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first article discusses the use of digital and telehealth interventions to increase physical activity in adults with spinal cord injuries. The study found that these interventions supported autonomy, competence, and relatedness, which are psychological needs that promote long-term physical activity adherence. The second article explores the ethical guidelines needed to create a more just youth sport environment. It argues for giving power to young participants themselves and respecting their agency, promoting nonhierarchical relationships, and allocating opportunities and benefits to all participants. The third article challenges the belief that narcissistic coaches are always detrimental to athletes. It suggests that narcissistic coaches may enhance athlete performance in highly competitive situations by motivating athletes to showcase their abilities. The fourth article examines the commercialization of youth sport in Sweden and how it reshapes cultural values. It found that commercial businesses promote immaterial values such as competence, individually adjusted training, and happiness on their websites. The fifth article takes a carnal sociological approach to understand the embodied experience of exercise addiction. It found that exercise addiction can be seen as both a virtue and a vice, providing health benefits and pleasurable sensations but also causing suffering and distress. The article raises questions about how mental health disorders are conceptualized. Finally, the sixth article responds to critiques of the Authentic and Hubristic Pride Scale, a tool used to assess pride. The authors address critiques regarding the scale's validity, cultural dependence, polysemy, and specific concerns about the hubristic pride component. They argue that further validation is needed but highlight [Extracted from the article]

Background: Narcissistic personality disorder (NPD) is associated with a complex interplay of genetic, neurobiological, and environmental factors. In this case report, we discuss the association between adverse childhood experiences (ACEs) and the development of NPD in adulthood. Case presentation: Here, we report a clinical case of NPD to illustrate how ACEs, particularly physical and emotional neglect, combined with early life parental overvaluation, can impair emotional regulation and self-worth, contributing to the development of narcissistic traits. We analyse, in light of existing literature, how ACEs are associated with a wide spectrum of personality disorders, how parental overvaluation is linked to grandiose narcissism, and how childhood neglect and abuse are associated with vulnerable narcissism. Conclusion: ACEs are the primary risk factor for the development of NPD in adulthood. Dysfunctional household environments and parenting practices compound the association between ACEs and pathological narcissism. It is important to address childhood trauma for the prevention and treatment of NPD. Further research is necessary to clarify how individual factors influence the relationship between ACEs and pathological narcissism. [ABSTRACT FROM AUTHOR]

Personality psychology subdivides the narcissism of healthy persons into the grandiose and the vulnerable types (2 factor model), which can be further described in a more differentiated way with the three personality factors extroversion, intolerance/antagonism and neuroticism (3 factor model). The grandiose and the vulnerable types of narcissism can also be found in narcissistically disturbed patients. The narcissistic personality disorder (NPD), which in DSM‑5 is exclusively characterized by the grandiose features also shows vulnerable features; however, these are hidden behind the grandiose features. Grandiose narcissism is relatively rare in the clinical routine. So far vulnerable narcissism could not be diagnosed in DSM‑5 or ICD-10; however, in the future this will be demonstrable in ICD-11 by the dimensional concept of personality disorder even if it does not exist as an official diagnosis in ICD-11. [ABSTRACT FROM AUTHOR]

This eye tracking study tested the hypothesis that narcissists' visual attention is motivated, focusing on two fundamental social motives: status and affiliation. We measured participants' full narcissism spectrum (narcissistic agency, antagonism, and neuroticism) via self-reports. We measured visual attention to status and affiliation images via eye-tracking in the lab. We hypothesized that narcissistic agency would relate to increased attention to status, and that narcissistic antagonism would relate to increased attention to status and decreased attention to affiliation. We formulated no hypotheses regarding narcissistic neuroticism. Results showed that only agentic narcissism was related to increased attention toward status. The three forms of narcissism were unrelated to attention to affiliation. These findings suggest that agentic narcissists' attention is driven by an underlying status motive. More broadly, findings are consistent with the notion that visual attention expresses and maintains people's personality traits via satisfying trait-congruent motives. [ABSTRACT FROM AUTHOR]

Prior research has established that individuals high in narcissism may favor certain professions over others, but the reasons for this remain speculative. The present study employs the Narcissistic Admiration and Rivalry Concept model to differentiate between two motivational drivers of narcissism – admiration (desire for praise) and rivalry (desire to denigrate others) – and explores their influence on vocational preferences in an online sample of 386 full-time U.S. employees. Further, we examine the role of work values (achievement, comfort, status, altruism, safety, autonomy) as mediators in these preferences. By understanding how narcissism's two dimensions shape interest in various vocations, we expand upon previous research on subclinical personality and career preferences, offering organizations a way to proactively identify workers with potentially derailing personality characteristics. Finding that work values mediate the relationship between narcissism and vocational interests suggests the importance of investigating this mediating mechanism with other bright and dark traits. [ABSTRACT FROM AUTHOR]

In this paper, we analyzed a fictional character from the movie series (James Bond from the 007 series) based on Kohut’s self psychology to understand the formation and evolution of narcissistic personality traits. James Bond experienced sudden parental loss due to a tragic accident. He endured childhood bullying, leading to a deficiency in mirroring selfobject experiences, idealized selfobject experiences, and twin ship selfobject experiences. These deficits culminated in his developing narcissistic personality disorder. However, James Bond was able to undergo a process of transmuting internalization through new selfobjects such as M and Madeleine. This enabled him to reactivate disrupted developmental processes and ultimately reach a state of healthy self. [ABSTRACT FROM AUTHOR]

Narcissistic personality is an ego centric personality characterized by obsession with oneself, disregard for others, and lack of empathy. It forms a spectrum from normal to pathological levels. A narcissistic person unconsciously fears death because he/she pursues immortality and omnipotence. A narcissistic person does not consider others important. Thus, he/she does not mourn separation or loss. It might be a characteristic defense of narcissistic personality. The authors selected by Japanese author Yoko Sano as a text. Many people loved the cat and cried and mourned when the cat died. However, he was reborn immediately a million times. The cat loved only itself. The cat then met a white cat and fell in love for the first time. They lived together. As time passed, the white cat died. For the first time, the cat cried out loud in sadness. After crying and crying, he stopped moving and dying. He was not reborn again. The authors viewed the cat as a narcissistic personality and interpreted its active avoidance and denial of separation, death, and mourning as a narcissistic defense. Repeating this only strengthened his narcissistic traits. However, the momentum of change was falling in love. Losing a loved one and going through the process of mourning the eternal separation of death for the first time became the trigger for the change in narcissistic personality. [ABSTRACT FROM AUTHOR]

