Pathological narcissism and narcissistic personality disorder

Putting self at stake by telling a story: Storyteller's narcissistic traits modulate physiological emotional reactions to recipient's disengagement

Telling a story to a disengaged recipient induces stress and threatens positive self-image. In this study, we investigated whether storytellers with overly positive and fragile self-images (e.g., individuals with grandiose and vulnerable narcissism) would show heightened behavioral, emotional, and psychophysiological reactivity to recipient disengagement.Building on Bavelas, Coates, and Johnson [1] we conducted a conversational experiment instructing the participants to tell about a "close call" experience to a previously unknown co-participant. We modified the co-participant's level of interactional engagement by asking them either to listen to the story carefully or to simultaneously carry out a counting task that distracted them from the content of the story. We found that the distraction condition was unrelated to the storytellers' narration performance, but a significant positive association was found between the story-recipients' observed lack of affiliation and the tellers' narration performance. The distraction of recipients was also associated with increased self-reported arousal in the tellers, indicating disengagement-induced stress in the tellers. Moreover, tellers higher in grandiose narcissism reacted with higher skin conductance response to disengagement, and vulnerable narcissism was associated with higher heart rate during narration in general. Our experiment thus showed that grandiose narcissists are emotionally sensitive to their co-participants' disengagement.

Exploring the Associations of Personality and Sexual Health Using the DSM-5 Alternative Model for Personality Disorders

This study explored the relationships between sexual health indicators (i.e., sexual satisfaction, distress, and function) and the DSM-5 Alternative Model for Personality Disorders, a promising dimensional framework for assessing personality pathology. A sample of 489 participants seeking help in private practice clinics completed self-report measures of sexual satisfaction, distress, and function, as well as dyadic adjustment, psychological distress, romantic attachment, personality impairment, and pathological personality facets. Results first showed that participants reaching the cutoffs for a personality disorder had significantly higher sexual distress and lower sexual function compared to participants without a personality disorder. Second, path analyses controlling for psychological distress, dyadic adjustment, and romantic attachment revealed that, for women, the Criterion B Intimacy Avoidance facet was consistently linked with higher sexual distress and lower sexual satisfaction and function. For men, result patterns were more complex, linking Criterion B Separation Insecurity with high sexual distress, and Separation Insecurity and Intimacy Avoidance facets with low sexual function. In addition, Criterion B Irresponsibility, Rigid Perfectionism, as well as Criterion A Intimacy impairment were linked with higher sexual satisfaction. These findings improve our understanding of the links between personality and sexual health and provide support for considering personality difficulties in sexual health interventions.

Cognitions in antisocial personality and their association with "dark" traits

Unlike the cognitions associated with depressive symptoms, little is known about those associated with antisocial personality and with its related traits ("dark traits"). Using the scrambled sentences task, an instrument from depression research, we investigated cognitions such as justifications (external blaming for one's behavior) and harm to others (based on the notion that some of these individuals enjoy harming or humiliating others) that we hypothesized may be prevalent in those high in antisocial personality traits. Confirming our hypothesis, these cognitions were associated with ratings on different antisocial personality scales and with antisocial and detachment scores in the alternative model of personality disorders of the DSM-5 (AMPD) in three non-clinical samples, but not with depressive symptoms or neuroticism. Cognitions including harm to others were differentially associated with high sadism. These findings empirically characterize classes of cognitions that are shared by individuals with antisocial tendencies, and that differ from those associated with depressive symptoms.

Exploring the Influence of Dark Triad and Light Triad Traits on Sport Sciences Students

Background and Objectives: The primary purpose of the article was to examine the relationship between dark and light personality traits in university students enrolled in the Faculty of Sport Sciences. Materials and Methods: Data were collected from 518 students (208 female, 310 male) with an average age of 20.89 (±2.25). The Short Dark Triad and the Light Triad Scales were used. Harman's single-factor analysis minimized measurement error, and various statistical methods assessed the effect of gender and age on personality traits. Results: Results indicated a positive correlation among dark personality traits, while light personality traits exhibited more complex relationships. Gender and age were found to significantly influence certain personality traits. Conclusions: This study contributes to the sports literature by exploring the role of demographic variables in personality formation.

Association between pathological narcissism and emotion regulation: The role of self-mentalizing?

Pathological narcissism (PN) is a common psychopathological issue leading to maladaptive strategies to cope with self-esteem threats, including self-enhancement and exploitation (grandiose strategies) or internalized shame, depression, and social withdrawal (vulnerable strategies). Mentalizing is a key process for regulating self and other representations and their associated emotions. Patients with PN further struggle with emotion dysregulation (ED), which during development is intertwined with the growing capacity to mentalize. We seek to contribute to emerging empirical data documenting the associations between PN and ED and between PN and mentalizing, and to provide information on the nature of their mutual relationships. In the present study, we assessed PN, ED, and three mentalizing dimensions (mentalizing self, other, and motivation to mentalize) in 183 patients consulting in our outpatient unit specialized in ED. We found that narcissistic vulnerability was negatively associated with self-mentalizing and positively associated with overall ED, both even after adjustment for borderline and attention deficit hyperactivity disorder (ADHD) symptoms. However, the association with ED was not maintained after further adjustment for self-mentalizing or overall-mentalizing, which suggests that mentalizing may play a mediating role in this relationship. On the other hand, narcissistic grandiosity was positively associated with other-mentalizing and ED and negatively associated with self-mentalizing in bivariate analyses, but these last two associations were not maintained after adjustment for comorbid borderline and/or ADHD symptomatology. This study provides new information on the link between PN and ED and on key mentalizing dimensions meaningfully relating to PN, notably through a potential role of self-mentalizing processes between PN and ED.

In the mind of Narcissus: The mediating role of emotional regulation in the emergence of distorted cognitions

INTRODUCTION

Currently narcissism is considered one of the most widespread phenomenon. As a consequence, its different types (grandiose and vulnerable narcissism) have been investigated from several different perspectives. The present research attempts to explore the differences between the two types of narcissism and their links with different cognitive components that are connected to these personality traits. The primary aim of our study is to investigate the possible connections among maladaptive schemas (entitlement, vulnerability, emotional deprivation) and cognitive evaluation systems (self-esteem, systemizing-empathizing) and narcissism.

METHODS

We applied both correlation and path analyses to explore the hypothesized associations.

RESULTS

The results show that early maladaptive schemas are strongly associated with narcissism and the empathizing system. The different subtypes of narcissism have different connections with self-esteem.

CONCLUSION

Our results show that the two types of narcissism have different manifestations and connections with the early maladaptive schemas, Emphatizing Quotient, and self-esteem. Our empirical results serve as important and empirically supported inputs to counseling and clinical practice.

