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THE RELATIONSHIP BETWEEN PARENTAL NARCISSISM AND CHILDREN'S MENTAL VULNERABILITY:
THE MEDIATION ROLE OF THE REARING STYLE
Francesco Dentale, Valeria Verrastro, Irene Petruccelli, Pierluigi Diotaiuti, Filippo Petruccelli, Luigi Cappelli, Pietro
San Martini
The hypothesis that parental narcissism is related to depression and anxiety of the young adult children and that this
relationship is mediated by the parental rearing style as reported by the offspring was investigated. Subjects were 409
young adults (264 females), aged 22.85 (SD = 2.00) and their parents. Parental narcissism was measured with the
Narcissistic Personality Inventory (NPI); the rearing style, as remembered by the offspring, was measured with the
Parental Bonding Instrument (PBI) that includes Parkers’s scales of care and overprotection and Gilbert’s scales of put-
down/shaming andfavouritism; depression and anxiety were assessed with the Beck Depression Inventory (BDI) and
the State-Trait Anxiety Inventory (STAI) respectively. Two total mediation models (one for fathers and one for
mothers), including parental NPI as a predictor, PBI scales as mediators and children’s scores on BDI and STAI as
criteria, showed adequate goodness of fit indices. The sums of indirect effects of both paternal and maternal narcissism
on children’s depression and anxiety, via all rearing style dimensions, were significant. These results suggest that
parental narcissism is related to children’s depression and anxiety and that this relationships is mediated by the re aring
style as recalled by the offspring.
Parental narcissism; Rearing style; Children’s depression and anxiety;
1. Introduction
The assessment of the parenting skills in custody domain frequently includes a parental psychopathological evaluation
(Ackerman & Ackerman, 1996; Bagby, Nicholson, Buis, Radovanic, & Fidler, 1999; Lempel, 1999), based on the
assumption that pathological personality traits of the parents may influence the quality of their rearing behaviors and as
a consequence of the children’s mental health. As evidence of this theoretical mediation model connecting parental
pathological traits (PPT) with their children’s mental health via the quality of rearing behaviours, many studies (see
Laulik, Chou, Browne & Allamb, 2013 for a systematic review) showed that PPT are correlated with the quality of
parent–child interactions and rearing practices such as inconsistent parental discipline, low parental affection, assistance
and encouragement, insensitive or intrusive interactions with the children, harsh or disoriented parental behavior. In
particular, of eleven studies selected and examined by the authors, nine confirmed the positive correlation between
parental Personality Disorders (PD) traits and impaired rearing behaviors even when the effects where controlled for
relevant confounding factors. Moreover, importantly, several studies showed that PD traits in the parents were found to
be related to specific psychiatric conditions in the children (see Dutton, Denny-Keys & Sells, 2011 for a review). For
instance Calvo, Lazaro, Castro, Morer, & Toro (2007) showed that in parents of children with Obsessive Compulsive
Disorder there were higher scores on PD traits if compared with control parents, and similarly Nordahl, Ingul, Nordvik
& Wells (2007) found a significant relationship between PD traits in the mothers (i.e. interpersonal difficulties with a
self-centered style) and Generalized Anxiety Disorder and Oppositional Defiant Disorder prevalence in the children.
Referring to specific PDs, Laulik et al. (2013) found that parental cluster B disorders and in particular Borderline
Personality traits exerted a negative effect on parenting in eight of the studies examined. Surprisingly, in spite of the
clinical and legal interest toward the effect of parental narcissism on rearing behaviours and children’s mental health
(e.g. Rappoport, 2005; Brown, 2008), only few empirical studies were conducted to investigate these hypotheses
systematically.
1.1 Characteristics of the normal and pathological narcissism: lack of empathy and need to control the others
The scientific concept of narcissism has been variously defined by different relevant authors in a psychodynamic
theoretical framework (Freud, 1914; Kohut, 1971; Kernberg, 1975). They have clarified the main characteristics of
narcissistic personality as well as its relations to normal and abnormal personality development.