This study aimed to examine the role of travel-related motivations and preferences for activities (such as learning about local culture, relaxation and entertainment, status and social recognition, escape and curiosity, and experience) in the relationship between narcissistic personality traits and the preference for luxury tourism versus cultural tourism. A sample of 1342 Israeli community members was analyzed. The methodology utilized parallel mediation analyses to assess how different forms of narcissism (extraverted, antagonistic, neurotic, and communal) were associated with the desire for luxury tourism over cultural tourism, as mediated by various travel-related motivations. The results indicated that narcissistic personality traits were generally associated with a preference for luxury tourism, primarily through indirect associations via travel motivations such as relaxation and entertainment, status and social recognition, and experience. The conclusion highlights the implications for understanding how specific travel-related motivations influence tourism preferences among individuals with varying levels of narcissistic traits, suggesting that tourism management strategies could benefit from a nuanced approach to personality in marketing. [ABSTRACT FROM AUTHOR]

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Abstract Background Narcissistic personality disorder (NPD) is associated with a complex interplay of genetic, neurobiological, and environmental factors. In this case report, we discuss the association between adverse childhood experiences (ACEs) and the development of NPD in adulthood. Case presentation Here, we report a clinical case of NPD to illustrate how ACEs, particularly physical and emotional neglect, combined with early life parental overvaluation, can impair emotional regulation and self-worth, contributing to the development of narcissistic traits. We analyse, in light of existing literature, how ACEs are associated with a wide spectrum of personality disorders, how parental overvaluation is linked to grandiose narcissism, and how childhood neglect and abuse are associated with vulnerable narcissism. Conclusion ACEs are the primary risk factor for the development of NPD in adulthood. Dysfunctional household environments and parenting practices compound the association between ACEs and pathological narcissism. It is important to address childhood trauma for the prevention and treatment of NPD. Further research is necessary to clarify how individual factors influence the relationship between ACEs and pathological narcissism.

Objectives Methods Results Conclusion Narcissistic personality disorder as captured in categorical diagnostic systems (e.g., DSM‐5) emphasizes grandiose features more associated with masculine norms and under‐emphasizes vulnerable features more associated with femininity. This poses significant implications in diagnostic outcome and clinical treatment in women with narcissistic preoccupations. Research finds that clinicians using the DSM‐5 categorical system tend to diagnose vulnerable narcissism in women as other ‘feminized’ personality disorders (e.g., borderline), but no research has explored gender differences in narcissism using the new ICD‐11 dimensional framework for personality disorders. This study investigated the clinical utility of the ICD‐11 approach in capturing gender differences in narcissistic presentations.Adopting an online vignette‐based study, mental health clinicians (N = 157; 71.3% female) completed ratings of ICD‐11 personality disorder severity and trait domains for two cases reflecting ‘grandiose’ and ‘vulnerable’ narcissism in hypothetical male or female patients.The results showed that ratings of core impairments in personality functioning and overall severity were consistent irrespective of patient or clinician gender, contrasting prior research using categorical models.While some differences were observed in trait domain (e.g., negative affectivity) between patient gender, these results suggest the clinical utility of the ICD‐11 model as emphasizing elements of personality functioning in the process of assessment and diagnosis, therefore potentially being less susceptible to influences of gender stereotype in aiding clinical conceptualization. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate changes in narcissistic personality traits and empathy deficits in adults with attention-deficit hyperactivity disorder (ADHD) after pharmacotherapy, focusing on psychostimulant treatment. Understanding these comorbidities is crucial for optimizing treatment and improving therapeutic outcomes. Methods: This cross-sectional cohort study consisted of 75 randomly selected ADHD patients. The patients were started on methylphenidate or atomoxetine as per the indications for treatment. A Sociodemographic Data Form, Adult ADHD Self-Report Scale (ASRS), Pathological Narcissism Inventory (PNI), and Empathy Quotient (EQ) were applied. Based on the study design, Adult ASRS, PNI and EQ were re-administered to the patients at the end of 3 months of treatment. The levels of pathological narcissism and empathy in patients were assessed before and after treatment. Results: The median and minimum--maximum in PNI grandiosity score decreased significantly from 67.00 (30-108) before treatment to 60.00 (24-102) after treatment (P < .001). The mean ± Standard Deviation (SD) PNI Vulnerability score decreased statistically significantly from 63.83 ± 26.02 before treatment to 60.06 ± 24.64 after treatment (P = .003). The median and minimum--maximum in PNI total score was 134.50 (64-208) pre-treatment, which showed a statistically significant decrease after treatment (P < .001). The mean ± SD EQ score decreased statistically significantly from 33.86 ± 7.03 before treatment to 36.53 ± 7.55 after treatment (P = .001). Conclusion: Psychostimulant treatment in adult ADHD patients can ameliorate narcissistic traits and enhance empathy, thereby improving social functioning and interpersonal relationships. These findings suggest that psychostimulants may positively modulate neural circuits involved in narcissism and empathy, potentially leading to better treatment outcomes. [ABSTRACT FROM AUTHOR]

Objective: This study aims to explore the interconnections between social anxiety disorder (SAD), adverse childhood experiences, and pathological narcissism. Methods: The study included 66 patients diagnosed with SAD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria and 55 healthy controls. All participants were assessed using The Liebowitz Social Phobia Scale (LSAS), Childhood Trauma Questionnaire (CTQ), Hypersensitive Narcissism Scale (HSNS), and Narcissistic Personality Inventory-16 (NPI-16) scales. Statistical analyses included descriptive statistics, Student’s t-test, Chi-squared test, correlation tests to examine relationships between variables, and logistic regression to identify significant predictors of SAD, particularly focusing on the role of childhood trauma and narcissistic traits. Results: The SAD patients had significantly higher scores on the CTQ total and subscales, as well as on the HSNS, compared to the healthy control group (p < .001). Additionally, there was a positive correlation between LSAS scores and both CTQ (r=.585, p < .01) and HSNS scores (r=.582, p < .01). However, no significant association was found between NPI-16 scores and LSAS or CTQ scores (r=-.064, p>.05). Conclusion: This study highlights the increased levels of narcissistic pathology and history of childhood trauma in SAD patients. Vulnerable narcissism emerges as a key factor in SAD, emphasizing the need for comprehensive treatment approaches considering childhood trauma and narcissistic vulnerability. [ABSTRACT FROM AUTHOR]

