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Objective: Evidence suggests that pathological narcissism impacts psychotherapy process and outcome. This study investigates whether traits of pathological narcissism account for distinctiveness (construal) of patients' interpersonal perceptions in treatment settings. Methods: Patients enrolled in psychological/psychotherapeutic treatment (N = 150) described a segment of a session in a written format and subsequently assessed both self- and clinician's behavior on the dimensions of dominance and hostility (patient-reported ratings), along with their pathological narcissistic traits. Three independent raters also assessed interpersonal behaviors (observer-reported ratings) based on the written session descriptions. Indices of construal were defined by the residuals of self-reported (net of observer-reported) ratings and were regressed onto pathological narcissistic traits. Results: No association emerged between pathological narcissism and construal in patients' perceptions of their clinicians. However, grandiose traits of pathological narcissism were related to distinctively perceiving oneself as more dominant, while vulnerable traits were related to distinctively perceiving oneself as more hostile. The former association (but not the latter) also held after incorporating additional observer ratings to investigate the robustness of the results. Conclusion: Findings are discussed in light of treatment-related self-enhancement and self-concealment processes.

Dysfunctional eating attitudes and behaviors are very common among women. Recent findings suggest that these attitudes are linked to traits of pathological narcissism. However, mechanisms underlying this association need to be elucidated. We investigated the relationship between traits of pathological narcissism and dysfunctional eating attitudes and behaviors in women, testing whether perfectionistic tendencies mediate this association. The study involved a community-based sample of women (N = 306) who completed measures of grandiose and vulnerable narcissistic traits, attitudes of perfectionistic discrepancy and perfectionistic self-presentation, and dysfunctional eating attitudes and behaviors. Results show that vulnerable narcissistic traits are linked to dysfunctional eating attitudes and behaviors. Moreover, discrepancy between the actual self and the ideal self partially explains why women high in vulnerable narcissism engage in dysfunctional eating attitudes and behaviors. Grandiose narcissism was not uniquely associated with dysfunctional eating. The study suggests that the narcissistic need for being perfect, but not the narcissistic need for presenting oneself as perfect to others, promotes dysfunctional eating attitudes and behaviors in women.

The authors investigate whether and how borderline and pathological narcissistic traits differ in their associations with trait and state rejection sensitivity, and with affective reactions to experiences of social rejection occurring in daily life. Community adults (N = 189) completed baseline measures of rejection sensitivity, borderline personality, and pathological narcissism, and daily measures of perceived social rejection and affective states for 7 days. Vulnerable narcissism was the main driver of negative anticipated emotions for social rejection. Borderline personality made people prone to experiencing social rejection in daily life. Moreover, borderline personality traits predicted greater self-directed aggressive impulses when experiencing social rejection. Grandiose narcissism showed only a negative association with anticipatory anxiety for rejection. These findings highlight that sensitivity to social rejection is crucial in both borderline personality and pathological narcissism.

Numerous studies have established the importance of body image self-consciousness in predicting sexual distress and dissatisfaction in women. However, there is a dearth of information analyzing whether the same relation applies to men. Sexual perfectionism is a sexual correlate that has shown diverse links with sexual-related outcomes. The aim of the present study was to determine the degree to which certain sexuality-related factors, such as body image self consciousness and sexual perfectionism, and certain personality traits, namely grandiose and vulnerable narcissistic traits, may be associated with sexual discomfort in men. An online survey including self-report measures of sexual correlates variables and narcissistic personality traits was administered to a sample of 212 men, who provided the data used to investigate these associations. We performed a stepwise regression analysis, including the sexual-specific variables in the first step and vulnerable and grandiose narcissism in the second step. Sexual distress was linked to vulnerable narcissistic features and body image self-consciousness, according to our research. The clinical implications of our findings emphasize the need of evaluating body image concerns and taking personality characteristics into account when addressing sexual difficulties in men.

The Pathological Narcissism Inventory (PNI) is extensively used in recent empirical literature on pathological narcissism. However, most studies using the PNI are community-based, and no studies have used the PNI to investigate narcissistic presentations in personality disordered patients. This study investigates measurement invariance of the PNI in community participants and patients with personality disorders, and examines differences of narcissistic presentations in these samples through a multimethod approach. Results show that the PNI can be used reliably to measure and compare traits of pathological narcissism in community participants and patients with personality disorders. Personality disordered patients show higher traits reflecting vulnerable narcissism and overt manifestations of grandiose narcissism, compared with controls. Finally, network analysis indicates that traits of grandiose fantasies and entitlement rage have a central role in defining manifestations of PNI pathological narcissism, regardless of the presence of an underlying personality disorder. Research and clinical implications are discussed.

Research on pathological narcissistic traits and sexuality are mainly focused on the dysfunctional aspects of sexuality. The present study aims to explore the relationship between narcissistic traits and sexual satisfaction in men, testing whether sexual self-esteem mediates this association. Participants included 212 men who completed measures of grandiose and vulnerable narcissistic traits, sexual self-esteem, and sexual satisfaction. Results highlight how vulnerable narcissistic traits are negatively associated with sexual satisfaction. This association is fully mediated by sexual self-esteem. On the contrary, grandiose narcissistic traits are not directly associated with sexual satisfaction, but with sexual self-esteem only, which explains the indirect effect of grandiose traits on sexual satisfaction. In conclusion, sexual self-esteem in personality configurations with high pathological narcissistic traits accounts for the relationship between narcissistic traits and sexual satisfaction.