Loneliness in narcissistic vulnerability: Examining domains of personality functioning

Research has indicated loneliness to be a detrimental correlate of narcissistic vulnerability. However, no research has examined if this relationship persists across time or why it occurs. The present study explores the link between narcissistic vulnerability and loneliness across time and examines which domains of personality dysfunction (i.e., identity, self-direction, empathy, and intimacy) may account for why narcissistic vulnerability is related to loneliness. Adult participants (N = 298) were recruited from Prolific and completed study questionnaires assessing narcissistic vulnerability, narcissistic grandiosity, loneliness, domains of self and interpersonal functioning, and neuroticism. Two months later, participants repeated the measure of loneliness. Correlations among all study variables were calculated, followed by linear regression analyses to investigate how personality functioning domains may mediate the longitudinal relationship between narcissistic vulnerability and loneliness. The effects of baseline loneliness, relationship status, and trait neuroticism were controlled for. Narcissistic vulnerability, but not narcissistic grandiosity, was associated with loneliness at baseline and 2 months later. Intimacy functioning, but not identity, self-direction, or empathy functioning, was a significant mediator of the relationship between narcissistic vulnerability and loneliness over time. These findings suggest that narcissistic vulnerability may contribute to the development or maintenance of loneliness across time, highlighting the role of impaired intimacy functioning in this relationship. The impact of these findings on our understanding of interpersonal functioning in narcissistic vulnerability, as well as clinical implications, is discussed.

Identification of the Core Characteristics of Vulnerable/Hypersensitive Narcissism and its Association with the Dark Triad in a Large International Sample: A Network Analysis Study

The current paper aimed to investigate the network structure and centrality indexes of hypersensitive narcissism using the hypersensitive Narcissism Scale (HSN). Additionally, we aimed to explore its relationships with dark triad personality aspects. A globally diverse sample of "53,981" participants (47.9% non-United States responders) completed the HSN and Dark Triad Dirty Dozen scale (DTD). We estimated the network structure across genders to determine the core characteristics of hypersensitive narcissism. Additionally, bridge and central nodes (characteristics) were identified. All analyses were performed using R-Studio programming software. The network comparison test indicated significant differences in the network structures between males and females (Network-Invariance: 0.0489, P < 0.01; Global Strength Invariance: 0.101, P < 0.01). In the network of HSN for male participants, characteristics with the highest strength centrality were "Highly affected by criticism" (HSN.2, strength = 1.08) and "Self-absorbed in personal pursuits" (HSN.8, strength = 1.28). For female participants, "Self-absorbed in personal pursuits" (HSN.8, strength = 1.32) and "privately annoyed by others' needs" (HSN.10, strength = 1.21) were the highest central characteristics. The assessment of bridge strength indicated that nodes HSN.2 (Highly sensitive to criticism), scoring 0.42, and DTD.1 (Tendency to manipulate for gain, a component of Machiavellianism), scoring 0.428, showed the highest bridge strength values. The current study identified core characteristics of hypersensitive narcissism and its correlation with dark triad personality, revealing gender-specific patterns and bridging symptoms between the two constructs. These findings showed that focusing on these core characteristics may be advantageous in treating individuals exhibiting elevated levels of narcissism.

Psychoeducation for Pathologic Narcissism and Narcissistic Personality Disorder: A Review and Proposal for a Good Psychiatric Management-based Six-week Group Program

Pathologic narcissism (PN) and narcissistic personality disorder (NPD) are 2 common and stigmatized clinical constructs that are known to have large consequences for patients' functioning and mental health-related outcomes. To date, no treatment for these conditions has been empirically validated, but there is a relative consensus about the importance of psychoeducation. Here we present a model for a psychoeducational intervention for patients with PN or NPD. We start with a review of the current evidence on the role of psychoeducation in different treatment models for PN, and we discuss several aspects regarding the content and format of this type of intervention. Based on this review, we outline a 6-week Good Psychiatric Management-based psychoeducation group program that we developed. We also describe how such a psychoeducational intervention can be implemented individually, with fewer resources, in general care settings. Finally, we discuss the strengths and limitations of our approach and elaborate on the rationale for our proposal. We believe that this program proposal is a first step in the development of psychoeducational programs for PN and NPD that can be further corrected and enhanced.

A Deviance Regulation Theory Intervention Affects the Association Between Narcissistic Traits and Alcohol Harm Reduction Strategies in College Students

Background: College students continue to report problematic alcohol use. To mitigate adverse outcomes, recent studies have employed harm reduction strategies known as Protective Behavioral Strategies (PBS). Deviance Regulation Theory (DRT), an impression management intervention, has been used to promote the use of PBS. DRT relies on impression management to modify behavior. This may be especially important for individuals with higher levels of trait narcissism. Method: College student drinkers (n = 132) were randomly assigned to receive a positive message about PBS users, a negative message about non-PBS users, or control. Participants reported on current PBS use norms, daily alcohol use, PBS use, and any alcohol-related problems experienced during the previous week for the next 10 weeks. Results: Data were analyzed using multilevel regression to examine PBS use across time by condition. When PBS norms were low, narcissism was strongly associated with lower rates of PBS use in the control group. If individuals received a positive or negative message, the association between narcissism and PBS use was diminished, among individuals with low PBS norms. There were no significant differences at mean or high levels of norms, indicating the messaging was only important for the highest risk group (i.e., those with low PBS norms). Discussion: The results of this study suggest that message framing may be effective at reducing the robust negative association between narcissism and PBS use for individuals with low PBS norms. Positive messages about individuals that use PBS may be one approach to mitigating problematic alcohol consumption in this at-risk group.

Adult ADHD and pathological narcissism: A retrospective-analysis

Adult attention deficit hyperactivity disorder (ADHD) is often associated with personality pathology. However, only few studies have been conducted on the link between ADHD and pathological narcissism (PN), with or without a diagnosis of narcissistic personality disorder (NPD). In order to fill this gap, PN and NPD were assessed in 164 subjects suffering from ADHD, with several other measures including ADHD severity, quality of life, depression, anxiety, impulsivity, and emotion dysregulation (ED). We found that a significant proportion of ADHD patients suffered from NPD, and that both narcissistic grandiosity and vulnerability were associated with ADHD hyperactivity and impulsivity symptoms, but not with inattentive symptoms. These two dimensions seemed to be negatively associated with well-being and positively associated with most of the other studied psychiatric dimensions except ED, the latter being only associated with vulnerability, even after adjustment on borderline symptoms. Overall, despite important limitations that limit the generalizability of our findings to the overall ADHD population (notably linked to selection bias), we believe that this exploratory study sheds light on the potential clinical relevance of narcissistic pathology in adult ADHD patients.

What do we need in order to successfully treat persons with pathological narcissism? How does change happen? Treatment principles and mechanisms of change emerging from single cases treated by experts: A commentary

Persons with pathological narcissism (PN) or narcissistic personality disorder present with a wide array of symptoms and social problems. They need effective psychotherapies but empirical evidence for what works with them is mostly lacking. In this issue of the Journal and Clinical Psychology: In Session four authors from different orientations described single cases of patients suffering from different manifestations of PN. In this commentary we reviewed in detail the four cases and tried to distill (a) the treatment principles adopted; (b) the actual mechanisms of therapeutic change. We hope that the list of principles and mechanisms and change we identified here can help both clinicians and researchers develop and test effective options for persons with PN who are difficult to treat but do have chances to change in a meaningful way in treatment.