Malignant narcissism describes a personality disorder that encompasses five core components: narcissism, psychopathy, sadism, paranoia, and aggressiveness. Despite the extensive theoretical and clinical literature on malignant narcissism and its recent momentum in the popular discourse, there is a dearth of empirical evidence on the syndrome. The objective of the current research is to document the associations between malignant narcissism, the Dark Tetrad (Machiavellianism, narcissism, psychopathy, sadism), and paranoia using a scoring procedure for malignant narcissism based on Personality Inventory for DSM-5 facets. A comparative approach was followed, using two types of relative importance analyses—general dominance analysis and relative weight analysis—to determine the nature of the core psychopathological features of malignant narcissism. The French-Canadian version of the Revised Green et al., Paranoid Thoughts Scale was used and had to be validated prior to relative importance analyses, and showed strong psychometric properties. Results from a nonclinical sample (N = 1151) globally indicate that malignant narcissism is more strongly associated with Machiavellianism and psychopathy, followed by narcissism, and then by sadism and ideas of reference, confirming that malignant narcissism is mainly an antagonistic psychopathology. The conceptual and clinical implications of this finding are discussed. [ABSTRACT FROM AUTHOR]

"The Omnipotent State of Mind: Psychoanalytic Perspectives" edited by Jean Arundale is a book that delves into the concept of omnipotence from a psychoanalytic standpoint. Divided into three sections, the book examines the origins, purpose, and challenges associated with omnipotence. It explores how omnipotence manifests in different stages of life and its connection to psychological defenses and pathological structures. The article based on the book discusses the concept of omnipotence, its relationship with narcissistic object relations, and its impact on culture and society, particularly in the context of political populism. The article concludes by emphasizing the importance of relinquishing omnipotence for personal growth and development. [Extracted from the article]

Modern diagnostic and classification frameworks such as the ICD‐11 and DSM‐5‐AMPD have adopted a dimensional approach to diagnosing personality disorder using a dual "severity" and "trait" model. As narcissistic personality has historically struggled to be adequately captured in dominant diagnostic systems, this study investigated the utility of the new ICD‐11 framework in capturing diverse narcissistic expressions. Participants were mental health clinicians (N = 180, 67% female, age = 38.9), who completed ratings of ICD‐11 personality severity, trait domains and a clinical reflection for two hypothetical case vignettes reflecting either prototypical "grandiose" or "vulnerable" narcissism. The majority of clinicians (82%) endorsed a diagnosis of personality disorder for both grandiose and vulnerable vignettes. Discriminant elements of personality impairment included rigid, unrealistically positive self‐view, low empathy and high conflict with others for grandiosity, and incoherent identity, low self‐esteem and hypervigilant, avoidant relations with others for vulnerability. Regarding trait profile, grandiose narcissism was predominately dissocial whereas vulnerable narcissism was primarily associated with negative affectivity and detachment. Qualitative responses highlight distinct clinical themes for each presentation. These findings suggest that clinicians using the ICD‐11 framework are able to identify common core elements of personality dysfunction in grandiose and vulnerable narcissism while also recognizing their distinctive differences. [ABSTRACT FROM AUTHOR]

Introduction: Currently narcissism is considered one of the most widespread phenomenon. As a consequence, its different types (grandiose and vulnerable narcissism) have been investigated from several different perspectives. The present research attempts to explore the differences between the two types of narcissism and their links with different cognitive components that are connected to these personality traits. The primary aim of our study is to investigate the possible connections among maladaptive schemas (entitlement, vulnerability, emotional deprivation) and cognitive evaluation systems (self‐esteem, systemizing‐empathizing) and narcissism. Methods: We applied both correlation and path analyses to explore the hypothesized associations. Results: The results show that early maladaptive schemas are strongly associated with narcissism and the empathizing system. The different subtypes of narcissism have different connections with self‐esteem. Conclusion: Our results show that the two types of narcissism have different manifestations and connections with the early maladaptive schemas, Emphatizing Quotient, and self‐esteem. Our empirical results serve as important and empirically supported inputs to counseling and clinical practice. [ABSTRACT FROM AUTHOR]

This article provides a comprehensive overview of Narcissistic Personality Disorder (NPD) from both a psycholinguistic and neuroscientific perspective. It explores the distinct communication patterns associated with different subtypes of NPD and identifies specific brain regions and functional abnormalities associated with the disorder. The integration of psycholinguistic and neuroscientific findings can improve diagnosis and treatment for individuals with NPD by addressing cognitive distortions and emotional dysregulation. The article acknowledges the need for further research to refine diagnostic criteria and deepen our understanding of the disorder. Additionally, a list of references is provided, offering a valuable resource for further research on NPD. [Extracted from the article]

Research has indicated loneliness to be a detrimental correlate of narcissistic vulnerability. However, no research has examined if this relationship persists across time or why it occurs. The present study explores the link between narcissistic vulnerability and loneliness across time and examines which domains of personality dysfunction (i.e., identity, self‐direction, empathy, and intimacy) may account for why narcissistic vulnerability is related to loneliness. Adult participants (N = 298) were recruited from Prolific and completed study questionnaires assessing narcissistic vulnerability, narcissistic grandiosity, loneliness, domains of self and interpersonal functioning, and neuroticism. Two months later, participants repeated the measure of loneliness. Correlations among all study variables were calculated, followed by linear regression analyses to investigate how personality functioning domains may mediate the longitudinal relationship between narcissistic vulnerability and loneliness. The effects of baseline loneliness, relationship status, and trait neuroticism were controlled for. Narcissistic vulnerability, but not narcissistic grandiosity, was associated with loneliness at baseline and 2 months later. Intimacy functioning, but not identity, self‐direction, or empathy functioning, was a significant mediator of the relationship between narcissistic vulnerability and loneliness over time. These findings suggest that narcissistic vulnerability may contribute to the development or maintenance of loneliness across time, highlighting the role of impaired intimacy functioning in this relationship. The impact of these findings on our understanding of interpersonal functioning in narcissistic vulnerability, as well as clinical implications, is discussed. [ABSTRACT FROM AUTHOR]