According to Freud, some individuals develop an ego characterized as a sexual loaded object, acquiring in this
manner a narcissistic personality with a natural tendency to be dominant and to influence the others. Successively, in
order to improve their theoretical models for the treatment of borderline personality disorders, Kernberg and Kohut
proposed, as main characteristics of narcissism, not only sense of superiority, grandiosity, self-absorption,
exhibitionism, arrogance and feelings of entitlement but also fragile self-esteem and emotional instability. Importantly,
on a theoretical point of view narcissistic personality characteristics are generally considered as relatively stable over
time (e.g. Kernberg, 1975) and, recently, some longitudinal studies (Samuel et al. 2011; Vater et al. 2014) found
moderate to high levels of test-retest correlations across a temporal interval of two years, confirming the stability
hypothesized.
More recently, a large discussion has developed in the literature (see Pincus & Lukowitsky, 2010 for a review)
aimed at clarifying the nature of normal and pathological narcissism. The former has been generally characterized by a
series of defensive strategies, that permit to enhance one’s self-image and self-esteem. As such strategies are largely
used by healthy individuals, it did not seem appropriate to consider them as abnormal aspects of personality. Differently,
pathological narcissism has been viewed as composed of two complementary aspects, grandiosity - as reflected for
instance in exaggerated self-esteem and exhibitionism -, and vulnerability, characterized by fragile self-esteem and
emotional instability. Interestingly, Miller & Campbell (2008) showed that personality profiles of normal and
pathological narcissistic individuals, although differing in extraversion and neuroticism (i.e. high extraversion and low
neuroticism in the formers vs. low extraversion and high neuroticism in the latters), shared an antagonistic interpersonal
style that included (1) a strong need for power and control of the others and (2) a certain lack of empathy toward other
people.
1.2 Parental narcissism, pathogenic rearing behaviors and affectionless control
Regarding parental narcissistic traits, several clinicians, on the basis of their clinical experience (Fraiberg, 1980; Espasa,
2004), have suggested that narcissistic parents are likely to present a tendency to deny the needs of their children and to
use them as “props” for their own self-esteem, thus assigning them a complementary role. For instance, Espasa (2004)
argued that insufficiently elaborated narcissistic needs may be recalled and renewed when individuals become parents,
bringing their children to adapt themselves to this projective parental scenario. If these projective identifications are
severe and inflexible, parents may become unable to empathize with the real needs of their children, and this may result
in distressing familiar conditions that prepare the ground for the development of different forms of psychopathology in
the offspring. For instance, recently Rappoport (2005), in order to illustrate the accommodation strategies of narcissistic
parents’ children, introduces the term “co-narcissism”. The author focused on narcissistic parents with a very low self-
esteem, interpersonally rigid, easily offended, self-absorbed, blaming, not empathic with others and who attempt to
control others’ views of them for defensive purposes. Co-narcissistic children, attempting to preserve their relationship
with parents, tend to please them, defer their points of view and would be often depressed or anxious as they may easily
considered selfish if they act assertively. Interestingly as reported by Horne (1998), parental narcissism was found to be
negatively correlated with self-esteem of the offspring, suggesting that, as hypothesized by Rappoport, children of
narcissistic parents tend to please the parents’ needs in order to avoid relational conflicts and preserve the attachment
relationship.
Parental narcissism may be seen therefore as a factor that may undermine the quality of the rearing style. More
specifically, the rearing style of narcissistic people seems to be in line with the dysfunctional pattern of affectionless
control (e.g. Parker, 1979), characterized by excessive control (overprotection) and lack of empathy (low care).