Impulsivity mediates the association between narcissism and substance-related problems beyond the degree of substance use: a longitudinal observational study

BACKGROUND

Narcissism has been implied as a putative risk factor for substance use disorders (SUDs). However, previous research did not disentangle the degree of substance use from substance-related problems, the symptoms of SUDs. This preregistered study addressed the open question whether grandiose and vulnerable narcissism and their constituent traits convey specific SUD risk, that is, explain substance-related problems beyond the degree of use. Furthermore, we tested whether impulsivity or substance use motives linked to narcissistic self-regulation mediate this association.

METHODS

Narcissism, impulsivity, substance use motives, past-year substance use, and substance-related problems were assessed in 139 (poly-)substance users, 121 of whom completed a one-year follow-up. For significant longitudinal associations between narcissism factors and substance-related problems controlled for the degree of use, we tested impulsivity and substance use motives as mediators.

RESULTS

Grandiose narcissism (r =.24, p =.007) and its constituent factors antagonistic (r =.27, p =.003) and agentic narcissism (r =.18, p =.050), but not vulnerable narcissism, prospectively predicted substance-related problems beyond the degree of substance use. Associations of grandiose narcissism and antagonistic narcissism with substance-related problems were fully mediated by impulsivity, but not substance use motives. Impulsivity explained roughly one third of the association of both grandiose (P̂M = 0.30) and antagonistic narcissism (P̂M = 0.26) with substance-related problems.

DISCUSSION

We demonstrate that grandiose narcissism- particularly antagonistic but also agentic narcissism- is specifically linked to substance-related problems beyond the degree of substance use. The mediating effect of impulsivity but not substance use motives suggests that impulsivity may be a more important mechanism than narcissistic self-regulation in promoting SUD in narcissism. However, future studies may use more targeted measures than substance use motives to further probe the role of self-regulation. Similar result patterns for alcohol compared to all substances together indicate that mechanisms may be alike across substances. In conclusion, narcissistic individuals may not use substances more but have a higher SUD risk, informing prevention and treatment.

Homework assignments in relational psychoanalytic treatment of personality disorders: A case study of a patient with narcissistic personality disorder

Homework assignments, or specific tasks patients are asked to engage in or complete between sessions, are a controversial topic among psychoanalysts. While many argue these interventions contradict psychoanalytic principles, others believe they can help address problems and promote coping skills. We propose that homework can be a legitimate aspect of relational psychoanalysis when used in a way that is attuned to the patient's experience and that homework may be an important component of treating personality disorders (PD). We present the case of a man diagnosed with narcissistic PD. He often felt superior to and reported that he despised others, though the core self-image was of fragile. He embraced the role of the omnipotent caregiver, which came with boredom and anger and lack of satisfaction in his social life. The patient tried to control therapy, asserting that he could psychoanalyze himself. As a result, therapy was stalled and progress was limited. At this point, the therapist asked him to complete homework assignments that encouraged him to refrain from his compulsive caregiving to better understand what motivated this behavior. Through this process, the patient came to realize he acted out of avoidance, as he did not want to disclose his own vulnerabilities and flaws. At that point he was able to experience relationships while adopting different stances and finding new meanings. We argue that homework can be fully integrated into the relational psychoanalytic repertoire to improve self-reflection and foster change in patients with PD.

Testing and treatment-by-attitude in psychotherapy for pathological narcissism: A clinical illustration

Pathological narcissism is a personality constellation comprising distorted self-image, maladaptive self-esteem regulation, and difficulties in intimate relationships. Patients with elevated pathological narcissism may not necessarily meet criteria for narcissistic personality disorder, and may seek treatment for a range of mental health concerns across various clinical settings. An understanding of key principles of control-mastery theory (CMT) can help clinicians understand the specific goals and challenges of the individual patient with pathological narcissism, and can illuminate ways in which the patient may work in psychotherapy. This paper outlines how patients with pathological narcissism may engage in testing of their pathogenic beliefs, and how therapists can respond in ways that facilitate the patient's sense of safety and foster psychological work. The role of the therapist's attitude is highlighted as a means for countering pathogenic beliefs associated with pathological narcissism. Clinical material from a single case of time-limited supportive psychotherapy will be used to illustrate these principles and associated therapeutic processes. Insights from CMT regarding pathogenic beliefs and the patient's plan for addressing them can help to explain how therapy works or does not work for patients with pathological narcissism.

Proposition of a transdiagnostic processual approach of emotion dysregulation based on core triggers and interpersonal styles

Emotion dysregulation (ED) has primarily been described in patients suffering from borderline personality disorder (BPD) and is an integral part of this diagnosis, but it is also a transdiagnostic construct that can be found in several other psychiatric disorders. The strong relationships between ED and BPD may lead clinicians to underestimate ED associated to other clinical contexts. This can lead to difficulties in diagnostic and treatment orientation, especially in the context of comorbidities. In this article, after reviewing the literature on the development and functioning of emotion dysregulation, and on the evidence for emotion dysregulation in eight disorders (borderline personality disorder, pathological narcissism with/without narcissistic personality disorder, obsessive-compulsive personality disorder, antisocial personality disorder, bipolar disorder, autism spectrum disorder, complex post-traumatic stress disorder, and adult attention deficit hyperactivity disorder), we present a transdiagnostic processual model of emotion dysregulation based on core triggers and interpersonal styles to try to address this issue and to provide a simple but technical tool to help clinicians in their diagnostic assessment and treatment orientation. By focusing more on typical patterns and interpersonal dynamics than only on categories, we believe that this model may contribute to the actual need for improvement of our current psychiatric classifications, alongside other well-studied and under-used dimensional models of psychopathology (e.g., HiTOP, AMPD), and may be useful to build more specific treatment frameworks for patients suffering from ED.

