“…Narcissistic personality disorder (NPD) is known to be associated with perfectionism, shame, and aggression, and several studies have pointed to the presence and impact of these features in patients with NPD (Fjermestad-Noll et al, 2019;Kealy, Tsai, & Ogrodniczuk, 2012;Kernberg, 2009;Marčinko et al, 2014;Ogrodniczuk, Piper, Joyce, Steinberg, & Duggal, 2009;Velotti, Ellison, & Garofalo, 2014). In particular, the co-occurrence of and interaction between perfectionism, shame, and aggression can challenge self-esteem, escalate vulnerability, and contribute to susceptibility to symptoms of depression in NPD (Dawood & Pincus, 2018;Huprich, Porcerelli, Keaschuk, Binienda, & Engle, 2008;Marčinko et al, 2014;Ronningstam, 2011). Perfectionism is related to shame and aggression, especially in situations when perfectionistic standards are not possible to attain.…”