1.3 Affectionless control as a pathogenic rearing style
In the attachment theory framework (e.g., Bowlby, 1977), it is generally argued that parents, not able to be a secure base
for their children, induce the development of an insecure attachment, making them more prone to psychopathology. In
order to investigate the relationship between parental rearing style and psychopathological vulnerability of the children,
several instruments have been developed based on the memories of the offspring, such as the Children’s Reports of
Parental Behavior Inventory (CRPBI; Schaefer, 1965), the Egna Minnen Betraeffande Unde Uppfostran (“My growth
memories”; EMBU, Perris, Jacobson, Lindstrom, Van Knorring, & Perris, 1980), and the Parental Bonding Instrument
(PBI; Parker, Tupling, & Brown, 1979; Parker, 1989; Cappelli & San Martini, 2004, for the Italian version). Importantly
some reviews (e.g. Brewin, Andrews, & Gotlib, 1993) showed that the scales based on retrospective reports of parental
behavior generally revealed an adequate level of reliability and validity. Moreover, the use of these questionnaires
appear to be more simple in respect to other methods (e.g. interview) that implies a training for the judges and/or the
assessment of their agreement.
According to Parker, the rearing pattern of affectionless control, defined in terms of low care and overprotection, is a
factor of psychopathological risk for the offspring. In order to measure this style, he devised the Parental Bonding
Instrument (Parker, Tupling & Brown, 1979; Parker, 1979), that evaluates the parental rearing style as recalled by the
children. This instrument has been widely used in studies that have generally confirmed Parker’s claim of a
psychopathological potential of affectionless control, particularly with reference to the risk of depression and anxiety in
the children (e.g. Safford, Alloy & Pieracci, 2007; Gladstone & Parker, 2005). More recently Gilbert, Allan & Goss
(1996) broadened the pattern of affectionless control, including in the assessment of the parental style the tendency to
debase and humiliate the child (putdown-shaming) and the tendency to favour brothers or sisters to the detriment of the
subject (favouritism). The former tendency may be ascribed to an antagonistic interpersonal style that, as already
mentioned, typically characterizes both normal and pathological narcissism. The cognitive salience of antagonistic
scenarios may explain also the tendency to favour the one or the other of the children, bringing the parents to transfer
their narcissistic/competitive interpersonal scripts onto the children and to ignore their natural need for approval.
1.4 Aim of the study
This study explores the relations between parental narcissism, affectionless control style (as retrospectively reported
by the offspring) and the psychological vulnerability of the young adult children. Specifically, our expectations are that,
in a non clinical sample, parental narcissism is related to children’s depression and anxiety, and that this relations are
mediated by the rearing style retrospectively reported by the offspring (Parker, Tupling & Brown, 1979; Parker, 1979;
Gilbert, Allan & Goss, 1996)
2. Method
2.1 Measures
Narcissistic Personality Inventory (NPI; Raskin & Terry, 1988; Montebarocci, 2002, for the Italian version). The NPI is
generally conceived as a measure of normal (Pincus & Lukowitsky, 2010; Miller & Campbell, 2008), but for some
aspects also of pathological narcissism (Ackerman, Witt, Donnellan, Trzesniewski, Robins & Kashy, 2011). It is
composed of 40 items consisting of two opposite statments (e.g. “I think I am a special person” vs. “I am no better or
worse than most people”). Participants are forced to choose the alternative that best matches with him/her. The Italian
version showed a Cronbach's alpha of .83 . In accordance with the studies mentioned above on the temporal coherence
of narcissistic personality characteristics (Samuel et al. 2011; Vater et al. 2014), NPI scores showed a high level of test-
retest correlation over time (Del Rosario & White, 2005), suggesting that also parents involved in the present research
may show a similar stability, especially in adult age.
State–Trait Anxiety Inventory (STAI, Y form; Spielberger, Gorsuch, Lushene, Vagg & Jacobs, 1983; Pedrabissi &
Santinello, 1989, for the Italian version). Anxiety was assessed with the trait scale of the STAI-Y form, an inventory
containing 20 items that assess symptoms of anxiety on a 4-point Likert scale (1 _ almost never, 4 _ almost always).
The Italian version presented alphas > .85 in both adult and adolescent samples, .
Beck Depression Inventory (BDI; Beck, Rush, Shaw & Emery 1979; Scilligo, 1983, for the Italian version). The BDI
was used to assess the presence and severity of depressive symptoms over the last two weeks. It is a 21-item inventory
with four response options. The Italian version presented an alpha = .89 .