Pathological narcissism (PN) is a common psychopathological issue leading to maladaptive strategies to cope with self‐esteem threats, including self‐enhancement and exploitation (grandiose strategies) or internalized shame, depression, and social withdrawal (vulnerable strategies). Mentalizing is a key process for regulating self and other representations and their associated emotions. Patients with PN further struggle with emotion dysregulation (ED), which during development is intertwined with the growing capacity to mentalize. We seek to contribute to emerging empirical data documenting the associations between PN and ED and between PN and mentalizing, and to provide information on the nature of their mutual relationships. In the present study, we assessed PN, ED, and three mentalizing dimensions (mentalizing self, other, and motivation to mentalize) in 183 patients consulting in our outpatient unit specialized in ED. We found that narcissistic vulnerability was negatively associated with self‐mentalizing and positively associated with overall ED, both even after adjustment for borderline and attention deficit hyperactivity disorder (ADHD) symptoms. However, the association with ED was not maintained after further adjustment for self‐mentalizing or overall‐mentalizing, which suggests that mentalizing may play a mediating role in this relationship. On the other hand, narcissistic grandiosity was positively associated with other‐mentalizing and ED and negatively associated with self‐mentalizing in bivariate analyses, but these last two associations were not maintained after adjustment for comorbid borderline and/or ADHD symptomatology. This study provides new information on the link between PN and ED and on key mentalizing dimensions meaningfully relating to PN, notably through a potential role of self‐mentalizing processes between PN and ED. [ABSTRACT FROM AUTHOR]

Introduction: Pathological narcissism (PN) can be defined as the compromised and fluctuating ability to regulate self-esteem, the latter depending on external validation, admiration, or enhancement, all resulting in grandiose (e.g., self-enhancement, aggressiveness, manipulation) or vulnerable (e.g., depression, anxiety, self-criticism, avoidance) dysfunctional reactions when confronting with self-esteem threats. A link has been suggested between PN and emotion dysregulation (ED), but to date, no systematic review has been conducted. Methods: We conducted a systematic review of the literature published until February 2024 studying the association between PN (with or without a diagnosis of narcissistic personality disorder) and ED, divided in two domains: emotion regulation difficulties and strategies. Results: Twenty-two studies were included in our analysis. Altogether, the available data are insufficient to conclude on the link between grandiose narcissism and emotion regulation difficulties in non-clinical population (notably due to different patterns of associations depending on the scale used to assess narcissism). However, the small number of studies conducted in clinical population seems to indicate a possible absence of association between the two constructs. On the other side, there is considerable evidence for the existence of a positive association between vulnerable narcissism and emotion regulation difficulties, regardless of the scale used to assess narcissism and the type of population considered. Finally, regarding emotion regulation strategies, data are too scarce to draw any conclusion, even though there seems to be a trend toward positive association between narcissistic vulnerability and expressive suppression. Conclusion: ED seems to be highly associated with narcissistic vulnerability. Given that every patient suffering from PN may experience vulnerable states, we believe that ED should be considered as an important part of psychoeducation programs and psychotherapeutic treatments designed for this population. [ABSTRACT FROM AUTHOR]

In recent years taking selfies and posting them on social media has become a social, cultural phenomenon globally. But this behaviour can be detrimental to a person's mental health, if they are regularly indulging in it. In this study we estimated the prevalence of selfitis and investigated its relationship with self-esteem, appearance anxiety and narcissistic personality trait among 403 students of a medical college in south India, using a cross-sectional study design. Standardised tools such as Selfitis Behaviour Scale, Rosenberg Self-Esteem Scale, Appearance Anxiety Inventory and Narcissistic Personality Inventory-16 were used to collect data and Pearson's correlation coefficient was utilised to investigate relationship between the study variables. The prevalence of selfitis was found to be 68.4%, with 51.1% having borderline, 16.13% acute, 1.24% chronic-selfitis. A mild positive correlation was found between selfitis and appearance anxiety (r = 0.376). This could be due to the need to seek approval and reassurance about their appearance through increased engagement with selfie-taking behaviour. Also, since the majority of students had features of selfitis (borderline, acute and chronic), they would be spending a large part of each day taking selfies and uploading them on social media. This could interfere with their academic performance and also impede social interactions. We recommend that adolescents need to be educated about the consequences of indulging in excessive selfie-taking behaviour and its negative impact on their perceived self-image. [ABSTRACT FROM AUTHOR]

Objective: Narcissistic personality disorder is conceptualized by Kernberg as one of the levels of personality, characterized by an unstable identity and primitive defense mechanisms such as splitting. The present study aimed to explain narcissistic personality disorder based on primary object relations with the mediating role of defense mechanisms. Methods and Materials: This descriptive study was conducted using a correlational design. The statistical population included all students enrolled in universities in Qom city during the 2020-2021 academic year, from which 397 individuals were selected using a convenience sampling method. Participants completed the Narcissistic Personality Questionnaire, Object Relations Questionnaire, and Self-Concept Scale. Structural equation modeling was conducted using data obtained from the questionnaires. Findings: The results showed that object relations directly explained 63% and indirectly through defense mechanisms explained 25% of the narcissistic personality. In total, the estimation of the structural model, where object relations were the predictor variable and defense mechanisms were included as the mediating variable, indicated that this model explained 88% of the narcissistic personality. Conclusion: Therefore, it can be concluded that narcissistic personality is explained both directly and indirectly through defense mechanisms by object relations. [ABSTRACT FROM AUTHOR]

