Narcissism and Interpersonal Problems Among Psychiatric Outpatients

Abstract

A growing body of evidence points to significant interpersonal problems associated with narcissism in clinical samples. Less well understood are the mechanisms by which narcissism negatively impacts one's interpersonal functioning. The present study investigated defensive style as a possible mediator of the relationship between narcissism and interpersonal problems. A sample of 53 adult psychiatric outpatients completed measures of narcissism, defensive style, interpersonal problems, and current symptom distress. Mediation analysis was conducted, controlling for current symptom distress, using 95% bootstrapped confidence intervals to examine the indirect effect of narcissism on interpersonal problems via defensive style. Narcissism was significantly associated with immature and neurotic defensive styles. Although narcissism was not directly related to interpersonal problems, a significant indirect effect was observed for narcissism on interpersonal problems via neurotic defensive style. This finding suggests that narcissism contributes to the use of neurotic defenses, which in turn influence one's interpersonal functioning.

It's Not That Great Anymore: The Central Role of Defense Mechanisms in Grandiose and Vulnerable Narcissism

“…The underlying defensive structure of the grandiose facet seems to expose its vulnerability and furthermore explains the relationship between GN and VN. A study of Mielimaka et al (61) found similar results for narcissism, which can be considered comparable since the used measures base their operationalization of narcissism on its grandiose facet: they found that pathological narcissism itself was not directly related with interpersonal problems but indirectly related when mediated by neurotic defense mechanisms. Following this thought, an interesting finding of Jauk and Kaufman (40) on the relationship between GN and VN revealed that solely the severity of grandiosity explains the difference between the two facets and that GN and VN may be dissociable at lower levels of grandiosity but merge into an antagonistic core with signs of psychological maladjustment at higher levels.…”

“…Fernie et al (62) found denial to be especially prominent in VN. Mielimaka et al (61) reported a strong relationship between immature and neurotic defenses based on the DSQ and pathological narcissism, albeit not differentiating between GN and VN. To our best knowledge, the only existing study on defense mechanisms, differentiating between GN and VN, has recently been published by Khodabakhsh Pirklany and Safaeian (82), finding high expressions of GN and VN related to intermediate/neurotic and maladaptive defenses, and this being significantly higher than for individuals with low expressions in pathological narcissism.…”

“…A study with narcissistic psychiatric outpatients showed an association between high levels of narcissism and greater interpersonal impairment by engaging in domineering, vindictive, and intrusive behaviors and a failure to complete treatment (5,60). Mielimaka et al (61) later found that the defensive style mediated the relationship between narcissism and interpersonal problems: Albeit narcissism was not directly related to interpersonal problems, they found an indirect effect when mediated by neurotic defense mechanisms. Ultimately, the differentiation between GN and VN has shown to be of informative value: Studies on the relationship between pathological narcissism (GN and VN), defensive functioning, and coping abilities have shown that GN and VN are associated with diverging coping strategies (62).…”

The Dark Triad Predicted by Belief in Determinism and Objectification

“…According to MacDonald (2014), we all fall somewhere along this continuum, with narcissistic responses ranging from mild to a potentially pathological level of narcissism. The lower end of this continuum includes individuals who display narcissistic behaviors but are capable of functioning well personally and socially (Mielimaka, Ogrodniczuk, Kealy, Cheek, & Joyce, 2018). Healthy narcissism incorporates, "a steady sense of one's worth, based on genuine achievement, the capacity to recover from disappointment or failure and the ability to find comfort and support in relationships" (MacDonald, 2014, p. 145).…”

“…On the opposite end of the continuum are those who suffer from unhealthy or pathological narcissism. Individuals on this end of the continuum act in domineering, vindictive, and disruptive behaviors, leading to issues in maintaining meaningful, long-term relationships and experience difficulty in enacting prosocial behaviors due to their egocentrism, grandiosity, and poor self-awareness (Mielimaka et al, 2018). Although rare, extremely unhealthy narcissism can be classified as narcissistic personality disorder.…”