Individual differences in envy experienced through perspective-taking involves functional connectivity of the superior frontal gyrus

Envy is the painful or resentful awareness of another’s advantage combined with a desire to possess that same advantage. Recent neuroscientific research has begun to shed light on the brain regions that process the experience of envy, including regions of the prefrontal cortex involved in emotional processing and social cognition. It is still unclear, however, which regions of the brain are functionally connected during the experience of envy. We recorded functional neuroimaging data while inducing simulated envy in participants, experienced through a perspective-taking hypothetical scenario task. In this task, participants took the perspective of a protagonist portrayed in a written description and compared themselves to either i) a self-similar/superior individual, ii) a self-dissimilar/superior individual, or iii) a self-dissimilar/average individual. During each comparison, participants also reported how much envy they experienced while taking the protagonists perspective. We demonstrate an inverse relationship in the connectivity of the left superior frontal gyrus to both the right supramarginal gyrus and the precuneus with respect to self-reported envy ratings across participants. In other words, we show that the greater the functional connectivity that the left superior frontal gyrus shares with the right supramarginal gyrus and precuneus, the less reported envy a participant experiences. Overall, our results are in line with previous research implicating the superior frontal gyrus in the reappraisal of negative emotions and extend these findings by showing this region is also involved in modulating the simulated experience of the social comparative, negative emotion of envy.

Narcissism in Political Participation

Much attention has focused on the social, institutional, and mobilization factors that influence political participation, with a renewed interest in psychological motivations. One trait that has a deep theoretical connection to participation, but remains underexplored, is narcissism. Relying on three studies in the United States and Denmark, two nationally representative, we find that those scoring higher in narcissism, as measured by the Narcissistic Personality Inventory-40 (NPI-40), participate more in politics, including contacting politicians, signing petitions, joining demonstrations, donating money, and voting in midterm elections. Both agentic and antagonistic components of narcissism were positively and negatively related to different types of political participation when exploring the subfactors independently. Superiority and Authority/Leadership were positively related to participation, while Self Sufficiency was negatively related to participation. In addition, the combined Entitlement/Exploitativeness factor was negatively related to turnout, but only in midterm elections. Overall, the findings support a view of participation that arises in part from instrumental motivations.

Reexamining construct validity of the Short Dark Triad (SD3) scale

Background

The conceptualization of negative personality has evolved over the last few decades but the scientific assessment of negative traits is still at a nascent stage. The present study aimed to test the construct and external validity of the Short Dark Triad (SD3) scale, one of the most widely used scales to measure the dark triad, by conducting three independent studies.

Participants and procedure

Exploratory factor analysis (EFA) was conducted on 379 participants and confirmatory bifactor analysis was carried out on a sample of 414 participants. Additionally, an independent sample of 168 participants was used to test the external validity of SD3.

Results

In study 1, after the triarchic model was disconfirmed by a confirmatory factor analysis (CFA), an EFA was run on the original 27-item scale, which produced a two-factor model consisting of a dark dyad and narcissism. This was followed by a confirmatory bifactor analysis in study 2, which revealed that while Machiavellianism and psychopathy are better measured as manifestations of a general negative disposition, narcissism emerges as a distinct trait which is not significantly captured by the dark core of personality. Moreover, study 3 revealed that dark dyad is a better correlate and predictor of negative traits as com-pared to narcissism.

Conclusions

In keeping with these findings, we propose that narcissism should be measured holistically with equal emphasis on all its con-stituents and facets and that the intrinsic dimensionality of these traits must be captured while scoring. Implications and future directions are duly discussed.

On the uses and abuses of narcissism as a public health issue

Psychiatry understands narcissism as a pathological condition associated with poor social outcomes and difficulty relating to others. Millennials have been depicted by psychological research as 'narcissistic', and the term has lost accurate meaning. We underline the intellectual laxity of conflating social changes with narcissism and suggest ways forward.

Narcissism personality trait and performance: task-oriented leadership and authoritarian styles as mediators

Purpose

The present study explored the direct as well as indirect relationships between narcissism personality trait and performance. Two leadership styles (task oriented and authoritarian styles) were identified as possible mediators.