The article is devoted to the study of the relationship between narcissism personality type and self-regulation. 150 students participated in our research. The main part of the selection is students studying at a higher education institution. The study showed that when evaluating the differences between groups with different severity of the indicator of self-regulation and self-attitude, significant differences were obtained only on two scales: lack of empathy and envy of the achievements of others. A lack of empathy and envy of others’ achievements appeared to be more common among respondents with low self-esteem, i.e., those with predominantly negative self-images. The effects of personality type and narcissistic personality traits on self-attitude factors are negative, except for grandiose selfworth and belief in one’s own uniqueness. It was found that there is a contradiction in the structure of self-attitude of a narcissistic personality: a positive self-attitude maintains an acceptable level due to greatness and belief in one’s own uniqueness and specialness, but precisely these characteristics emerge. being the basis for envy and manipulation in interpersonal relationships. Realizing that such strategies are unacceptable leads to shame and experiencing one’s own flaws. In response, the personality either focuses on the painful side of such experiences, which increases feelings of envy, leading to narcissistic outbursts of anger and submissive behavior, or strives for self-affirmation and social achievement, which helps maintain a sense of superiority. [ABSTRACT FROM AUTHOR]

Objectives. This case study endeavors to provide an in-depth understanding of the schema and mode structure of narcissistic personality disorder (NPD) and to illustrate a possible therapeutic approach using schema therapy (ST). Material and methods. The recorded material from a 2-year therapeutic journey of a 38-year-old female client diagnosed with NPD was transcribed and systematically analyzed, together with the results of questionnaires that were given to the client at the start of therapy and at the end of the process. Results. The Millon Clinical Multiaxial Inventory (MCMI-III) was initially used to confirm the presence of NPD in the client. Concurrently, the Young Schema Questionnaire (YSQ) and Schema Mode Inventory (SMI) were employed to measure changes across the course of treatment. The MCMI-III confirmed the existence of NPD. The YSQ revealed a high presence of schemas in the domains of disconnection and rejection, as well as schemas of subjugation, entitlement, and approval seeking. The SMI indicated elevated scores on Vulnerable and Angry Child Modes, Detached Self-Soother and Self-Aggrandizer, Punitive and Demanding Parent. The scores for Happy Child and Healthy Adult were medium. Upon completion of therapy, a reevaluation of the questionnaire’s scores demonstrated a reduction in narcissism on MCMI-III from 89 to 78, indicating that the client no longer met the criteria for NPD but only for narcissistic personality traits. The scores for YSQ and SMI also decreased significantly. Conclusions. The use of schema therapy was an adaptive and successful approach to addressing the narcissistic personality pathology of the client. The utilization of a limited reparenting stance allowed empathic confrontation of the main narcissistic modes. The utilization of mode conceptualization and schema understanding reduced feelings of shame and promoted participation of the client’s Healthy Adult Mode in the therapeutic process.

Background: Depression is a prevalent psychiatric disorder that can arise at any age and is often present as a co-occurring illness in different illnesses. There is a high comorbidity rate between major depressive disorder and personality disorders (PDs). The current study aimed to investigate the significant impact of personality disorders on depression severity, functional impairment, and suicidal tendencies in individuals with depression. Methods: The researchers conducted a cross-sectional observational study involving 120 patients, with an age range from 18 to 56 years of both genders, recruited from Okasha's Institute of Psychiatry in Cairo, Egypt. Their major depressive disorder diagnosis was verified through the use of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Participants underwent evaluations using the SCID-II to evaluate personality disorders, the Hamilton Depression-Rating Scale (HAM-D) to assess the severity of depression, the Columbia Suicide Severity Rating Scale (C-SSRS) to investigate suicidal ideation, and the Global Assessment of Functioning Scale (GAF) to determine functional level. Results: Borderline personality disorder and narcissistic personality disorder were the predominant personality disorders in the sample, with prevalence rates of 55.8% and 40.8%, respectively. Sixty-six percent of the participants reported experiencing suicidal thoughts at some point in their lifetime, whereas only 17.5% had actually attempted suicide. Borderline personality disorder showed a strong correlation with more severe depression (P value 0.043), a decline in functioning (P value 0.001), the existence of suicidal thoughts (P value 0.001), and a past of suicide attempts (P value 0.038). Conclusions: Personality disorders are highly prevalent in patients with depression, borderline PD, and narcissistic PD were the most common PDs. Borderline PD showed a significant effect on depression severity. PDs, mainly borderline, avoidant, depressive, and narcissistic PDs contribute to more impairment of functioning of the MDD patients. There is a significant effect of the presence of co-morbid personality disorder on suicidal thoughts and suicidal attempts, mainly depressive and borderline PDs. [ABSTRACT FROM AUTHOR]

Background: Burnout is a maladaptive response to chronic stress, particularly prevalent among clinicians. Anesthesiologists are at risk of burnout, but the role of maladaptive traits in their vulnerability to burnout remains understudied. Methods: A secondary analysis was performed on data from the Italian Association of Hospital Anesthesiologists, Pain Medicine Specialists, Critical Care, and Emergency (AAROI-EMAC) physicians. The survey included demographic data, burnout assessment using the Maslach Burnout Inventory (MBI) and subscales (emotional exhaustion, MBI-EE; depersonalization, MBI-DP; personal accomplishment, MBI-PA), and evaluation of personality disorders (PDs) based on DSM-IV (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition) criteria using the assessment of DSM-IV PDs (ADP-IV). We investigated the aggregated scores of maladaptive personality traits as predictor variables of burnout. Subsequently, the components of personality traits were individually assessed. Results: Out of 310 respondents, 300 (96.77%) provided complete information. The maladaptive personality traits global score was associated with the MBI-EE and MBI-DP components. There was a significant negative correlation with the MBI-PA component. Significant positive correlations were found between the MBI-EE subscale and the paranoid (r = 0.42), borderline (r = 0.39), and dependent (r = 0.39) maladaptive personality traits. MBI-DP was significantly associated with the passive-aggressive (r = 0.35), borderline (r = 0.33), and avoidant (r = 0.32) traits. Moreover, MBI-PA was negatively associated with dependent (r = − 0.26) and avoidant (r = − 0.25) maladaptive personality features. Conclusions: There is a significant association between different maladaptive personality traits and the risk of experiencing burnout among anesthesiologists. This underscores the importance of understanding and addressing personality traits in healthcare professionals to promote their well-being and prevent this serious emotional, mental, and physical exhaustion state. [ABSTRACT FROM AUTHOR]