Traits of narcissistic vulnerability in adults with autism spectrum disorders without intellectual disabilities

The relationship between Autism Spectrum Disorders (ASD) and Narcissistic Personality Disorder (NPD), considering the dimensions of narcissistic grandiosity and vulnerability, represents an important differential diagnosis and potential ground of comorbidity, since both conditions show high grades of pervasiveness, a life-long course, ego-syntonic traits, and difficulties in building up and sustaining interpersonal relationships Although the co-diagnosis rates, according to the categorical criteria in use, are limited (0%-6.4%), it is common to encounter diagnostic doubts in clinical practice. Here we investigated the dimensions of narcissistic vulnerability and grandiosity in a sample of 87 adults diagnosed with ASD without intellectual disabilities through the administration of the Pathological Narcissism Inventory-52 Items (PNI-52). The mean scores of our sample were compared with the normative distribution available in the literature, and we found that individuals with ASD scored significantly higher than neurotypical controls at the Total Score and at the Vulnerable Narcissism subscale, but not at the Grandiose Narcissism subscales. Demographic features did not influence these results. Vulnerable narcissism was significantly associated with the "Ritvo Autism and Asperger Diagnostic Scale - Revised" subscale Social Relatedness. These findings could potentially be indicative of a greater comorbidity rate between the two disorders with respect to the one reported to date, possibly because DSM-5 criteria are mainly focused on the grandiose dimension. Potential explanatory links between ASD phenomenology and vulnerable narcissism, such as the personality dimension of neuroticism, are discussed, together with the possible role of narcissistic vulnerability in mediating internalizing symptoms (e.g., anxiety, depression) in individuals with ASD.

The Association Between Child Maltreatment and Pathological Narcissism: A Three-Level Meta-Analytic Review

Emerging evidence has documented the positive association between child maltreatment and both phenotypes of pathological narcissism (i.e., vulnerable and grandiose narcissism). However, results across these studies are inconsistent. Therefore, the present meta-analysis aimed to examine the extent to which child maltreatment is associated with vulnerable and grandiose narcissism, and whether these associations differed by study or sample characteristics. A systematic literature review was conducted in Web of Science, ScienceDirect, PubMed, Google Scholar, and China National Knowledge Infrastructure. Three-level meta-analyses were performed in R to synthesize the effect sizes. A total of 15 studies (N = 9,141 participants) producing 129 effect sizes were included. Results showed that child maltreatment was positively related to both vulnerable narcissism (mean r = .198; p < .001) and grandiose narcissism (mean r = .087; p < .001), but only to a small extent. Further, the association between child maltreatment and vulnerable narcissism was stronger for neglect (r = .278) than for physical abuse (r = .130). The strength of the association between child maltreatment and grandiose narcissism was larger for samples that were on average younger than 18 years (r = .187) than for samples that were on average older than 18 years (r = .068). Also, the strength of the association was stronger for females than for males. Child maltreatment is a risk factor for developing both vulnerable and grandiose narcissism. Interventions targeting pathological narcissism should be aware of potential trauma resulting from victimization of child maltreatment.

Narcissistic Personality Disorder as Prodromal Feature of Early-Onset, GRN-Positive bvFTD: A Case Report

Background

Behavioral variant frontotemporal dementia (bvFTD) typically involves subtle changes in personality that can delay a timely diagnosis.

Objective

Here, we report the case of a patient diagnosed of GRN-positive bvFTD at the age of 52 presenting with a 7-year history of narcissistic personality disorder, accordingly to DSM-5 criteria.

Methods

The patient was referred to neurological and neuropsychological examination. She underwent 3 Tesla magnetic resonance imaging (MRI) and genetic studies.

Results

The neuropsychological examination revealed profound deficits in all cognitive domains and 3T brain MRI showed marked fronto-temporal atrophy. A mutation in the GRN gene further confirmed the diagnosis.

Conclusions

The present case documents an unusual onset of bvFTD and highlights the problematic nature of the differential diagnosis between prodromal psychiatric features of the disease and primary psychiatric disorders. Early recognition and diagnosis of bvFTD can lead to appropriate management and support for patients and their families. This case highlights the importance of considering neurodegenerative diseases, such as bvFTD, in the differential diagnosis of psychiatric disorders, especially when exacerbations of behavioral traits manifest in adults.

Predicting narcissistic personality traits from brain and psychological features: A supervised machine learning approach

Narcissism is a multifaceted construct often linked to pathological conditions whose neural correlates are still poorly understood. Previous studies have reported inconsistent findings related to the neural underpinnings of narcissism, probably due to methodological limitations such as the low number of participants or the use of mass univariate methods. The present study aimed to overcome the previous methodological limitations and to build a predictive model of narcissistic traits based on neural and psychological features. In this respect, two machine learning-based methods (Kernel Ridge Regression and Support Vector Regression) were used to predict narcissistic traits from brain structural organization and from other relevant normal and abnormal personality features. Results showed that a circuit including the lateral and middle frontal gyri, the angular gyrus, Rolandic operculum, and Heschl's gyrus successfully predicted narcissistic personality traits (p < 0.003). Moreover, narcissistic traits were predicted by normal (openness, agreeableness, conscientiousness) and abnormal (borderline, antisocial, insecure, addicted, negativistic, machiavellianism) personality traits. This study is the first to predict narcissistic personality traits via a supervised machine learning approach. As such, these results may expand the possibility of deriving personality traits from neural and psychological features.

Two-Wave Stability of Grandiose and Vulnerable Narcissism During Adolescence: The Mediating Role of Empathy

ABSTRACT

Literature suggests that narcissistic traits may affect socio-affective development from early adolescence. Two interrelated narcissistic domains have been identified, i.e. , narcissistic grandiosity (NG) and narcissistic vulnerability (NV). This study aims to prospectively assess NG and NV during adolescence and to investigate the mediating role of empathy on the stability of narcissistic traits. One-hundred fifty-six adolescents (47.5% females) participated in a longitudinal prospective study. NG, NV, and empathy were assessed at baseline and 24-month follow-up. Compared with NG traits, NV showed a mean-level increasing pattern, albeit with a small effect size. Different empathy domains mediated the developmental trajectories of NG and NV. Specifically, the "fantasy" empathy domain partially mediated the stability of NG, whereas the "personal distress" domain partially mediated the mild increase of NV. The findings suggest that grandiose fantasies and negative activation to others' distress are crucial factors in shaping developmental trajectories of narcissistic traits during adolescence.

Under the thin skin of narcissus: Facial muscle activity reveals amplified emotional responses to negative social evaluation in individuals with grandiose narcissistic traits

Individuals with grandiose narcissism exhibit enhanced antagonism and a defensive pattern of discordance between their emotional and physiological reactions to self-threatening evaluations. Although theoretical perspectives link narcissistic defensiveness to negative emotions, empirical evidence linking grandiose narcissism to emotional reactivity remains mixed. The current study used self-reported affect, electrocardiography, and facial electromyography (fEMG) to examine whether people scoring high in grandiose narcissism show amplified physiological and self-reported emotional reactivity to negative social evaluation. Following two challenging cognitive tasks, participants received negative and neutral feedback in a face-to-face evaluation situation. Receiving negative feedback decreased self-reported positive affect and dominance, slowed heart rate, and amplified fEMG activity related to frowning and eye constriction. Although self-reported emotional reactions were unrelated to grandiose narcissism, fEMG activity associated with negative affect was significantly enhanced by grandiose narcissism. In conclusion, individuals with higher levels of grandiose narcissism may not be willing to report overt emotional reactivity to self-threatening feedback, but physiological responses "beneath their thin skin" reveal amplified threat-related facial muscle activity suggestive of a negative emotional state.