Parental Bonding Instrument, enlarged version (PBI; Parker, Tupling & Brown, 1979; Parker, 1979; Gilbert, Allan and
Goss, 1996; Cappelli & San Martini, 2004, for the Italian version). The parental rearing style was measured by an
enlarged version of the PBI, containing, the original scales of care and overprotection, and also Gilbert’s scales (Gilbert
et al., 1996) of putdown/shaming and favouritism. For each item the respondent was requested, with a 5 point-likert
scale, to assess the parental behaviour dunring the his/her first sixteen years of life. Two forms are available for each
scale, one for fathers and the other for mothers. All these scales, in the italian version, showed good internal
consistencies, with alphas ranging from .87 to .93 .
2.2. Respondents and procedure
Six hundred young adults were administered with the paternal and maternal forms of the PBI, along with the BDI and
the STAI. They were also invited to ask their parents to fill in the NPI if they agreed to do so. Both biological parents of
409 respondents (264 females and 145 males; aged 22.85, SD = 2.00) agreed to participate. Only one adult child for
each family was involved as participant. The mean age of mothers was 50.37 (SD = 5.14) and that of fathers was 54.10
(SD = 5.56). Mothers were prevalently housewives (28.6%), workers (13.9%), clerks (9.3%) and teachers (5.4%) while
fathers were prevalently workers (21.3%), clerks (14.2%), retired persons (8.1%) and entrepreneurs (4.6%).
2.3. Statistical analyses
To test the mediating model hypothesized, two path analyses (one for the fathers and one for the mothers) were
conducted, with parental narcissism as a predictor, PBI scales as mediators, and depression and anxiety as criteria, using
M-plus statistical package (Muthén & Muthén, 2007). A preliminary evaluation of partial mediation models did not
show any significant improvement in terms of fit indices with respect to the total mediation model. Moreover, the direct
effects estimated between parental narcissism and children’s vulnerability criteria (i.e. depression and anxiety scores)
were not significant. As a consequence these models were discarded following the scientific criterion of parsimony and
only total mediation models were considered (fig.1a and 1b). For the path coefficients a maximum likelihood estimation
method was used and 95% bias-corrected confidence intervals were calculated for all effects with a bootstrap procedure
(Preacher & Hayes, 2008).
INSERT FIGURE 1a and 1b ABOUT HERE
3. Results and discussion
3.1 Correlations between parental narcissism, PBI scales and children depression and anxiety
Kurtosis and asymmetry parameters showed values close to zero and thus compatible with an approximately normal
distribution.
As expected both paternal and maternal narcissism were negatively correlated with care and positively with all other
parental rearing scales (as evaluated by the children), with correlations ranging from small to medium in terms of
Cohen’s standards (See table 1). Moreover, they showed small but significant positive correlations with the scores of
depression and anxiety of the children. PBI scales were all highly inter-correlated, and as expected, moderately
correlated with depression and anxiety of the children in the expected direction.
Overall, this pattern of correlations appears to be consistent with the mediation model hypothesized (fig. 1a and 1b).
INSERT TABLE 1 ABOUT HERE
3.2 The indirect effect of paternal narcissism on children’s depression and anxiety: the mediation role of the paternal
rearing style
As illustrated in fig.1a, a total mediation model including paternal narcissism as predictor, paternal PBI scales as
mediators and children’s depression and anxiety as criteria was tested. As stated before, partial mediation models were
preliminarily evaluated and discarded, as no improvements in terms of fit indices was found with respect to the total
mediation model and no significant direct effects emerged between paternal narcissism and children’s depression and
anxiety.
The model showed an excellent fit, with a non-significant chi-square [χ2 (2 df) = .97, p = .61] and adequate levels for
other relevant fit indices (CFI = 1; TLI = 1.012; RMSEA = .00, CI = .00–.08; SRMR = .01), suggesting that the rearing
style fully mediated the effect of paternal narcissism on the scores of depression and anxiety. Overall, the model
accounted for 16% of depression and for 17% of anxiety variance. All individual direct effects (see fig.1a), between
paternal narcissism and PBI as well as between PBI and depression and anxiety, were significant (or close to
significant) and in the expected direction, except for put-down/shaming that did not show direct effects on depression
and anxiety.
