Narcissistic personality disorder: relations with distress and functional impairment

Abstract

This study examined the construct validity of Narcissistic Personality Disorder (NPD) by examining the relations between NPD and measures of psychological distress and functional impairment both concurrently and prospectively across two samples. In particular, the goal was to address whether NPD typically "meets" Criterion C of the DSM-IV definition of Personality Disorder, which requires that the symptoms lead to clinically significant distress or impairment in functioning. Sample 1 (N =152) was composed of individuals receiving psychiatric treatment, while Sample 2 (N=151) was composed of both psychiatric patients (46%) and individuals from the community. NPD was linked to ratings of depression, anxiety, and several measures of impairment both concurrently and at 6-month follow-up. However, the relations between NPD and psychological distress were (a) small, especially in concurrent measurements, and (b) largely mediated by impaired functioning. NPD was most strongly related to causing pain and suffering to others, and this relationship was significant even when other Cluster B personality disorders were controlled. These findings suggest that NPD is a maladaptive personality style which primarily causes dysfunction and distress in interpersonal domains. The behavior of narcissistic individuals ultimately leads to problems and distress for the narcissistic individuals and for those with whom they interact. Narcissistic Personality Disorder: Relations with distress and functional impairmentNarcissistic personality disorder (NPD), despite substantial interest from a theoretical perspective, has received very little empirical attention (1). In fact, some have concluded that "most of the literature regarding patients suffering with narcissistic personality disorder is based on clinical experience and theoretical formulations, rather than empirical evidence" (2; p. 303). A large majority of empirical studies on narcissism come from a social-personality psychology perspective which, while methodologically sophisticated and important, may not pertain to Narcissistic PD given the reliance on undergraduate samples and the use of the Narcissistic Personality Inventory (NPI, 3). Trull and McCrae (4) have noted that narcissism measured by the NPI appears to be made up of high Extraversion, low Agreeableness, and low Neuroticism from the Five-Factor Model of personality (5), while DSM definitions suggest low Agreeableness, high Neuroticism and no relation with Extraversion. These authors suggest that "most narcissistic scales do not square well with DSM-III-R criteria for NAR" (4; p.53).1 Correspondence concerning this article can be addressed to Joshua D. Miller, Ph.D., Psychology Building, Department of Psychology, University of Georgia, Athens, GA 30602. Fax: (706) 542-8048 E-mail: jdmiller@uga.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will un...

Personality Pathology of Adults With Autism Spectrum Disorder Without Accompanying Intellectual Impairment in Comparison to Adults With Personality Disorders

“…Similar to individuals with ASD, patients with NPD tend to focus predominantly on themselves. In the scientific literature, NPD relationships are described as self-centred and selfish (Miller et al 2007). The DSM-5 states that interpersonal relationships of patients with NPD are impaired due to a disregard for the sensitivities of others (APA 2013).…”

Réflexions sur le traitement basé sur la mentalisation ainsi que son adaptation pour des hommes présentant des troubles de la personnalité mixte ou narcissique

“…Toutefois, plusieurs d'entre eux souffrent sur le plan identitaire, sur le plan de la régulation de l'estime de soi, de même qu'en ce qui a trait à la régulation affective. Pour Miller et al (2007), cette condition est un style mal adapté de la personnalité qui cause principalement des dysfonctions et de la détresse dans le domaine interpersonnel (Miller, Campbell et Pilkonis, 2007, p. 174). De plus, les impacts quant au travail sont nombreux (Penny et Spector, 2002, p. 131), sans compter les conséquences que ce trouble de la personnalité peut avoir sur les plans organisationnel et sociétal (Volkan et Fowler, 2009, p. 221).…”

Interpersonal problems associated with narcissism among psychiatric outpatients: A replication study .

“…Fewer studies have investigated interpersonal functioning in clinical samples of NPD [11]. Among such studies, that of Ogrodniczuk et al [1] is the largest to date to examine the association between narcissistic pathology and interpersonal functioning.…”

“…The vast majority of studies of narcissism have occurred within the social-personality psychology field with non-clinical samples. While these non-clinical studies provide a wealth of knowledge on trait narcissism, their relevance for validating the NPD construct is limited [11,12]. Nevertheless, studies of non-clinical samples have linked narcissism to the interpersonal difficulties of hostility [13], a domineering/vindictive style ( [14,16], coldness, defensiveness, and emotionally detached attachment behaviours [17] and antagonism [18,19].…”