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

Sibling Abuse

While other forms of domestic violence, such as child and partner abuse have been widely recognized by the clinical world as matters of a serious nature (which has been demonstrated through research, intervention programs, and public outreach), sibling abuse has remained largely ignored over the past 40 years (Ammerman & Hersen, 1991; Caspi, 2012; Kiselica & Morrill-Richards, 2007; Morrill & Bachman, 2013; Phillips-Green, 2002). As sibling abuse has not received much recognition by professionals and, consequently, the public, it is a phenomenon often dismissed and misunderstood. Given the hidden nature of sibling abuse, this form of domestic violence tends to last over a long period of time and is may result in devastating long-term consequences. The handful of studies that have been conducted related to sibling abuse have found that both survivors and perpetrators experience a higher risk of developmental delays, depression, low self-esteem, deficits related to interpersonal competencies, drug abuse, and dating violence than those who have not survived or perpetrated sibling abuse (Caffaro & Conn-Caffaro, 2005; Caspi, 2012; Duncan, 1999; Morrill-Richards, 2009; Morrill-Richards & Leierer, 2010)

Siblicide: The Psychology of Sibling Homicide

Siblicide has been overlooked in both the family violence literature and homicide studies. This is unsurprising as sibling abuse research in general has remained on the periphery until recently, and since then has tended to focus on non-lethal conflict, bullying or bi-directional aggression. This chapter examines the available literature to present a comprehensive overview of this poorly understood phenomenon. We report on prevalence rates, the sociodemographic context of offenses and the patterns and dynamics that underpin offender and victim characteristics - including age, birth order, gender, genetic-relatedness, race and cultural collectivism. Individual risk factors such as the influence of psychopathology and substance use are explored, as well the impact of developmental disorders, that is, Autism and Asperger’s syndrome. The chapter will conclude by examining sibling homicide in the context of sociobiological and psychoanalytical perspectives

Idealism, violence and censure

This chapter builds on Sumner’s (1990, 1997, 2015) research by drawing attention to the work of Erich Fromm ([1941] 1969) and Ernest Becker (1975). Whilst there are important differences between their approaches, both theorists directly address the unconscious desires that motivate people to engage in extreme violence and other forms of destructive behaviour. The main themes addressed by Fromm and Becker will be discussed in relation to Cottee and Hayward’s (2011) research on the existential attractions of engaging in terrorist acts. The chapter concludes by considering the different ideas put forward by Fromm and Becker concerning the possibility for living in a more open, tolerant and less destructive world