There is an increasing amount of content in popular media attempting to connect narcissistic personality disorder with domestic violence and intimate partner violence, sometimes referred to as narcissistic abuse. Counselors may engage with both survivors and those who perpetrate domestic violence (DV) or intimate partner violence (IPV), as well as clients with narcissistic personality disorder (NPD) or narcissistic traits. There is, however, a lack of literature investigating counselor perceptions of NPD, narcissistic traits, DV, and IPV. Seven licensed professional counselors were interviewed who had worked with clients who had experienced DV or IPV as perpetrators or survivors of abuse. The researchers investigated licensed counselors' perceptions of NPD, narcissistic traits, DV, and IPV using hermeneutic phenomenological qualitative inquiry. Five themes emerged from this study: narcissistic characteristics, differentiating NPD versus narcissistic traits, mental health and IPV/DV, experience (or lack of) with NPD clients, and education. Although counselors reported working with a high number of IPV/DV cases, counselors demonstrated a nuanced understanding of narcissism and DV. Participants agreed narcissistic traits themselves were seen more often than NPD diagnoses, but it is likely loved ones who have experienced IPV/DV are looking to attribute the perpetrator's abuse to mental health. The limited amount of treatment provided to clients diagnosed with NPD paired with lack of diagnostic criteria regarding "narcissistic abuse" to describe perpetrators of IPV/DV indicates the need for increased education and further research of IPV/DV as it coincides with the term "narcissistic abuse" or NPD. [ABSTRACT FROM AUTHOR]

Social anxiety symptoms are associated with shyness and submissiveness. However, recent work has identified a subtype within Social Anxiety Disorder characterized by high levels of anger and impulsivity. This subtype bears conceptual similarities to prior accounts of vulnerable narcissism (e.g., hypersensitivity and interpersonal reactivity). However, no prior work has systematically evaluated the common and potentially distinguishing factors of these conceptually similar yet phenotypically distinct groups. Accordingly, the purpose of this study was to utilize a Latent Profile Analysis (LPA) to distinguish whether vulnerable narcissistic traits are present within high anger, risk-prone individuals who are also socially anxious, or alternatively whether LPA can differentiate these profiles based on response patterns to theoretically relevant variables. LPA identified five distinct profiles based on varying levels of social anxiety, anger, impulsivity, and narcissistic traits, and supported the existence of the angry-impulsive socially anxious subtype as well as a relationship between this group and self-reported narcissistic traits. These findings have implications for treatment of this subgroup, and may provide a foundation for future research investigating why interventions for adults with SAD and angry-impulsive features often have limited success. [ABSTRACT FROM AUTHOR]

Adult attention deficit hyperactivity disorder (ADHD) is often associated with personality pathology. However, only few studies have been conducted on the link between ADHD and pathological narcissism (PN), with or without a diagnosis of narcissistic personality disorder (NPD). In order to fill this gap, PN and NPD were assessed in 164 subjects suffering from ADHD, with several other measures including ADHD severity, quality of life, depression, anxiety, impulsivity, and emotion dysregulation (ED). We found that a significant proportion of ADHD patients suffered from NPD, and that both narcissistic grandiosity and vulnerability were associated with ADHD hyperactivity and impulsivity symptoms, but not with inattentive symptoms. These two dimensions seemed to be negatively associated with well-being and positively associated with most of the other studied psychiatric dimensions except ED, the latter being only associated with vulnerability, even after adjustment on borderline symptoms. Overall, despite important limitations that limit the generalizability of our findings to the overall ADHD population (notably linked to selection bias), we believe that this exploratory study sheds light on the potential clinical relevance of narcissistic pathology in adult ADHD patients. [ABSTRACT FROM AUTHOR]

Patients with primary or co-occurring narcissistic disorders are seen routinely in general psychiatry settings. Contemporary trends in training and practice have impacted psychiatrists' skills and confidence in identifying and treating these disorders, which can range from relatively benign to high-acuity presentations. The goal of this article is to introduce key principles derived from transference-focused psychotherapy (TFP) for use by clinicians in general practice in their work with patients with narcissistic disorders, even when those clinicians do not routinely provide individual psychotherapy. Practical application of TFP principles in work with patients with narcissistic disorders in general psychiatry are proposed, including in diagnostic evaluation, family engagement, prescribing, and safety assessment and risk management calculus. Many psychiatrists whose practices are focused primarily on psychopharmacology, or a "medical model," may not appreciate fully the impact of pathological narcissism in their work. Clinicians who may benefit from familiarity with TFP principles in work with patients with narcissistic disorders include the approximately one-half of U.S. psychiatrists who do not offer psychotherapy in their practice. [ABSTRACT FROM AUTHOR]

This article provides an overview of the psychological dynamics associated with torture and examines its consequences on the victims. Initially, we investigate the psychological processes driving torturers to engage in extreme violence and brutality. Central to this exploration are the concepts of dehumanization and desensitization, which allow torturers to emotionally distance themselves from their victims and enact their aggressive behaviors. We elucidate how dehumanization and desensitization are often associated with the presence of a disordered personality, such as psychopathy, antisocial personality disorder, and narcissistic personality disorder. Subsequently, we delve into the complex interplay of survival and defense mechanisms utilized by victims during the traumatic experience of torture. We examine how victims may form a traumatic bond with their tormentors as a coping mechanism for their physical and psychological suffering--a bond that may persist even after their release. This bond may manifest as a heteronomous will, in which victims continue to adhere to the torturer's demands even after liberation, resulting in a deconstruction of their identity and a profound sensation of existing as "living dead." This enduring bound can profoundly impact victims' emotions, behaviors, and relationships, contributing to the onset of severe clinical conditions, with evidence showing increased prevalence of post-traumatic stress disorder, anxiety, depression, and somatic symptoms among survivors. Finally, we evaluate therapeutic interventions that have demonstrated effectiveness in treating individuals who have endured torture. Drawing from a diverse range of therapeutic approaches, such as psychodynamic psychotherapy, trauma-focused cognitivebehavioral therapy, narrative exposure therapy, and the wraparound approach, clinicians can address the multifaceted psychological needs of torture survivors. Through empathetic and respectful therapeutic interventions, torture victims can receive the necessary support to navigate through the processing of their traumatic experiences. Consequently, they can regain a sense of agency and restore their self-esteem, thereby progressing along the trajectory towards achieving healing and recovery. [ABSTRACT FROM AUTHOR]