Design/methodology/approach

Narcissism was measured by using Narcissistic Personality Inventory (Ames et al., 2006), performance was measured by performance scale (Greene-Shortridge, 2008). Sinha's leadership scale (Sinha, 2008) was used to measure task-oriented and authoritarian leadership styles. 273 senior-level managers of a big public sector Indian organization participated in the study. SPSS 22 and SmartPLS 2.0 were used to analyze the data.

Findings

Correlation result shows that narcissism personality trait was positively related to authoritarian leadership style and negatively to task-oriented leadership style, task performance and teamwork dimensions of performance. Task-oriented leadership style mediated the relationship between narcissism and task performance and teamwork more than the authoritarian leadership style.

Originality/value

The study attempts to empirically test the behavioral manifestation of narcissism personality trait as positive or negative and has considered the whole measure of performance which has not been previously explored. Practical implications were also highlighted beside the theoretical concerns.

Profiles of narcissism and self-esteem associated with comprehensive mental health in adolescents

INTRODUCTION

This study firstly aimed to identify different profiles of narcissism and self-esteem in adolescents using latent profile analysis (LPA). A secondary aim was to examine associations between the identified profiles and subsequent measures of comprehensive mental health.

METHODS

Chinese adolescents (N = 1009, 50.8%girls, M_age = 12.99, SD = 0.66) completed a packet of measures on two occasions at 6-month intervals. Narcissism and self-esteem were assessed at Time 1. Positive and negative indicators of mental health were assessed at Time 2.

RESULTS

Latent profile analysis of narcissism and self-esteem identified six profiles: (1) high narcissism and high self-esteem; (2) high-moderate self-regard; (3) moderate self-regard; (4) low-moderate self-regard; (5) high narcissism but low self-esteem; (6) low self-regard. Adolescents in the high narcissism and high self-esteem and high-moderate self-regard profiles displayed positive mental health outcomes whereas adolescents in the high narcissism but low self-esteem and low self-regard profiles reported problematic mental health outcomes.

CONCLUSION

Differing profiles of narcissism and self-esteem in adolescents were identified; these profiles provide new insight into the structure of self-concept for adolescents. Further, the identified profiles of narcissism and self-esteem were differentially related to subsequent comprehensive mental health outcomes.

Internal Processing in Patients With Pathological Narcissism or Narcissistic Personality Disorder: Implications for Alliance Building and Therapeutic Strategies

Pathological narcissism (PN) and narcissistic personality disorder (NPD) have primarily been identified by striking external features, such as superiority, attention seeking and a critical or condescending attitude, and less attention has been paid to the internal processing contributing to this particular personality functioning. High dropout from treatment and challenges in building a therapeutic alliance with these patients call for further understanding of the complexity of disordered narcissism. Recent research on neuropsychological underpinnings to narcissistic pathology have provided valuable information that can inform therapeutic interventions for patients with this personality pathology. Internal processing in patients with PN or NPD is specifically influenced by compromised emotion processing and tolerance, identity diffusion, fluctuating sense of agency, reflective ability, perfectionism-related self- esteem, and ability to symbolize. The aim of this article is to review research studies with relevance for internal processing related to disordered narcissism and integrate findings with therapeutic strategies in alliance building with these patients.

Diagnosis, Classification, and Assessment of Narcissistic Personality Disorder Within the Framework of Object Relations Theory

Narcissistic personality disorder (NPD) remains a controversial diagnosis, with lack of consensus on essential features of the disorder and its boundaries. Within the framework of object relations theory (ORT), core organizing, structural features define NPD and provide a coherent conceptual framework for understanding clinical features of the disorder. In the ORT model, both grandiose and vulnerable presentations of NPD are characterized by a specific form of self-pathology, reflecting the impact of a grandiose self-structure in the setting of borderline personality organization. The grandiose self-structure provides some stability of self-functioning but does not confer the self-regulatory capacities provided by normal identity formation and is reliant on maintaining a sense of the self as exceptional. We compare the ORT model of NPD to diagnostic criteria in the Alternative Model for Personality Disorders (AMPD) of the DSM-5, highlighting significant correspondence between the two models as well as conceptual differences.

