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The assessment of the association between narcissism and suicidal risk is crucial.
Limitations: Only PubMed database; lack of longitudinal studies; most of studies (k = 24,70.6%)
used the DSM definition of narcissism.
This review was performed according to the
PRISMA statement.
Search strategy and selection criteria
We conducted a systematic search of PubMed
database until January 2020.
Studies were included if:they were published
in a peer-reviewed journal; they were written in
English; they were Cohort, Case Control, Cross
Sectional or Case Series with a sample size≥10.
Studies were excluded if:they were Systematic
Reviews or Overviews, Case Reports and Letters
to the Editor.
To provide a systematic overview of studies
investigating the association between
narcissism and suicidal risk we performed the
first systematic review on this topic.
We assessed different aspects of suicidal
thoughts and behaviors [Suicidal Ideation (SI),
Non-suicidal Self-Injury (NSSI), Deliberate Self-
Harm (DSH), Suicide Attempt (SA) and Suicide
(S)] and any definition of narcissism
[Narcissistic Personality Disorder (NPD),
Grandiose Narcissism (GN), Vulnerable
Narcissism (VN)].
ABSTRACT: Introduction: Although suicide showed an association with personality disorders, few studies focused on narcissism. This association is interesting, especially in what authors called a “narcissism epidemic”, considering
narcissistic wounds to which subjects could be subjected. Objectives: To systematically review the association between narcissism and suicidal risk. Methods: We focused on the association between narcissism and suicide (Suicidal
Ideation (SI), Non-suicidal Self-Injury (NSSI), Deliberate Self-Harm (DSH), Suicide Attempt (SA) and Suicide (S)). Studies were identified through a PubMed-based search. Reference lists were examined to extract additional articles.
This review was performed according to PRISMA Statement. Results: We included 34 studies. Most studies evaluated narcissism through DSM, showing heterogeneous results. NPD was associated with low impulsivity and high
planning, but also with a higher number of SAs. Studies evaluating narcissism as a trait were more coherent. SI, NSSI and DSH showed an association with vulnerable narcissism, explained by mediation and moderation models
including shame and dissociation. The grandiose component was associated with severe repetitive NSSIs and S in high suicidal risk samples. Impulsivity showed no effect. Conclusions: It is possible to develop hypothesis, even if not
causal relationships, on the association between narcissism and suicidal risk. Grandiose narcissism seemed to be protective for suicidal outcomes with low intent to die, while vulnerable narcissism seemed to be associated. However
grandiose narcissism seemed to be a risk factor for suicidal outcomes with high intent to die, showing low impulsivity and high planning and severity. New studies, differentiating between narcissistic components, are needed.
Copyright © 2021 Veronica Sprio, Fabio Madeddu, Raffaella Calati
raffaella.calati@unimib.com
v.sprio@campus.unimib.it
CAN NARCISSISM BE CONSIDERED A RISK FACTOR FOR SUICIDAL THOUGHTS AND BEHAVIORS?
A SYSTEMATIC REVIEW OF THE LITERATURE
Veronica Sprio (a), Fabio Madeddu (a), Raffaella Calati, Psy.D., Ph.D. (a, b)
(a) Department of Psychology, University of Milan-Bicocca, Milan, Italy
(b) Department of Adult Psychiatry, Nîmes University Hospital, Nîmes, France
The association between narcissism and suicide risk is underestimated in literature. The Narcissistic
Personality Disorder underlines a persistent grandiosity and a lack of empathy [1]. Several authors,
however, stressed the presence of a vulnerable narcissistic pole, characterized by shame and low
self-esteem [2, 3]. The analysis of suicidal risk considering these subcomponents is of crucial
importance.
AIM
RESULTS
Figure 1. PRISMA flow diagram. CONCLUSION
1. American Psychiatric Association (2014). Diagnostic and statistical manual of mental disorders. 5th edition. Wahington.
2. Kohut, H. (1972). Thoughts on narcissism and narcissistic rage. Psychoanalytic Study of the Child, VOL.27, 360–400.
3. Madeddu, F. (2020). I mille volti di Narciso. Fragilità e arroganza tra normalità e patologia. Milano: Cortina Raffaello.
METHODS
INTRODUCTION
Table 1. Data
Extraction.
Symbols: +: positive association; −: negative association, LA: lack of association.
Table 2. Results.