Hurting the Grandiose Self: Examining Presence, Frequency, and Functions of Nonsuicidal Self-Injury in Pathological Narcissism

The present study examines whether dimensions of pathological narcissism are associated with the presence, frequency, and function of nonsuicidal self-injury (NSSI). Adults (N = 252) completed questionnaires assessing narcissistic grandiosity, narcissistic vulnerability, fluctuation between these narcissistic states, and borderline personality disorder (BPD) symptoms. Those with a history of NSSI (n = 105) also reported the method, frequency, and function of their NSSI engagement. When controlling for co-occurring BPD symptoms, there were very few associations between vulnerability, grandiosity, and narcissistic fluctuation and NSSI presence and frequency. However, a clear pattern emerged regarding NSSI functions. Although vulnerability and narcissistic fluctuation were not associated with any functions of NSSI when co-occurring BPD symptoms were controlled for, grandiosity was positively associated with all interpersonal functions of NSSI (e.g., peer bonding, revenge) and negatively associated with the intrapersonal function of affect regulation. These results suggest a unique relationship between narcissistic grandiosity and NSSI that may inform clinical intervention.

Comparing the effectiveness of attention-seeking adjustment training and commitment-based training on family executive functions and narcissistic tendencies among married women with attention-seeking in Isfahan

BACKGROUND

The widespread use of social media has turned the healthy population into needy attention-seekers, one of the symptoms of personality and psychiatric disorders. The present research aimed to compare the effectiveness of "attention-seeking adjustment training" and "commitment-based training" on family executive function and narcissistic tendencies among attention-seeking women in Isfahan.

MATERIALS AND METHODS

The current research used a pretest, posttest quasi-experimental design with experimental and control groups. The statistical population consisted of 60 married women with the attention-seeking disorder. All the participants were selected from the counseling centers of Isfahan in 2022 HS. They were selected using the convenience method. Then, they were non-randomly assigned to two groups: the experimental and control groups. An "executive function questionnaire" and a "researcher-made narcissistic personality inventory" were devised as measurement instruments of the present study. Both groups were assessed by the research measurement instruments before and after the training. Whereas the control group remained on the waiting list, the experimental groups received the training.

RESULTS

All the data were analyzed by descriptive statistics (mean and standard deviation) and multivariate covariance analysis. As has been demonstrated, training improved the dependent variables (P ≤ 0/01). However, attention-seeking adjustment was more effective than commitment-based training.

CONCLUSION

According to the results, both the attention-seeking adjustment and the commitment-based training could be applied to improve the executive functions of families, as well as the narcissistic tendencies of partners.

Case reports: Using Good Psychiatric Management (GPM) conceptualizations in the dimensional assessment and treatment of personality disorders

Good Psychiatric Management (GPM) is a generalist clinical management approach for borderline personality disorder that incorporates common ingredients of good standard care for any psychiatric diagnosis with what works from prevailing specialist psychotherapies. Similar to all validated therapies for BPD, it relies on a specified formulation of the disorder' symptoms as arising from interpersonal hypersensitivity, to dynamically describe typical patterns of daily self- and interpersonal issues that drive the instability that defines the general personality dysfunction characteristic of the disorder. Recent adaptations of GPM have been proposed for narcissistic personality disorder and obsessive-compulsive personality disorder, with development of similar dynamic models for both (intrapsychic coherence model and model of overcontrol). New dimensional models of personality disorder diagnosis have been developed to address limitations of categorical approach, but the incorporation of these models into usage in the delivery of clinical services (where categorical approach remains the most used) is limited. This paper describes an adaptation of GPM to two cases of personality disorder that illustrate the usefulness of GPM models for dynamic representation of complex daily fluctuations in internal psychic coherence and interpersonal functioning. Specialist psychotherapies will never meet the demands of public health needs to treat personality dysfunction, and incorporation of new dimensional models of diagnosis are needed for treatments that can provide a minimal standard of care for providers and patients.

Measurement Invariance of the Pathological Narcissism Inventory and Multimethod Examination of Narcissistic Presentations in Community and Clinical Samples

The Pathological Narcissism Inventory (PNI) is extensively used in recent empirical literature on pathological narcissism. However, most studies using the PNI are community-based, and no studies have used the PNI to investigate narcissistic presentations in personality disordered patients. This study investigates measurement invariance of the PNI in community participants and patients with personality disorders, and examines differences of narcissistic presentations in these samples through a multimethod approach. Results show that the PNI can be used reliably to measure and compare traits of pathological narcissism in community participants and patients with personality disorders. Personality disordered patients show higher traits reflecting vulnerable narcissism and overt manifestations of grandiose narcissism, compared with controls. Finally, network analysis indicates that traits of grandiose fantasies and entitlement rage have a central role in defining manifestations of PNI pathological narcissism, regardless of the presence of an underlying personality disorder. Research and clinical implications are discussed.

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.

The Mediating Role of Autobiographical Memory in the Relationship Between Narcissism and Rejection Sensitivity

Both grandiose and vulnerable narcissistic individuals perceive a threat to the self when they face real or imaginary rejection. The sensitivity to rejection may affect them differently. Thus, this research examines the role of grandiose and vulnerable narcissism in the retrieval of self-threatening memories. The study aims to test the mediating role of autobiographical memory (AM) in the relationship between rejection sensitivity (RS) and two dimensions of narcissism. A total of 369 university students (ages between 18 and 32) participated in the study. The Rejection Sensitivity Questionnaire was applied to the participants, triggering the memory of positive and negative autobiographical rejection. Then, the Autobiographical Memory Characteristics Questionnaire and the Pathological Narcissism Inventory were applied. The results showed that the autobiographical memory characteristics differ depending on the dimension of narcissism when they face rejection. This changes depending on having positive or negative content as well as recalling the sensory details especially emotional characteristics of the AM. The use of AM as a mediator in the relationship between narcissism and rejection sensitivity has provided a viewpoint beyond experimental and relational studies. The results have shed light on the role of narcissism and RS in the processing of autobiographical memories.

Validation of the Five-Factor Model Antagonistic Triad Measure

The personality constructs psychopathy, narcissism, and Machiavellianism, collectively described as the Dark Triad (DT), all reference socially aversive behavioral tendencies. Each construct is theorized to have features that differentiate it from others. Unfortunately, existing measures of the DT suffer from several problems. The present study compared newly developed measures of psychopathy (Super-Short Form of the Elemental Psychopathy Assessment), narcissism (Super-Short Form of the Five-Factor Narcissism Inventory), and Machiavellianism (Super-Short Form of the Five-Factor Machiavellianism Inventory [FFMI-SSF] based on the Five-Factor Model of personality)-collectively referred to as the Five-Factor Model Antagonistic Triad Measure-to existing DT inventories using a sample of undergraduate students (N = 516). As predicted, FFMI-SSF showed better divergence from measures of psychopathy and better convergence with the expert Five-Factor Model (FFM) Machiavellianism profile than did existing Machiavellianism measures. Results also demonstrated that the factors within each FFM assessment manifested differentiated correlational profiles, underscoring the utility of the multifaceted assessment of these three constructs. In addition, the use of the FFM as the basis for the new DT measures provides a pathway for the integration of DT research into the larger field of basic and clinical personality science.