Processes of Change in Psychotherapy for Narcissistic Personality Disorder

The present study aims at determining the role for outcome of potential processes of change in psychotherapy for narcissistic personality disorder (NPD). They were examined on three levels: the content, the process, and the relationship. A total of 161 patients suffering with NPD were recruited in a naturalistic setting as part of the present study. They underwent a long- term clarification-oriented psychotherapy. Sessions 15, 20, and 25 were video- or audio-recorded and analyzed with an observer-rated instrument that measures the quality of the interaction processes from the patient's and therapist's perspectives. Different self-report measures were used to assess therapy outcomes. In-session improvement was observed in both patient and therapist processes across sessions. Patient improvement in the three levels of processes was systematically related with outcome. Only partial relationships were found between therapist improvement and outcome. The present study represents the first systematic insight into core changes in patients with NPD undergoing psychotherapy.

Principles of Psychodynamic Treatment for Patients With Narcissistic Personality Disorder

Narcissistic personality disorder is a pleomorphic entity that requires the psychodynamically oriented therapist to tailor the approach to the characteristics of the individual patient. Psychodynamic principles encompass a broad range of interventions depending on the patient's specific characteristics. The therapist's interventions range from interpretation of the transference to supportive approaches that emphasize empathic validation and direct advice. In the absence of systematic data on these variations, this article attempts to offer clinically based principles. Several themes are emphasized: the experience of shame, the predictable transference-countertransference developments, the role of comorbidity with other personality disorders and traits, and the approach to resistances.

The Bright and Dark Aspects of Grit in the Pursuit of Success

Grit, defined as passion and perseverance for long-term goals, predicts success in a number of social domains. The present two studies examined grit and its subscales, and how these relate to both adaptive and maladaptive personality traits pertaining to success. For Study 1, based on data from 249 participants, results indicated that grit was correlated positively with proactive personality, personal growth initiative, and competitiveness, and the perseverance subscale also was correlated positively with self- and other-oriented perfectionism. The findings of Study 1 led us to further explore the dark aspects of grit in Study 2: based on data from 222 participants, results indicated that grit was correlated negatively with Machiavellianism, hypercompetitiveness, and most forms of narcissism but positively correlated with adaptive grandiose narcissism. Collectively, results reveal grit to be a positive, adaptive trait but raise questions regarding the perfectionistic tendencies of gritty individuals and the unitary nature of the construct.

Pathological Narcissism and Symptoms of Major Depressive Disorder Among Psychiatric Outpatients: The Mediating Role of Impaired Emotional Processing

Research is scarce regarding the mechanisms by which pathological narcissism--consisting of narcissistic grandiosity and vulnerability--is linked with depression. The present study examined whether impaired emotional processing would mediate relations between pathological narcissism domains and depressive symptoms in a sample of 99 psychiatric outpatients. A significant indirect effect was found for narcissistic vulnerability on depressive symptoms, through unprocessed emotion as a mediator. Findings suggest that narcissistic vulnerability contributes to persistent and intrusive negative feelings, which in turn contribute to depressive symptom severity.

Forging Connections in Group Psychotherapy Through Right Brain-to-Right Brain Emotional Communications. Part 1: Theoretical Models of Right Brain Therapeutic Action. Part 2: Clinical Case Analyses of Group Right Brain Regressive Enactments

Part 1: Theoretical Models of Right Brain Therapeutic Action. The first part of this article on the central role of the right brain in group psychotherapy offers evidence-based theoretical models of therapeutic action cocreated by the group members and the group leader. It describes how recent advances in interpersonal neurobiology and neuropsychoanalysis allow for a deeper understanding of the underlying nonverbal right brain change mechanisms beneath the words in individual psychotherapy. It then expands this model to the group context, specifically focusing on the theoretical constructs of cohesion, attachment, transference-countertransference dynamics, and implicit affect regulation, all of which are right brain functions. Part 1 concludes with a discussion of the fundamental role of these right brain mechanisms in synchronized group regressions and reenactments of attachment trauma that allow for new beginnings in emotional and relational development. Part 2: Clinical Case Analyses of Group Right Brain Regressive Enactments. The second part of this article offers case examples and commentary on working with early dysregulated attachment histories and the affect blunting defense of dissociation. Clinical vignettes demonstrate how the group reenacts attachment dynamics in transient regressions into an earlier stage of preverbal development, outside of the domain of language. Such emotionally shared regressions of attachment trauma, rupture, and repair allow the group members and leader to companion each other into and out of enactments. In this manner, regulated reenactments of preverbal emotional experiences potentially allow the cohesive group to expand adaptive right brain capacities to regulate and communicate a broader range of affectively charged subjective self states, thereby cocreating new ways of being with others.