The total indirect effect of paternal narcissism (via all PBI scales) was significant both on depression (standardized sum
of indirect effects = .13, p < .001; CI = .06 -.20) and on anxiety (standardized sum of indirect effects = .13, p < .001; CI
= .06 -.20). With the exception of the indirect effect via put-down/shaming that did not contribute uniquely to the
mediation model, individual indirect effects of paternal narcissism were all significant (or close to significant) for both
children’s depression and anxiety, with standardized values ranging from .02 to .07
3.3 The indirect effect of maternal narcissism on children’s depression and anxiety: the mediation role of maternal
rearing style
A similar total mediation model was tested for the maternal scales (see fig. 1b) as, also in this case, a preliminary
analysis of partial mediation models did not show any improvement in terms of fit indices and no significant direct
effects emerged between paternal narcissism and children’s depression and anxiety.
Again the total mediation model revealed an excellent fit, with a non-significant chi-square [χ2 (2 df) = .40, p = .82] and
adequate levels of the other relevant fit indices (CFI = 1; TLI = 1.019; RMSEA = .00, CI = .00–.06; SRMR = .01).
Overall the model accounted for 21% of depression and for 17% of anxiety variance. All individual direct effects (see
fig.1b), between maternal narcissism and PBI as well as between PBI and depression and anxiety, were significant (or
close to significant) and in the expected direction, except for care that did not show any direct effects on both
depression and anxiety. The total indirect effect of maternal narcissism (via rearing scales) was significant both on
depression (standardized sum of indirect effects = .14, p < .001; CI = .07 -.22) and on anxiety (standardized sum of
indirect effects = .13, p < .001; CI = .06 -.21). Individual indirect effects of maternal narcissism were all significant (or
close to significant) for both depression and anxiety, ranging from .03 to .05 (standardized values), except for the
indirect effect via the care scale that did not offer any unique indirect contribution to the model.
Conclusions
As illustrated in the results section, total mediation models, including parental narcissism as predictor, PBI scales as
mediators and children’s depression and anxiety as criteria, showed a good fit both for fathers and for mothers, while
partial mediation models were discarded based on preliminary analyses that did not show any improvement in the fit
indices for them and any significant direct effect between parental narcissism and children vulnerability criteria (i.e.
depression and anxiety). Both paternal and maternal narcissism are significantly correlated with parental rearing
dimensions as well as with depression and anxiety of the young adult children in the expected direction. At the same
time, PBI scales and children’s depression and anxiety were significantly correlated with the expected pattern.
Importantly, paternal and maternal path analyses showed that the effect of parental narcissism was mediated by the
parental rearing style with significant sum a indirect effects both on depression and anxiety. These results are
compatible with a generally assumed mediation model, mentioned in the introduction (see Laulik, Chou, Browne &
Allamb, 2013 for a review), that posits parental pathological traits, quality of parenting behaviours and children’s
mental health indices as predictors, mediators and criteria respectively.
A relevant limitation of the present study is the use of retrospective measures of the parental rearing style as reported by
the young adult children. More specifically, an important review of the literature (Brewin, Andrews & Gotlib, 1993)
reported that the assessment of parental behaviour with retrospective reports has been questioned for some different
reasons, such as the low reliability and validity of autobiographical memories, the presence of memory impairment
associated with psychopathology, and the presence of specific mood-congruent memory biases associated with
psychopathology. However, based on a critical discussion of these limitations, Brewin et al. (1993) concluded that
retrospective measures of parental rearing are more reliable compared to what is generally thought and suggested to
reconsider their utility and validity, even though (they added) other studies should be carried out to further examine and
overcome them.