Interpersonal perceptions in treatment sessions: Pathological narcissism predicts self-rater discrepancies

OBJECTIVE

Evidence suggests that pathological narcissism impacts psychotherapy process and outcome. This study investigates whether traits of pathological narcissism account for distinctiveness (construal) of patients' interpersonal perceptions in treatment settings.

METHODS

Patients enrolled in psychological/psychotherapeutic treatment (N = 150) described a segment of a session in a written format and subsequently assessed both self- and clinician's behavior on the dimensions of dominance and hostility (patient-reported ratings), along with their pathological narcissistic traits. Three independent raters also assessed interpersonal behaviors (observer-reported ratings) based on the written session descriptions. Indices of construal were defined by the residuals of self-reported (net of observer-reported) ratings and were regressed onto pathological narcissistic traits.

RESULTS

No association emerged between pathological narcissism and construal in patients' perceptions of their clinicians. However, grandiose traits of pathological narcissism were related to distinctively perceiving oneself as more dominant, while vulnerable traits were related to distinctively perceiving oneself as more hostile. The former association (but not the latter) also held after incorporating additional observer ratings to investigate the robustness of the results.

CONCLUSION

Findings are discussed in light of treatment-related self-enhancement and self-concealment processes.

Validation of the pathological narcissistic inventory (PNI) and its brief form (B-PNI) in the Arabic language

BACKGROUND

The Pathological Narcissism Inventory (PNI) is a multidimensional measure developed to assess narcissistic grandiosity and narcissistic vulnerability. We aimed to validate the Arabic version of the original Pathological Narcissistic Inventory (PNI) and its brief form (B-PNI) in a community sample of Lebanese adults.

METHODS

The English language PNI items were translated into Arabic following a rigorous translation, back-translation, and linguistic evaluation. A total of 401 participants were administered the translated PNI, as well as previously validated Arabic versions of the Big Five Inventory-2, the Rosenberg Self-esteem Scale, the Patient Health Questionnaire (PHQ-9), and the Impulsivity-8 Scale.

RESULTS

Exploratory and confirmatory analyses supported the existence of seven first-order and two second-order factors of the PNI and B-PNI. Except for exploitativeness where females scored lower than males, no other significant differences by gender were observed for the remaining PNI subscale scores. Additionally, scores on all the subscales exhibited good reliability, while the associations with external measures supported the concurrent validity of the translated instrument.

CONCLUSION

The results of this study suggest that scores on the PNI and B-PNI are highly reliable with satisfactory concurrent and factorial validity, providing an assessment of broadly defined pathological narcissism among the Lebanese young adult population. The availability of the Arabic PNI and its brief form should facilitate improved understanding of pathological narcissism in Arabic cultures and the different factors that govern narcissistic personality pathology.

Narcissistic Personality Disorder Studied the Long Way: Predicting Change in Narcissistic Pathology During College

OBJECTIVE

Otto F. Kernberg pioneered the description, understanding, and treatment of pathological narcissism. Narcissism has emerged as a clinical construct of considerable interest in clinical psychology, psychiatry, and psychoanalysis and has often been featured in the literature on personality and social psychology. Considerable discussion in recent years has focused on whether levels of narcissism seen among young adults have been increasing. Nearly all of that discussion has been focused on changes in successive cohorts in normative (normal-range) expressions of narcissism. No direct prospective longitudinal study of the same individuals has assessed for pathological narcissism during college, the period that has been the specific focus of such lively debate. This study aimed to fill that gap in the literature.

METHODS

This multiwave, longitudinal study explored pathological narcissism during college by enrolling first-year undergraduate students (N=250) from the Longitudinal Study of Personality Disorders and by using individual growth curve (IGC) analysis. Participants were assigned to either a possible personality disorder or no personality disorder group, according to results from the International Personality Disorder Examination.

RESULTS

By the third wave of assessments, 16% of the sample received a probable or definite diagnosis of at least one axis II personality disorder. IGC analysis revealed that pathological narcissism declined across the first 4 years of college. Personality predictors of this pattern of change are also discussed.

CONCLUSIONS

This study highlights the need for a fine-grained prospective study of the same participants over time to illuminate patterns of change in narcissism.

Narcissism and central serotonergic neurotransmission in depression

OBJECTIVES

Based on previous research, it has been proposed that the development of depressive disorders is related to altered functioning of the serotonergic systems as well as the personality style, including narcissism. However, it is unclear to date how personality style, especially narcissism, depressive disorders and serotonergic activity are related.

METHODS

We included 74 patients with a depressive disorder (DP) and 74 healthy controls (HC) in the study. All participants completed the Personality Style and Disorder Inventory (PSDI) and the Beck Depression Inventory (BDI II). Moreover, we conducted EEG recordings for analysis of serotonergic neurotransmission by using the so-called intensity or loudness dependence of the auditory evoked potentials (LDAEP).

RESULTS

Significantly higher LDAEP results emerged for the DP group compared to the HC group, which indicated lower serotonergic activity in the patient's group. In addition, the positive correlation between ambitious-narcissistic personality and LDAEP reached significance in depressive patients.

LIMITATIONS

There was only a monocentric cross-sectional study with only one scale having differences between the two groups due to age and education.

CONCLUSIONS

Our data supports the theory of lower serotonergic activity in patients with depressive disorders and further suggests that high narcissistic personality traits are related to lower serotonergic neurotransmission in patients.

Childhood emotional neglect and depressive and anxiety symptoms among mental health outpatients: the mediating roles of narcissistic vulnerability and shame

BACKGROUND

Theorized to stem from experiences of childhood emotional neglect, narcissistic vulnerability has been identified as contributing to expressions of psychiatric distress such as depressive and anxiety symptoms, particularly due to shame-proneness.

AIMS

To investigate narcissistic vulnerability and shame as mediators between perceived childhood emotional neglect and depressive and generalized anxiety symptoms among psychiatric outpatients.

METHODS

Adults (N = 137) attending community mental health services completed self-report measures at intake. Mediation analyses tested the indirect effect of perceived emotional neglect on depressive and generalized anxiety symptom severity through narcissistic vulnerability; shame was added to subsequent models to examine narcissistic vulnerability and shame as sequential mediators.

RESULTS

Perceived emotional neglect was significantly associated with narcissistic vulnerability, which in turn was linked with depressive and generalized anxiety symptoms as separate dependent variables. Indirect effects were significant in each model, indicating narcissistic vulnerability as a significant mediator. With the inclusion of shame, narcissistic vulnerability and shame were significant as sequential mediators.