Narcissistic traits in young people: understanding the role of parenting and maltreatment

BACKGROUND

Elevated narcissism in young people often sets up a cascade of interpersonal and mental health challenges, reinforcing the need to understand its concomitants. Experiences of maltreatment and different parenting styles have been implicated but findings to date are inconclusive. By simultaneously considering multiple remembered parenting styles and maltreatment in a large sample, this study aims to elucidate possible prognostic factors associated with both grandiose and vulnerable narcissistic traits in youth.

METHODS

Young people (N = 328, age range: 17-25 years) reported on the remembered interpersonal environment and current grandiose and vulnerable narcissism traits. Structural equation modelling was used to examine maternal and paternal parenting styles and examine the association between experiences of parenting and grandiose and vulnerable narcissism.

RESULTS

Remembered overprotection from mothers and fathers was associated with both vulnerable and grandiose narcissistic traits. Remembered maternal overvaluation related to current grandiosity, and maternal leniency related to vulnerable narcissistic traits. For paternal parenting, the combination of overvaluation and leniency and overvaluation and care explained grandiose and vulnerable traits. There was no direct effect of remembered parental care or childhood maltreatment on current levels of narcissistic traits.

CONCLUSIONS

Remembered childhood experiences of being overprotected, overvalued and experiencing leniency in parental discipline, were associated with higher traits of pathological narcissism in young people. Care and maltreatment were non-specific risk factors. Remembered childhood environments of being excessively pampered are associated with grandiose and vulnerable narcissistic traits, characterised by the young person expressing unrealistic self-views, entitlement beliefs and impaired autonomy. In treatment these traits may emerge in the patient-therapist relationship and working through their developmental origins may contribute to outcomes.

Bruno Klopfer Award Address: Five-Factor Model Personality Disorder Scales

The predominant model of general personality structure is the Five-Factor Model (FFM), consisting of the five broad domains of neuroticism, extraversion, openness, agreeableness, and conscientiousness. A hypothesis of long-standing interest has been that personality disorders can be understood as extreme or maladaptive variants of the domains and facets of the FFM. The purpose of this article was to discuss the development and validation of FFM personality disorder scales. These scales assess the DSM-5 Section II personality disorders from the perspective of the FFM, as well as maladaptive variants of both poles of all five domains of the FFM.

Narcissistic Admiration and Rivalry: An Interpersonal Approach to Construct Validation

The present study applied the interpersonal perspective in testing the narcissistic admiration and rivalry concept (NARC) and examining the construct validity of the corresponding Narcissistic Admiration and Rivalry Questionnaire (NARQ). Two undergraduate samples (Sample 1: N = 290; Sample 2: N = 188) completed self-report measures of interpersonal processes based in the interpersonal circumplex (IPC), as well as measures of related constructs. In examining IPC correlates, the authors used a novel bootstrapping approach to determine if admiration and rivalry related to differing interpersonal profiles. Consistent with the authors' hypotheses, admiration was distinctly related to generally agentic (i.e., dominant) interpersonal processes, whereas rivalry generally reflected (low) communal (i.e., hostile) interpersonal processes. Furthermore, NARQ-admiration and NARQ-rivalry related to generally adaptive and maladaptive aspects of status-related constructs, emotional, personality, and social adjustment, respectively. This research provides further support for the NARC, as well as construct validation for the NARQ.

Self-Absorbed and Socially (Network) Engaged: Narcissistic Traits and Social Networking Site Use

Across two studies, the current research investigated how different dimensions of narcissism (grandiosity/agentic extraversion, entitlement/self-centered antagonism, vulnerability/narcissistic neuroticism) relate to social networking site (SNS) use and behaviors. Study 1 employed a community sample of young adults, whereas Study 2 examined college students. Participants completed assessments of narcissism and SNS use through an online survey. Grandiosity/agentic extraversion was generally associated with greater levels of downward social comparison relative to the other two dimensions. Entitlement/self-centered antagonism generally showed weak correlations with SNS outcomes. Vulnerability/narcissistic neuroticism was generally associated with greater upward social comparison and perceived social exclusion relative to the other two dimensions. Results suggest that SNS experiences may vary depending on the dimensions of narcissism.