Background Individuals with narcissistic traits, specifically vulnerable ones, are more prone to experiencing concerns related to self-worth and physical appearance and to showing heightened sensitivity to appearance evaluation. Negative body image and body image self-consciousness may, in turn, undermine sexual functioning, especially when apprehension is related to body appearance in sexual contexts. Methods We aimed to evaluate the associations between self-reported pathological narcissistic traits, both grandiose and vulnerable, and sexual functioning in a large sample of nonclinical women (N = 656). Furthermore, we tested the mediating role of body image self-consciousness in these associations. Outcomes Sexual functioning was measured through the Female Sexual Function Index. RESULTS The results highlight that vulnerable narcissistic traits are associated with lower sexual functioning, this association being mediated by higher levels of body image self-consciousness. Conversely, grandiose narcissistic traits are linked to lower body image self-consciousness and, consequently, higher levels of sexual functioning. Clinical Implications Considering the link between body image self-consciousness and sexuality is of utmost importance in clinical practice with women, as well as in promoting positive body appreciation. Clinicians working with individuals presenting with pathological personality traits should consider including an assessment of their sexual functioning.

Background Due to the high pressure they sustain, family members of substance users are thought to experience negative consequences in mental and physical health. This scoping review provided a comprehensive overview on the mental and physical health of adult Affected Family Members (AFMs). Method We searched in-journal English articles in PubMed, with no date limit, guided by the concepts of stress, strain, and burden, and including several terms related to substance use. Eligibility criteria included focus on adult AFMs, mental and physical health, and clinical forms of substance use. Results PubMed search identified 3549 articles, with 46 additional papers from other sources. Fifty-six articles were included, quantitative (N = 39), qualitative (N = 15) and both (N = 2). Quantitative findings show that AFMs are subject to increased stress and burden, and impaired mental health. Variable rates of physical problems emerge, with some medical conditions being more common among AFMs of substance users versus controls. Finally, evidence shows increased risk for aggression and reduced quality of life and social adjustment. AFMs report higher stress and strain if they are women, in low socio-economic families, and co-habiting with more severe substance users. Qualitative studies additionally suggest that stigma, self-blame, and social isolation are common. Conclusions AFMs of substance users represent a population at higher risk for negative health-related outcomes and should be systematically regarded as targets for treatment.

Purpose: Although there is growing interest in trans-negative attitudes and behaviors, few studies have investigated the psychological variables associated with them. The present study aims to assess the relationship between psychopathological symptoms, defensive style, personality traits and negative attitudes toward transgender people. Methods: Participants (N = 165) were asked to complete several questionnaires assessing their psychopathological symptoms (SCL-90-R), defensive style (REM-71), maladaptive personality traits (PID-5-BF), antitransgender attitudes (ATTI), and sociodemographic characteristics. A four-step hierarchical multiple linear regression analysis was carried out to investigate the predictive role of such variables on antitransgender attitudes. Results: We found a significant negative effect of mature defenses and a positive effect of antagonistic traits on trans-negative attitudes. Political and religious beliefs predicted trans-negative attitudes, whereas no effect was found for the other predictors. We also found a significant effect of age and an interaction effect between sexual orientation and gender, with heterosexual men showing higher levels of trans-negativity than non-heterosexual men. Conclusions: The study highlights the importance of both personality and social constructs in predisposing to negative attitudes toward transgender people. Future research should therefore take into account both personality and social variables

Empirical literature has shown that narcissism is often associated with limited empathy, but the mechanism underlying this association is still unclear. The present study investigated the role of identity instability as a mediator of the relationship between narcissistic traits and empathic capabilities. Narcissistic traits, identity instability, and cognitive and emotional empathic capabilities were assessed among 462 nonclinical participants through self-report measures. Results showed a positive association between narcissistic traits and cognitive empathy. On the other hand, a negative association between narcissistic traits and emotional empathy emerged. Furthermore, the study showed that the association between narcissistic traits and impairments in emotional empathy was partially explained by identity instability. Results thus demonstrated that narcissistic traits were associated with higher identity instability, and this, in turn, was associated with decreased abilities to be emotionally involved in others' affect states. These findings are discussed in the context of an object relations formulation of narcissistic personality.

This study investigated the association between narcissism and shame, considering different measures of narcissism, different levels of analysis, and different situational conditions. Nonclinical participants (N = 196) completed baseline measures, followed by daily questionnaires for 28 days. Multilevel models indicated that trait and daily vulnerable narcissism, as well as trait neuroticism, were positively associated with daily shame. When controlling for vulnerable narcissism, trait grandiose narcissism was unrelated to shame, and daily grandiose narcissism was mostly negatively related to it. As for situations, social stress and workload were related to increased shame, especially in those high in trait neuroticism, or narcissism scales with neurotic content. Results highlight the key role of shame in pathological narcissistic functioning.