Background: Dimensional conceptualization of personality pathology may be useful to describe and understand the nature of different manifestations of personality pathology, including malignant narcissism. Recently, a sound scoring procedure for malignant narcissism (i.e., MNARC index) based on the Personality Inventory for DSM-5 trait scores was proposed. The present study aimed at providing further evidence of the reliability and validity of the MNARC index in a sample of community-dwelling adults and in a sample of psychotherapy adult participants. Methods: Community-dwelling participants (N = 288; 59.4% female; mean age = 32.69 years), and psychotherapy participants (N = 168; 58.3% female; mean age = 34.52 years), were administered the Personality Inventory for DSM-5 and Five Factor Narcissism Inventory-Short Form. Moreover, community-dwelling adults completed the Machiavellianism Inventory-Version IV, Triarchic Psychopathy Measure, and Self-Report of Delinquency Scale; rather, clinical participants were administered the Structured Clinical Interview for DSM-5 Personality Disorders, Clinician- Administered Nonsuicidal Self-Injury Disorder Index, Columbia Suicide Severity Rating Scale, Aggression Questionnaire, and Structured Clinical Interview for the DSM-5 Alternative Model for Personality Disorders Module I. Results: The MNARC index showed adequate reliability in both samples, and MNARC index mean score significantly discriminated clinical participants from non-clinical participants; moreover, according to exploratory graph analysis, the 11 PID-5 scale weighted scores shaped a highly coherent personality profile. In the community sample MNARC index was significantly closer to grandiose narcissism than to vulnerable narcissism, as well as to Machiavellianism and even psychopathy. In multiple regression analysis, MNARC index, showed unique, positive, significant and non-negligible contribution to explaining the variation in all social deviance dimensions. Among psychotherapy participants, exploratory graph analysis findings suggested that MNARC index clustered together with histrionic personality disorder, narcissistic personality disorder, and antisocial personality disorder symptom counts, as well as narcissistic grandiosity. Notably, we observed positive and significant associations between MNARC index, and physical aggression, impairment in personality functioning, and self-harming behaviors, respectively. Conclusions: Confirming and extending previous data on the MNARC index, our findings supported the reliability and validity of the MNARC index. Our results expanded our empirical knowledge of malignant narcissism, while providing additional support to the possibility to rely on the Personality Inventory for DSM-5 for assessing constructs grounded in different theoretical perspectives. Although our findings should be considered in the light of several limitations (e.g., non-random nature of our sampling strategy; cross-sectional data), our results may be useful in improving our knowledge of narcissistic features among community and clinical participants. [ABSTRACT FROM AUTHOR]

Sara was a 65‐year‐old Caucasian woman who requested art therapy after the death of her partner. She had experienced incest by her father and verbal abuse by her mother until she left home at 21. Her life was characterized by broken relationships due to alienating anger outbursts and an interrupted work history; she met three criteria for narcissistic personality disorder. Sara initially was socially isolated and intellectualizing. She desired recognition but was fearful of exposure. The Expressive Therapies Continuum (ETC) theoretical framework, which consisted of a gradual progression from cognitively‐dominated sessions to more emotionally focused processing, guided the therapeutic work. The ETC theory encourages transparency and collaboration between therapist and client regarding therapeutic tasks and goals, and provides a framework for addressing and repairing ruptures in the therapeutic alliance. Art therapy began with the cognitive tasks which Sara completed relatively comfortably, then encouraged integration of emotion via expressive writing, diagrams, and body mapping. Through careful attention to repair of ruptures by directly discussing and adapting the direction and tasks of therapy, Sara slowly was able to experience emotions other than anger. She integrated cognitive and emotional insights about her life and developed empathy for her childhood self. At termination Sara had cultivated two friendships and met only one criterion of NPD. Limitations of this case study include a lack of research evidence for ETC‐guided art therapy with NPD clients and by the retrospective approach. Future research efforts could provide this support by encouraging clinicians to conduct prospective case study research. [ABSTRACT FROM AUTHOR]

Persons with pathological narcissism (PN) or narcissistic personality disorder present with a wide array of symptoms and social problems. They need effective psychotherapies but empirical evidence for what works with them is mostly lacking. In this issue of the Journal and Clinical Psychology: In Session four authors from different orientations described single cases of patients suffering from different manifestations of PN. In this commentary we reviewed in detail the four cases and tried to distill (a) the treatment principles adopted; (b) the actual mechanisms of therapeutic change. We hope that the list of principles and mechanisms and change we identified here can help both clinicians and researchers develop and test effective options for persons with PN who are difficult to treat but do have chances to change in a meaningful way in treatment. [ABSTRACT FROM AUTHOR]

The following case study provides a description of the transference‐focused psychotherapy (TFP) treatment of a young man diagnosed with narcissistic personality disorder (NPD). TFP is an individual, psychodynamic therapy developed to treat a range of personality disorders. TFP is evidence‐based for the treatment of borderline personality disorder and has been adapted for the treatment of NPD. This case illustrates the application of the strategies and techniques of TFP to treatment of NPD as well as challenges clinicians may face in arriving at timely diagnosis of the disorder. Although no specific treatment for NPD has been empirically validated, TFP utilizes the therapeutic techniques identified across modalities for successful treatment of pathological narcissism. This report describes how treatment interventions such as goal setting, developing a therapeutic alliance, using a treatment contract and addressing treatment interfering behaviors contributed to this patient's improvement in self‐reflection, formation of healthier and more flexible ideas about self and other, increased self‐agency, tolerance of normative disillusionments and increase in empathy. [ABSTRACT FROM AUTHOR]