Another important limitation is that the study assumes that individual differences on parental narcissism are relatively
invariant over time. In particular, individual differences of parental narcissism when the child was a young adult are
assumed to be similar to those present earlier when the child was younger than sixteen. As we mentioned in the
introduction (Samuel et al. 2011; Vater et al. 2014), many authors have hypothesized, and shown empirically, that
narcissistic personality characteristics are substantially consistent over time. Furthermore, test-retest correlation of NPI
scores has been shown to be high across an interval of two years (Del Rosario & White, 2005) in the adult life. These
results may suggest the presence of a similar invariance also in the parents involved in our research, even if the cross-
sectional nature of the data does not permit to assess how the measure is stable over time in this case.
Another consequence of the cross-sectional nature of our design is that it does not allow to draw methodologically
correct causal inferences, but only to show a compatibility of the data with the mediation model assumed.
Furthermore, Maxwell & Cole (2007) have shown that parameters estimations in cross-sectional designs may differ
substantially from the values of a classical three-steps longitudinal model (Maxwell & Cole, 2007) that is considered as
a gold standard for the study of mediation. However, Maxwell & Cole conclusions concerned a condition where
predictors, mediators and criteria are all changing over time whereas, in the present research, at least the mediators (i.e.
adults’ retrospective reports of parental rearing style) are not expected to vary across adult age temporal intervals (e.g.
20, 25, 30 years) in their true variance, but only for the just mentioned lack of reliability and validity of the
autobiographical memory due to mood-congruent effects or to other mnemonic impairments (Brewin, Andrews &
Gotlib, 1993). A way to carry out the aims of the present study designing a multi-steps longitudinal model, is assessing
the rearing style across temporal intervals within the first 16 years of life (e.g. 10, 13, 16 years) until the young
adulthood (e.g. 19 years), a proposal that may be realized in future studies but only with substantial modifications of the
PBI or with other kind of rearing measures.
A final limitation is that parental psychopathology was not assessed and, therefore, the direct and indirect effects
emerged, may be due to other mental health dimensions not controlled for.
This study may be extended in the future to further clarify the differential effect of normal and pathological narcissism
on the vulnerability of the offspring. On the one hand, by including in the assessment of the parents also measures of the
pathological facet of narcissism, on the other hand, by including in the research also parents with a psychiatric diagnosis
of narcissistic personality disorder.
A further evidence in favour of the pathogenic effect of parental narcissism via the associated rearing style could also
come from investigations comparing the narcissistic features and rearing styles of parents of normal vs. those of clinical
children, i.e. parents of normal sons and daughters vs. parents of psychiatric sons and daughters.
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Table 1
Correlations below the main diagonal are among paternal scales
and those above the main diagonal are among maternal scales.
Narc
Care
Over
Put
Fav
Dep
Anx
Narcissism
-.29
.30
.35
.20
.17
.15
Care
-.16
-.52
-.64
-.48
-.30
-.28
Overprotection
.25
-.44
.54
.48
.32
.31
Put-Down
.35
-.56
.50
.57
.38
.34
Favoritism
.31
-.49
.40
.71
.42
.36
Depression
.17
-.32
.27
.32
.36
.58
Anxiety
.15
-.32
.31
.31
.35
.58
All Correlations are significant at the 0.01 level (2-tailed).
Figure 1a: Path diagram of the mediating model hypothesized that illustrates all direct effects estimated among paternal
narcissism, paternal rearing dimensions and children depression and anxiety
Care
Paternal
Care
Paternal
Overprotection
Paternal
Put-Down/Shaming
Paternal
Favouritism
Children
Depression
Children
Anxiety
-.16
Paternal
Narcissism
.25
.36
.31
-.16
-.15
.09
.16
.03
.22
.22
-.01
Figure 1b: Path diagram of the mediating model hypothesized that illustrates all direct effects estimated among maternal
narcissism, maternal rearing dimensions and children depression and anxiety
Maternal
Care
Maternal
Overprotection
Maternal
Put-Down/Shaming
Maternal
Favouritism
Children
Depression
Children
Anxiety
-.29
Maternal
Narcissism
.30
.35
.20
-.02
-.03
.10
.12
.16
.27
.20
.14