The Role of Vulnerable and Grandiose Narcissism in Psychological Perpetrated Abuse Within Couple Relationships: The Mediating Role of Romantic Jealousy

The aim of this study was to analyze the direct and indirect relationships between the two phenotypes of narcissism, vulnerable and grandiose, and the tendency to perpetrate psychological abuse, exploring the mediating role of romantic jealousy. Our sample included 473 participants (213 males), aged 18-30 years (M = 22.74; SD = 2.81), involved in a stable romantic relationship. A structural equation modeling was conducted to test our model and a multigroup analysis was performed to test gender differences. Results show that the two forms of narcissism are both linked to psychological perpetrated abuse, but in different ways. Vulnerable narcissism was linked to psychological abuse only indirectly, through the role of romantic jealousy. On the contrary, grandiose narcissism was positively and directly associated with psychological abuse within the romantic relationship. Moreover, the model was invariant across genders. Limitations, strengths, and theoretical and clinical implications are discussed.

Addiction and the Dark Triad of Personality

In this article, we review associations between the Dark Triad of personality (narcissism, Machiavellianism, and psychopathy) and addictive behaviors, both substance-related and non-substance-related. We summarize evidence from personality and clinical research and integrate it with prevailing models of addiction. Specifically, we discuss addictive behavior in the light of affect regulation, which is likely more relevant in narcissism, as well as inhibitory deficits, a putative mechanism in psychopathy. These mechanisms can be related to central motives of the respective personality constructs, such as stabilization of self-esteem in narcissism and impulsive stimulation seeking in psychopathy. We conclude that different mechanisms might lead to similar observable behavior in narcissism and psychopathy at earlier stages of the addiction cycle, but psychopathic disinhibition might be particularly relevant at later stages. This underpins the importance of considering personality factors for the understanding and treatment of addiction.

The Dark Triad and Deception Perceptions

The present cross-sectional study (N = 205) tested the hypothesis that the Dark Triad traits – narcissism, Machiavellianism, and psychopathy – and the PID-5 maladaptive personality traits – Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism – are associated with specific deception-related perceptions: perceived cue-based deception detectability, perceived deception production ability, and perceived deception detection ability. Participants completed personality and deception measures in an online setting. All three Dark Triad traits and Antagonism were associated with perceived deception production ability, but not (substantially) with perceived deception detection ability and cue-based deception detectability. The results provide a more fine-grained picture of biases associated with the Dark Triad traits in the context of deception and further support the relevance of Antagonism and Detachment as deception-relevant personality traits.

Leader–follower narcissism and subgroup formation in teams: a conceptual model

Purpose

Drawing on existing theory, a model is developed to illustrate how the interaction between leaders and followers similarity in narcissism and goal congruence may influence subgroup formation in teams, and how this interaction influences team identification and team performance.

Design/methodology/approach

The proposed model draws on dominance complementary, similarity attraction, faultline formation and trait activation theories.

Findings

Leader–follower similarity in narcissism and goal congruence may stimulate subgroup formation, possibly resulting in conformers, conspirators, outsiders and victims, especially when performance pressure on a team is high. Followers who are low in narcissism and share goals with a leader who is narcissistic are likely to become conformers. Followers who are high in narcissism and share goals with a narcissistic leader are likely to become confederates. Followers who do not share goals with a narcissistic leader will be treated by the leader and other members as outsiders if they are high in narcissism, and victimized if they are low in narcissism. In addition, the emergence of these subgroups leads to reduced team identification and lower team performance.

Practical implications

Higher level managers, coaches and human resource professions can assess and, if necessary, counteract low team identification and performance resulting from the narcissistic personality characteristics of leaders and followers.

Originality/value

The model addresses how and under what conditions narcissistic leaders and followers may influence subgroup formation and team outcomes.