Pathological narcissism is a personality constellation comprising distorted self‐image, maladaptive self‐esteem regulation, and difficulties in intimate relationships. Patients with elevated pathological narcissism may not necessarily meet criteria for narcissistic personality disorder, and may seek treatment for a range of mental health concerns across various clinical settings. An understanding of key principles of control‐mastery theory (CMT) can help clinicians understand the specific goals and challenges of the individual patient with pathological narcissism, and can illuminate ways in which the patient may work in psychotherapy. This paper outlines how patients with pathological narcissism may engage in testing of their pathogenic beliefs, and how therapists can respond in ways that facilitate the patient's sense of safety and foster psychological work. The role of the therapist's attitude is highlighted as a means for countering pathogenic beliefs associated with pathological narcissism. Clinical material from a single case of time‐limited supportive psychotherapy will be used to illustrate these principles and associated therapeutic processes. Insights from CMT regarding pathogenic beliefs and the patient's plan for addressing them can help to explain how therapy works or does not work for patients with pathological narcissism. [ABSTRACT FROM AUTHOR]

In order to effectively treat individuals suffering from Narcissistic Personality Disorder (NPD), it is crucial to establish therapeutic goals and identify tasks to achieve them. However, this is a challenging process with NPD patients because they often struggle to find meaningful goals beyond the pursuit of status. Moreover, in order to change Furthermore, to promote change, they must confront painful emotions such as shame, guilt, or fear, which they habitually try to avoid. Additionally, they face difficulties in forming a positive perception of their therapists and cooperating towards mutually agreed‐upon goals and tasks. As a consequence, NPD patients ask for change but hardly engage themselves in the work necessary to achieve it. Therapists therefore need to pay the uttermost attention to drafting, negotiating and continuously updating a reasonable and realistic therapeutic contract. In this paper we describe the story of a man in his thirties with NPD who was ridden with depression, guilt, envy and anger and did not find ways to pursue the healthy and adaptive behaviors he would need to pursue in order to leave a richer social life. The therapist overcame ruptures in the therapeutic alliance and then involved the patient in a process where they set the steps to follow, making sure the patient was convinced they made sense. After a contract was reached progress became possible. Implications for the role of the therapeutic contract in NPD treatment are discussed. [ABSTRACT FROM AUTHOR]

This article examines the challenges and potential for treating individuals with Narcissistic Personality Disorder (NPD). It acknowledges historical beliefs that NPD was difficult to treat, but presents more recent clinical observations that suggest treatment is possible. The article discusses the specific challenges therapists face when working with NPD patients, such as high dropout rates and slow progress, and emphasizes the importance of understanding the co-creation of treatment difficulties. It also explores different approaches to treatment development for NPD, aiming to provide clinicians with insights into effective interventions and promote a more hopeful approach to treatment. [Extracted from the article]

Homework assignments, or specific tasks patients are asked to engage in or complete between sessions, are a controversial topic among psychoanalysts. While many argue these interventions contradict psychoanalytic principles, others believe they can help address problems and promote coping skills. We propose that homework can be a legitimate aspect of relational psychoanalysis when used in a way that is attuned to the patient's experience and that homework may be an important component of treating personality disorders (PD). We present the case of a man diagnosed with narcissistic PD. He often felt superior to and reported that he despised others, though the core self‐image was of fragile. He embraced the role of the omnipotent caregiver, which came with boredom and anger and lack of satisfaction in his social life. The patient tried to control therapy, asserting that he could psychoanalyze himself. As a result, therapy was stalled and progress was limited. At this point, the therapist asked him to complete homework assignments that encouraged him to refrain from his compulsive caregiving to better understand what motivated this behavior. Through this process, the patient came to realize he acted out of avoidance, as he did not want to disclose his own vulnerabilities and flaws. At that point he was able to experience relationships while adopting different stances and finding new meanings. We argue that homework can be fully integrated into the relational psychoanalytic repertoire to improve self‐reflection and foster change in patients with PD. [ABSTRACT FROM AUTHOR]

Clinical and subclinical forms of narcissism may increase suicide risk. However, little is known and there are controversies on this topic. This systematic review aims at providing an overview of studies investigating this association. We used PubMed, Scopus, and PsycInfo databases and followed PRISMA. We focused on cohort, case-control, cross-sectional and case series studies. We referred to both clinical (i.e., narcissistic personality disorder (NPD) and/or NPD criteria) and subclinical forms (i.e., grandiose and vulnerable narcissistic traits) of narcissism. Moreover, we considered: Suicidal Ideation (SI), Non-Suicidal Self-Injury(s) (NSSI), Deliberate Self-Harm (DSH), Suicide Attempt(s) (SA), Suicide Risk (SR), and Capability for Suicide. We included 47 studies. Lack of association between NPD diagnosis/criteria and suicide-related outcomes (SI) or mixed results (SA) were found. Higher homogeneity emerged when considering narcissistic traits. Vulnerable narcissism was associated with SI, less impulsive NSSI, and DSH. Grandiose narcissism was associated with severe NSSI and multiple SA with high intent to die, but it was protective against SI and SR. Vulnerable narcissism seemed to be associated with suicide-related outcomes characterized by low intent to die, while grandiose narcissism seemed to be a risk factor for outcomes with high planning and severity. Between-study heterogeneity and lack of longitudinal studies. Assessing suicide risk in subjects with clinical or subclinical forms of narcissism may be useful. Moreover, considering the most vulnerable form of narcissism, and not just the grandiose one, may contribute to a more nuanced risk stratification and to the identification of distinct therapeutic approaches. [Display omitted] [ABSTRACT FROM AUTHOR]

Narcissistic personality disorder (NPD) is a personality disorder that affects various aspects of life, including relationships, employment, school, and finances. Persons with NPD usually feel unhappy and disappointed when no one helps them and is not praised for their achievements. Diagnosing narcissism is generally done using a screening test that consumes time and costs a lot. This research aims to evaluate the performance of several feature selection (FS) approaches on machine learning (ML) techniques (support vector machine (SVM), random forest classifier (RFC), and Naive Bayes). Three scenarios of FS (all features, the information gain technique and the gain ratio (GR) feature technique) are used for each ML method. Several experiments using the benchmark narcissistic disorder dataset have been done. It adopts the k-fold cross-validation (10-fold cross-validation) strategy. We evaluate the method's performance by measuring its accuracy, error rate, and processing time. It is shown that the RFC GR strategy gives the best performance with an accuracy of 100%. [ABSTRACT FROM AUTHOR]