CONCLUSION

Narcissistic vulnerability and shame may operate as mechanisms in conferring affective symptom severity from perceived childhood emotional neglect. Narcissistic vulnerability and susceptibility to shame may thus be important treatment targets when addressing psychological distress in the context of childhood adversity.

"It's not you, it's me": identity disturbance as the main contributor to interpersonal problems in pathological narcissism

BACKGROUND

Core impairments in self and other functioning typify individuals with personality disorder. While interpersonal dysfunction is a known element of narcissistic disorders, empirical research investigating intrapersonal elements is lacking. The aim of this study was to investigate the internal representations of individuals with grandiose and vulnerable features, as manifested through their attachment styles, and the specific role of identity disturbance in explaining the relationship between pathological narcissism and maladaptive interpersonal functioning.

METHODS

A sample of 270 university students completed the Brief Pathological Narcissism Inventory (B-PNI), the Severity Indices of Personality Problems (SIPP), the Relationship Questionnaire (RQ), and the Inventory of Interpersonal Problems (IIP-32).

RESULTS

Both vulnerable and grandiose narcissism were positively associated with both fearful and preoccupied attachment, and negatively associated with secure attachment, whilst grandiose narcissism was also positively associated with dismissive attachment. Furthermore, unstable representations of self, poor self-reflective functioning, and low sense of purpose fully mediated the relationship between interpersonal problems and grandiose narcissism while partially mediating the relationship between interpersonal problems and vulnerable narcissism.

CONCLUSIONS

Overall, our findings suggest that for individuals presenting with narcissistic features, capacity for adaptive interpersonal functioning is grounded by deficits in identity integration. Implications of these findings are discussed.

Structural brain alterations in young adult males with narcissistic personality disorder: a diffusion tensor imaging study

PURPOSES

1. To find a difference in white matter (WM) between young adult males with narcissistic personality disorder (NPD) and healthy controls (HCs). 2. To find some correlations between white matter in the abnormal regions of NPD group and the pathological narcissism inventory (PNI).

MATERIALS AND METHODS

Eighteen male participants with NPD (age M = 18.39, SD = 0.164; education M = 12.33, SD = 0.14) were included in our experiment. NPD participants met the DSM-IV criteria for NPD and without other personality disorders evaluated by trained clinical psychiatrists using the Structured Clinical Interview of DSM-IV for Personality Disorders (SCID-II). Moreover, healthy controls were also confirmed to be free of any axis I or II disorders and matched with education level, age and handedness (age M = 18.83 years, SD = 0.246; education M = 12.56, SD = 0.202; all participants were right handed). Those who have had major life events in the last six months, mental and physical illnesses, claustrophobia and oral implants have been excluded. We used tract-based spatial statistics (TBSS) on diffusion tensor images (DTI) and analysis of Pearson correlation between abnormal brain regions of white matter fibers and the pathological narcissism inventory.

RESULTS

There was no significant difference in age and education level between NPD and HCs (p > 0.05). There were significant differences in PNI score and its subscales between NPD group and HCs (p < 0.01). Fractional anisotropy (FA) values were found decreased mainly in the right superior longitudinal fasciculus and the bilateral posterior thalamic radiation (include optic radiation). Lower axial diffusivity (AD) values were identified mostly in the left retrolenticular part of internal capsule and the left posterior thalamic radiation (include optic radiation). There existed a significant correlation between DTI data and pathological narcissism inventory.

CONCLUSIONS

The decreased brain white matter microstructures among three clusters were found in the association, projection/thalamic and connection pathways of white matter in young adult males with NPD. The abnormal white matter brain regions may be one of the neuropathological basis of the pathogenesis of young males with NPD, and it may be related to white matter development in early adulthood.

Do highly sensitive persons display hypersensitive narcissism? Similarities and differences in the nomological networks of sensory processing sensitivity and vulnerable narcissism

BACKGROUND

Individuals with high sensory processing sensitivity (SPS) ("highly sensitive persons") are thought to be easily excitable and overwhelmed, highly attentive to aesthetic impressions, and particularly sensitive to sensory stimulation. Public discourse suggests that those who describe themselves as highly sensitive see themselves as fundamentally different from others, and view their personality as a gift and a burden. From a clinical personality perspective, high sensitivity could be considered to have substantial overlaps with hypersensitive narcissism, or generally vulnerable narcissism.

METHOD

We investigated the associations and shared nomological networks between high sensitivity and hypersensitive narcissism in two studies using convenience and representative samples (n₁  = 280, n₂  = 310).

RESULTS

There is evidence for replicable associations between SPS and hypersensitive (.53 ≤ r ≤ .54) as well as vulnerable narcissism (.44 ≤ r ≤ .54), associations were not attributable to general neuroticism. Nomological networks were similar and pointed to a neurotic-introverted personality profile with reduced personality functioning. Latent class analyses further pointed to substantial and practically relevant person-level covariance.

CONCLUSION

Sensory processing sensitivity and hypersensitive narcissism are substantially related constructs. For clinicians, this points to the importance of being attentive to narcissistic self-regulatory strategies in individuals presenting as highly sensitive.

Proximal Processes, Temperament, and Pathological Narcissism: An Empirical Exploration from the Longitudinal Study of Personality Disorders

INTRODUCTION

It is argued that all personality pathology represents the final emergent product of a complex interaction of underlying neurobehavioral systems, which are reflected in personality factors, in conjunction with environmental inputs. Neurobehavioral systems manifest themselves in dispositional temperament and personality processes. Environmental inputs include, obviously, interpersonal relationships (e.g., parenting, social, and mentoring relations) as well as other factors such as abuse, neglect, and/or environmental insults (e.g., economic hardship, deprivation). Narcissistic personality disorder (NPD) is hypothesized to reflect both dispositional and environmental inputs to its pathogenesis. Temperament and personality-based theorizing regarding NPD proposes high dispositional levels of anger and related temperament features that could shape early development and subsequent NPD. Many classic theorists (e.g., Freud, Kernberg, Kohut, Miller) have also proposed that profound parenting failures are implicated in the emergence of NPD, each suggesting some failure in proper engagement and responsivity with the developing child. Such a failure in parenting can be thought of as reflecting diminished proximal process engagement with the developing child.

METHOD

Using data from the Longitudinal Study of Personality Disorders, the present study examines both proximal process and temperament factors in relation to clinically significant NPD features from a prospective perspective.

RESULTS

Results suggest that both proximal process and temperament (notably anger) factors independently predict the level of NPD features over time.

CONCLUSION

Both interpersonal relationships and temperament should be considered in models of etiology of NPD, it is not just one or the other.