Recognising Narcissistic Abuse and the Implications for Mental Health Nursing Practice

Emotional and psychological abuse are components of what are now more commonly accepted as aspects of domestic violence in addition to physical assault. Narcissistic abuse formulations of domestic violence are lesser known concepts and not recognised in UK health care in general, nor commonly in UK mental health services and by default mental health nursing. The effects on the individual who has experienced narcissistic abuse can be fatal or extremely debilitating, long lasting and individual recovery can be a complex process. This article will argue that the language and formulation of narcissistic abuse should be at the forefront of the multidisciplinary teams', and in particular mental health nurses' knowledge in order that victims can be directly supported or signposted to support to enable timely interventions and in-depth understanding.

Facial Emotion Recognition and Social-Cognitive Correlates of Narcissistic Features

Narcissistic personality disorder (NPD) is associated with both seeming indifference and hypersensitivity to social feedback. This study evaluated whether rejection sensitivity and empathic difficulties in NPD are accounted for by altered facial emotion recognition (FER). Two-hundred non-clinical individuals self-reported NPD features, rejection sensitivity, and empathy and performed an FER task assessing the ability to determine the presence or absence of an emotion when viewing neutral and negative facial stimuli presented at varying emotional intensities (25%, 50%, 75%). Those with higher NPD features were faster at accurately recognizing neutral and low, 25%-intensity emotional stimuli. This response pattern mediated the association between NPD features and increased anger about rejection. Thus, individuals with high NPD traits are hypervigilant toward subtle negative emotions and neutral expressions; this may explain their tendency to experience intense angry feelings when facing the possibility that the others would not meet their need for acceptance.

Toward Understanding and Measuring Grandiose and Vulnerable Narcissism Within Trait Personality Models

Abstract. Research on trait narcissism is hindered by considerable confusion over its underlying structure, especially differences between pathological and normal narcissism, and grandiose and vulnerable narcissism. To address this problem, we describe two studies that examined the factor structure of a broad range of narcissism items and the implications for current narcissism theory. In Study 1, 881 undergraduates completed a scale composed of items taken trans-theoretically from narcissism scales that targeted grandiose, vulnerable, and normal narcissism descriptions. An exploratory factor analysis (EFA) was conducted and construct validity was established. In Study 2, 298 community-based participants were surveyed. Fit indices of a reduced 20-item scale and test-retest reliability were examined. Both studies supported a hierarchical structure of distinct grandiose and vulnerable factors, each with interpersonal and intrapersonal components. Thus, trait narcissism seems best described by grandiose and vulnerable dimensions, each of which can be focused toward the self or others.

The Severity of Personality Pathology: A Risk Factor for Concurrent Substance Use Disorders in Alcohol Use Disorder

Objective: Co-occurrence of substance use disorders (CO-substance use disorders) among individuals with alcohol use disorder (AUD) is largely recognized as a critical clinical issue. However, the specific clinical variables involved are still unclear. The recent findings are controversial in pointing out the unique contribution of both impulsivity and emotion dysregulation on CO-substance use disorders. Furthermore, the co-variation between AUD and other substance use disorders includes different aspects of maladaptive personality functioning (i.e., overall severity and specific features). Therefore, this study aims at clarifying the role of impulsivity, emotional dysregulation, and severity of personality pathology on CO-substance use disorders among treatment-seeking individuals with AUD. Methods: One hundred ninety-three treatment-seeking individuals with AUD (DSM-IV-TR) were consecutively recruited. Impulsivity (Barratt Impulsiveness Scale [BIS-11]), emotional dysregulation (Difficulties in Emotion Regulation Scale [DERS]), and personality pathology (Structured Clinical Interview for DSM-IV Axis II Personality Disorder [SCID-II]) were assessed after a 2-week detoxification period. The analyses were based on several stepwise forward logistic regressions. The total score of BIS-11 and DERS together with the number of SCID-II criteria were considered, in following the order, as independent variables controlling for the comorbidity with other lifetime Axis I disorders. CO-substance use disorders was the dependent variable (i.e., any CO-substance use disorders, benzodiazepine and cannabis/cocaine use disorders). Results: The number of SCID-II criteria was the only significant predictor of overall CO-substance use disorders, odds ratio (OR) = 1.16; 95% confidence interval (CI) [1.07, 1.26], p < .01, and cannabis/cocaine use disorders, OR = 1.19; 95% CI [1.08, 1.31], p < .01. On the contrary, DERS total score was the most robust predictor of benzodiazepine use disorder, OR = 1.02; 95% CI [1.01, 1.04], p < .01, albeit the severity of maladaptive personality functioning was also significantly associated with this disorder, OR = 1.09; 95% CI [1.00, 1.18], p < .05. Conclusions: The severity of maladaptive personality pathology represents one of the main aspects involved in CO-substance use disorders among individuals with AUD. This dimension predicts the CO-substance use disorders above and beyond specific personality dimensions and other psychiatric conditions. Therefore, personality functioning should be precisely assessed and personality pathology should be addressed in the framework of AUD treatments for promoting effective long-term outcomes.

