Expanding the validity of the malignant self-regard construct in an Italian general population sample

Exploring Guilt Differences in Grandiose Narcissism, Vulnerable Narcissism, and Malignant Self-Regard

Narcissistic personality disorder is a heterogeneous and complex pathology which manifests itself very differently in individuals. The aim of the present study was to analyze differences and similarities in morality and sensitivity to feelings of guilt among grandiose narcissism (GN), vulnerable narcissism (VN), and malignant self-regard (MSR). We expected that MSR and VN would be most sensitive to deontological and altruistic guilt, and that MSR and VN would have higher levels of moral standards than GN. A nonclinical sample of 752 participants was evaluated. Results showed a significant association among MSR, VN, and GN. According to our hypothesis, GN turned out to be the one with the lowest association values to guilt measures. Our results demonstrated that MSR is strongly associated with all types of guilt, GN is associated with a substantial lack of guilt, and VN is associated with deontological guilt and self-hate, but not altruistic guilt. Results confirm the relevance of considering and understanding guilt when differentiating GN, VN, and MSR.

Malignant Self-Regard: Overview and Future Directions

Malignant self-regard (MSR) is a self-representation that encompasses the shared features of depressive personality disorder, masochistic/self-defeating personality disorder, depressive-masochistic personality, and vulnerable narcissism. In this review we begin by describing the construct's historical precursors, which begin in early psychoanalytic/dynamic theory, and then trace its development across iterations of the Diagnostic and Statistical Manual of Mental Disorders. Special attention is paid to differentiating MSR from vulnerable narcissism. We then consider MSR's place within transdiagnostic, transtheoretical, and dimensional models of personality pathology. We focus heavily on MSR's impact on various personality systems (e.g., thought and affect systems) and also on overall personality functioning. The empirical research on MSR in relation to these systems is thoroughly reviewed and largely supports its psychometric properties and clinical significance. We suggest that MSR may map onto the distress subfactor in the hierarchical taxonomy of psychopathology (HiTOP) and that MSR seems to occupy the shared internalizing space across the neurotic and borderline level of personality organization in Kernberg's model of personality disorders. We also identify four major directions for future research: the possible benefits of self-defeating tendencies that involve pathological narcissism and self-esteem; MSR's relationship to overall health and well-being; depressive states and MSR severity; and how MSR fits within the Alternative Model for Personality Disorders and the personality disorder framework of the International Classification of Diseases.

Worries, Preparedness, and Perceived Impact of Covid-19 Pandemic on Nurses' Mental Health

Background: In times of global public health emergency, such as the COVID-19 pandemic, nurses stand at the front line, working in close contact with infected individuals. Being actively engaged in fighting against COVID-19 exposes nurses to a high risk of being infected but can also have a serious impact on their mental health, as they are faced with excessive workload and emotional burden in many front-line operating contexts.

Purpose: The aim of the study is to analyze how risk factors such as perceived impact, preparedness to the pandemic, and worries were associated with mental health outcomes (crying, rumination and stress) in nurses.

Methods: A cross-sectional study design was performed via an online questionnaire survey. Participants included 894 registered nurses from Italy. Participation was voluntary and anonymous. Multiple binary logistic regression was carried out to analyze the relationship between risk factors and health outcomes.

Results: Increased job stress was related to higher levels of rumination about the pandemic (OR = 4.04, p < 0.001), job demand (OR = 2.00, p < 0.001), impact on job role (OR = 2.56, p < 0.001), watching coworkers crying at work (OR = 1.50, p < 0.05), non-work-related concerns (OR = 2.28, p < 0.001), and fear of getting infected (OR = 2.05, p < 0.001). Job stress (OR = 2.52, p < 0.01), rumination (OR = 2.28, p < 0.001), and watching colleagues crying (OR = 7.92, p < 0.001) were associated with crying at work. Rumination was associated with caring for patients who died of COVID-19 (OR = 1.54, p < 0.05), job demand (OR = 1.70, p < 0.01), watching colleagues crying (OR = 1.81, p < 0.001), non-work-related worries (OR = 1.57, p < 0.05), and fear of getting infected (OR = 2.02, p < 0.001).

Conclusions: The psychological impact that this pandemic may cause in the medium/long term could be greater than the economical one. This is the main challenge that health organizations will have to face in the future. This study highlights that the perceived impact and worries about the pandemic affect nurses' mental health and can impact on their overall effectiveness during the pandemic. Measures to enhance nurses' protection and to lessen the risk of depressive symptoms and post-traumatic stress should be planned promptly.