An Appraisal of Narcissistic Rage Through Path Modeling

Pathological narcissism and borderline traits have been consistently associated with interpersonal aggression. Shame has been identified as an important trigger of aggressive behaviors in individuals with pathological personality traits, especially for narcissistic vulnerability and borderline traits. This is in line with Kohut's theory on narcissistic rage, that is, aggression, anger, and destruction that act as a protection for a grandiose self. The present study aims to investigate the interrelations between pathological narcissism, borderline traits, shame, and trait aggression, concepts that are parts of the narcissistic rage phenomenon introduced by Kohut, using path models. A total of 399 participants completed self-report questionnaires assessing personality traits (narcissistic grandiosity and vulnerability, and borderline traits), shame, and aggression. Three path models including these variables were tested and compared to one another on fit indices. Results show that shame acts as a mediator between pathological traits (narcissistic vulnerability and borderline traits) and trait aggression, whereas the relationship between narcissistic grandiosity and aggression was direct (i.e., shame was not involved). Results expand the narcissistic rage theory by suggesting that it might represent an internalizing type of aggression that manifests in the context of narcissistic vulnerability and borderline traits, which is not the case for narcissistic grandiosity that exerts a direct effect on trait aggression.

Narcissism on interpersonal circumplex model: Reactions to imaginary abandonment and rejection

AIM

Narcissism is a direct result of the lack of self-expression. Thus, this trait is enshrined in cycles of strategies to protect self-worth in interpersonal relationships. The aim of the present study was to understand in what way narcissistic individuals understand their interactions with themselves and others.

METHOD

The study included two groups comprising high grandiose narcissism (GN, n = 43) and high vulnerable narcissism (VN, n = 44). The participants who received scores that were one standard deviation (SD) above the mean, either on the PNI-grandiosity or on the PNI-vulnerable dimensions, constituted the GN and VN groups among 518 students (Age: M = 23.57, Sd = 2.13).

RESULTS

The chi-square test was performed to evaluate the dimensions of narcissism with respect to responses of the participants and their partners (behavioral, cognitive, and emotional). The Pathological Narcissism Inventory (PNI) was administered to evaluate narcissistic characteristics. The "Criticism Story" of the Story Completion Inventory in Romantic Relationships (SCIRR) was used for criticism. The circular pattern between the responses of the participants and their partners was examined using the Interpersonal Schemas Scale (ISS). The results revealed that the vulnerable group gave more complementary responses emotionally and made more complementary predictions in terms of the expected reactions from the romantic partner than the grandiose group.

DISCUSSION

The results were discussed in reference to the basic self-esteem-protecting motivations of the groups.

Female Narcissism: Assessment, Aetiology, and Behavioural Manifestations

Despite putative gender differences in the expression of narcissism, prominent theories have virtually dismissed the role of females in the development and manifestation of narcissism. The contention that narcissism is a pathology of the self that may partly differ in males and females is further evident in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 reports that up to 75% of those diagnosed with Narcissistic Personality Disorder (NPD) are men. Such figures suggest that the representation of narcissism as codified in the DSM-5 may only be marginally applicable to females, given its prominent focus and nature on capturing grandiose themes which closely resemble commonly masculine norms. The overemphasis on grandiose features extends to the empirical literature which defines narcissism as a normative personality trait and is widely assessed using the Narcissistic Personality Inventory (NPI), on which males obtain significantly higher scores than females. As this review will demonstrate, one limitation frequently occurring in the literature is the attempt to comprehend narcissistic manifestations in females through the lens of what has commonly been defined as narcissism (DSM/NPI). In this review, the literature concerning the diagnostic assessment and conceptualisation of narcissistic personality disorder, aetiological factors, aggression, and partner violence perpetration will be discussed in relation to the importance of gender. This is followed by a review of existing gaps in theory and research, and suggestions for fruitful directions that can aid a richer and more meaningful literature on narcissism inclusive of gender issues.

When Do Narcissists Burn Out? The Bright and Dark Side of Narcissism in Surgeons

This study addresses narcissism as an important psychological factor for the prediction of burnout. Previous research has produced inconsistent findings on whether narcissism is beneficial or detrimental to the development of burnout which is due to the fact that narcissism is viewed as an overall construct rather than on a dimensional level. This study applied a two-dimensional approach to narcissism in burnout. Three hundred-fifty-two surgeons from Germany were asked to complete the Maslach Burnout Inventory and the Narcissistic Admiration and Rivalry Questionnaire. Linear regression analyses revealed that high scores in admiration predicted high personal fulfillment, low emotional exhaustion, and depersonalization. For rivalry, the opposite picture emerged. The results indicate that admiration seems to have a protecting effect, whereas rivalry appears to promote burnout severity.

The concept of Narcissistic Personality Disorder-Three levels of analysis for interdisciplinary integration

In this paper, I distinguish three different levels for describing, and three corresponding ways for understanding, deficient empathy as the core of NPD (Narcissistic Personality Disorder). On the macro level, deficient empathy can be explained as disturbed interpersonal functioning, and is understood as lack of recognition. On the meso-level, deficient empathy can be described as psychic disintegration, and can be understood specifically in its dissocial aspects. Psychic disintegration in NPD correlates with somatic changes, i.e., dysfunctional affective empathy and mind-reading on the micro level of description, which is the third level. The "core-deficit-model of NPD" that I outline, while not rejecting reductionist approaches outright, argues in favor of integrating (top-down/bottom-up) functionalist descriptions of empathy into a wider conceptual framework of bio-psycho-social functioning. The "core-deficit-model of NPD" is interdisciplinary, can bypass monodisciplinary skepticism, and removes purported barriers between explaining and understanding the "lack" of empathy as the core of pathological narcissism.

Grandiosity, vulnerability, and narcissistic fluctuation: Examining reliability, measurement invariance, and construct validity of four brief narcissism measures

Continued interest in the distinction between grandiose narcissism, vulnerable narcissism and the fluctuation between grandiose and vulnerable states has expanded the repertoire of self-report instruments. The present study examined the psychometric properties of four brief narcissism measures [the Narcissistic Personality Inventory-13 (NPI-13), Hypersensitive Narcissism Scale (HSNS), Super-Brief Pathological Narcissism Inventory (SB-PNI), and the g-FLUX] in a Finnish sample of university students. Confirmatory factor analyses supported the reliability of the NPI-13, g-FLUX, SB-PNI Vulnerability, and two HSNS subfactors (Oversensitivity and Egocentrism). Tests of measurement invariance indicated the NPI-13, SB-PNI Vulnerability, HSNS Oversensitivity, and the g-FLUX perform similarly between males and females and are generally similar between individuals in younger and older age groups. Construct and predictive validity were evaluated by examining relations between narcissism measures and relevant criteria including psychopathology symptoms, self-esteem, well-being, five factor traits, and empathy. Results supported the construct validity of all four measures, while correlational profiles highlighted the convergence between the g-FLUX and measures of both grandiosity and vulnerability. The NPI-13 was most predictive of NPD symptoms, whereas vulnerable narcissism measures were most predictive of psychopathology. Results further establish the psychometric properties of the NPI-13, SB-PNI Vulnerability, HSNS Oversensitivity, Egocentrism, and provide new validation of the g-FLUX.