Pathological narcissism and psychosocial functioning

Pathological narcissism involves maladaptive efforts to regulate the self and is conceptualized by 2 key features: narcissistic grandiosity and narcissistic vulnerability. Prior research has found that narcissism is associated with poorer functioning over the long term, especially interpersonal functioning. Despite this, the specific contributions of grandiosity and vulnerability to different domains of functioning remain understudied. In particular, there has been scant literature investigating pathological narcissism and its effects on functioning in large clinical samples. Understanding how grandiosity and vulnerability each contributes to dysfunction will help inform the conceptualization, prognosis, and treatment recommendations, alike, for narcissism. This study examined the relations between narcissism and different domains of dysfunction in a sample of 288 current or recent psychiatric outpatients. Results suggest that narcissistic grandiosity is associated with specific deficits in interpersonal functioning, whereas vulnerability is associated with all forms of dysfunction. However, after accounting for the shared variance in the predictors, vulnerability continues to be predictive of all forms of dysfunction, whereas grandiosity serves as a modest protective factor. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Grandiose and Vulnerable Narcissistic States in Interpersonal Situations

Clinicians have noted that narcissistic individuals fluctuate over time in their levels of grandiosity and vulnerability. However, these fluctuations remain poorly understood. Interpersonal theory asserts that interpersonal situations are central to the expression of personality and psychopathology, and therefore are a key context in which to understand the dynamic processes underlying narcissistic states. The present study is the first to examine narcissistic states assessed during interpersonal situations. Specifically, perceptions of others' warmth and dominance, momentary grandiosity and vulnerability, and one's own warm and dominant behavior were assessed across situations in daily life in a large sample (person N=286; occasion N=6,837). Results revealed that more grandiose individuals perceived others as colder and behaved in a more dominant and cold fashion, on average. But in the moment, relatively higher grandiosity was associated with perceiving others as warmer and more submissive and resulted in more dominant and warm behavior. On the other hand, trait vulnerability was associated with perceptions of coldness and cold behavior, and these effects were only amplified in momentary spikes of vulnerability. This study provides much-needed insight into the contexts that contribute to fluctuations in grandiosity and vulnerability.

Vulnerable narcissism and addiction: The mediating role of shame

Problem drinking and gambling are addictive behaviours experienced by young adults and commonly occur with narcissism. Research has acknowledged two distinct forms of narcissism: grandiose and vulnerable. There has been work that has examined the relationship between grandiose and vulnerable narcissism and addictive behaviours, but it has been limited, particularly with vulnerable narcissism. Evidence suggests vulnerable narcissism, but not grandiose narcissism, is associated with greater negative affect. Accordingly, shame, a potent social emotion could be a mediator in the narcissism-addiction pathway. Shame has been implicated in both vulnerable narcissism and problem drinking and gambling. Thus, we hypothesized that shame would mediate the relationship between vulnerable narcissism and addictive behaviours. Young adults (N = 210) completed self-report baseline (Time 1) and 1-month follow-up (Time 2) assessments of shame, narcissism, problem drinking, and gambling. As predicted, those with elevated vulnerable narcissism at Time 1 had increased shame at Time 2, which predicted problem drinking and gambling at Time 2. This relationship was not observed for grandiose narcissism. Overall, our results suggest that feelings of shame are essential to understanding the vulnerable narcissism-addiction pathway, and an important consideration when designing clinical interventions for at-risk young adults.