Pathological Narcissism and Narcissistic Personality Disorder

Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania 16802, USA.
Annual Review of Clinical Psychology (Impact Factor: 12.67). 12/2009; 6(1):421-46. DOI: 10.1146/annurev.clinpsy.121208.131215
Source: PubMed


We review the literature on pathological narcissism and narcissistic personality disorder (NPD) and describe a significant criterion problem related to four inconsistencies in phenotypic descriptions and taxonomic models across clinical theory, research, and practice; psychiatric diagnosis; and social/personality psychology. This impedes scientific synthesis, weakens narcissism's nomological net, and contributes to a discrepancy between low prevalence rates of NPD and higher rates of practitioner-diagnosed pathological narcissism, along with an enormous clinical literature on narcissistic disturbances. Criterion issues must be resolved, including clarification of the nature of normal and pathological narcissism, incorporation of the two broad phenotypic themes of narcissistic grandiosity and narcissistic vulnerability into revised diagnostic criteria and assessment instruments, elimination of references to overt and covert narcissism that reify these modes of expression as distinct narcissistic types, and determination of the appropriate structure for pathological narcissism. Implications for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and the science of personality disorders are presented.

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Available from: Aaron Pincus, Sep 30, 2015
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    • "The reality is that narcissism lacks a definition shared across the various interested researchers in disciplines ranging from psychiatry to social/personality psychology (Cain et al., 2008; Miller & Campbell, 2008; Pincus & Lukowitsky, 2010). Nothing better reflects this state of affairs than the diversity of instruments available to measure narcissism, of which there has been a proliferation in the past decade or so (see, e.g., Samuel & Widiger, 2008; Watson & Bagby, 2011, for reviews; but also more recent additions from Back et al., 2013; Gebauer et al., 2012; Glover, Miller, Lynam, Crego, & Widiger, 2012). "
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    ABSTRACT: Narcissism continues to suffer from a lack of consensual definition. Variability in the definition is reflected in the growing multitude of measures with oftentimes diverging nomological nets. Although the themes of narcissistic grandiosity and vulnerability appear to have achieved reasonable agreement on their central importance, the lower order structure of each is not well understood and debates remain about how (and whether) they can be integrated into a coherent whole. However, it is clear that a narrow focus on higher order grandiosity without consideration of concomitant vulnerability neglects clinically important features of narcissism. Occasioned by the potential for a new personality disorder model in the Diagnostic and Statistical Manual of Mental Disorders-Fifth edition, several colleagues and I demonstrated that pathological narcissism, as measured by the Pathological Narcissism Inventory, could not be adequately summarized by the lower order traits of Grandiosity and Attention Seeking, and argued that this should be reflected in the diagnostic manual in some form. Miller, Lynam, and Campbell then subjected these same data to critical reanalysis and interpretation. I respond here to several points raised by Miller and colleagues. In so doing, I highlight areas of agreement, disagreement, and suggest directions for future research. © The Author(s) 2015.
    Assessment 08/2015; DOI:10.1177/1073191115599054 · 3.29 Impact Factor
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    • "Narcissism is also linked to a lack of empathy, sense of entitlement, and envy. More recent conceptualizations of narcissism emphasize the need to delineate between grandiose and vulnerable dimensions of narcissism (e.g., Miller & Campbell, 2008; Pincus & Lukowitsky, 2010), as these dimensions manifest divergent nomological networks (Miller et al., 2011). Grandiose narcissism is linked to extraversion, dominance , self-assurance, exhibitionism, and aggression; vulnerable narcissism is distinguished by introversion, defensiveness, anxiety, interpersonal coldness and hostility, as well as vulnerability to stress (Wink, 1991). "
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    ABSTRACT: The present study examined the characteristics of individuals (N = 104 undergraduate couples) who date grandiosely or vulnerably narcissistic individuals, including the experience of developmental trauma, general and pathological personality traits, and psychopathology, using multiple data sources. In addition, relationship duration was tested as a moderator of the relations between the narcissism dimensions and relationship adjustment. Actor–Partner Interdependence Models indicated that negative relationship adjustment was found when both partners had higher entitlement/exploitativeness traits and had been together for a longer period of time. Overall, there were no clear patterns of partner characteristics, although some evidence for homophily emerged for traits related to grandiose narcissism.
    Personality and Individual Differences 06/2015; 79. DOI:10.1016/j.paid.2015.01.029 · 1.86 Impact Factor
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    • "In the DSM classification , however, NPD criteria have become increasingly narrow in their focus on narcissistic grandiosity. " This leads to the lowest prevalence rate among DSM Axis II personality disorders, limited psychotherapy research, and a significant disconnect with the much more common use of pathological narcissism as a diagnosis in clinical practice " (Pincus & Lukowitsky, 2010; P. 8.17). "
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    ABSTRACT: Objective: For decades, both theory and research have focused on the role of self-esteem and shame in constructing narcissistic traits. However, studies on the exact relationship between these two and overt and covert facets of narcissism have been equivocal. Methods: The current study is correlational. It examined these relationships among 308 Iranian college students (155 males, 153 females, mean age=23.49 years, SD=2.83). The target population was all students of national universities of Tehran, Iran. The sampling method was non-random multi-step clustering. Participants were asked to fill four self-report measures: Narcissistic Personality Inventory (NPD), Rosenberg Self-esteem Scale (RSES), Test of Selfconscious Affect (TOSCA-3), and Hypersensitive Narcissism Scale (HSNS). The data were analyzed by SPSS 19.0.0 software, using Pearson’s Correlation, T-test and Multiple Regression Analysis methods. Results: Surprisingly, there was no significant difference between men and women with respect to NPI scores. Findings also revealed that shame was negatively related to overt narcissism (r=-0.22, P<0.05) and positively related to covert narcissism (r=0.23, P<0.05). Self-esteem was found to be positively correlated with overt narcissism (r=0.42, P<0.01) and negatively correlated with covert narcissism (r=-0.30, P<0.01). Conclusion: The results provide support for the models of overt narcissism in which the narcissistic self serves as a buffer against inner feelings of inferiority. It also supports the importance of shame and low self-esteem in shaping the covert narcissistic traits. However, shame could not differentiate between overt and covert narcissism. The empirical, cultural, and clinical implications of the findings are discussed.
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