Narcissism in patients admitted to psychiatric acute wards: its relation to violence, suicidality and other psychopathology

<p>Abstract</p> <p>Background</p> <p>The objective was to examine various aspects of narcissism in patients admitted to acute psychiatric wards and to compare their level of narcissism to that of an age- and gender-matched sample from the general population (NORM).</p> <p>Methods</p> <p>This cross-sectional study interviewed 186 eligible acute psychiatric patients with the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF). The patients filled in the Narcissistic Personality Inventory-21 item version (NPI-21), The Hospital Anxiety and Depression Scale (HADS) and the Rosenberg Self-Esteem Scale. High and low narcissism was defined by the median of the total NPI-21 score. An age- and gender-matched control sample from the general population also scored the NPI-21 (NORM).</p> <p>Results</p> <p>Being male, involuntary admitted, having diagnosis of schizophrenia, higher self-esteem, and severe violence were significantly associated with high narcissism, and so were also low levels of suicidality, depression, anxiety and GAF scores. Severe violence and high self-esteem were significantly associated with high narcissism in multivariable analyses. The NPI-21 and its subscales showed test-retest correlations ≥0.83, while the BPRS and the HADS showed lower correlations, confirming the trait character of the NPI-21. Depression and suicidality were negatively associated with the NPI-21 total score and all its subscales, while positive association was observed with grandiosity. No significant differences were observed between patients and NORM on the NPI-21 total score or any of the NPI subscales.</p> <p>Conclusion</p> <p>Narcissism in the psychiatric patients was significantly associated with violence, suicidality and other symptoms relevant for management and treatment planning. Due to its trait character, use of the NPI-21 in acute psychiatric patients can give important clinical information. The similar level of narcissism found in patients and NORM is in need of further examination.</p

How does it feel to be a narcissist? : narcissism and emotions

Emotional processes are of key importance for the understanding of narcissism, in both its grandiose and its vulnerable forms. The current chapter provides an overview on the links between narcissism and emotionality. The two forms of narcissism differ distinctly in their hedonic tone, with vulnerable narcissism being characterized by negative emotionality and low well-being and grandiose narcissism being linked to positive emotionality and high well-being. Both forms are related to strong mood variability that is thought to stem from contingent self-esteem. Both forms are related to hubristic pride, but only vulnerable narcissism is linked to shame-proneness, envy, and schadenfreude. Both forms are characterized by outbursts of anger, but the underlying causes and the expression of anger differ between the two forms. Specifically, vulnerable narcissism is linked to uncontrollable narcissistic rage that stems from a fragile sense of self and results in disproportionate and dysfunctional aggression. Grandiose narcissism, in contrast, goes along with instrumental aggression that serves the purpose of asserting one's dominance in the face of strong direct status threats. Vulnerable narcissism is related to deficits in emotion regulation, yet research has just begun to shed light on the regulation processes of grandiose narcissists. The chapter concludes with reflections on how recent theoretical and methodological developments might be employed to gain a fuller understanding of narcissists' emotional lives