Core Aspects of Grandiose Narcissism in Childhood: Grandiosity and Entitlement in Social Context

Arriving at a definition of narcissism has been a controversial process. Recently, two defining aspects of narcissism have been identified, self-importance and entitlement, that can be expressed both grandiosely and covertly (Krizan & Herlache, 2018). The present project focuses on grandiose narcissism in children. Grandiose narcissism is understood as multidimensional (e.g., with dimensions of grandiosity and entitlement) but research on its core aspects in children is limited. A better understanding of the dimensions of narcissism in children is critical, primarily because they have been shown to relate to different outcomes in adults. Evidence suggests that entitlement is associated with more problematic social outcomes than grandiosity. The aim of this project was to assess the potentially different social correlates of grandiosity and entitlement in children. This was achieved using self-report and peer-report data collected in a short-term longitudinal design with 5th and 6th grade students in Montreal, Quebec, Canada and Barranquilla, Colombia. The results of Study 1 suggest that grandiosity and entitlement are two related but distinct dimensions of grandiose narcissism in children, measurable across two cultural contexts. Grandiosity in particular was associated with positive self-appraisals of social competency and self-worth, above and beyond acceptance by peers. Study 2 assessed the relation between grandiosity/entitlement and peer-assessed prosocial behaviours (care, justice, comfort, proactive and reactive help) and aggression (physical and relational). Within time, entitlement was found to negatively relate to all prosocial behaviours, and prior levels of entitlement negatively predicted later care and justice. Prior levels of entitlement also positively predicted subsequent physical aggression. These same patterns were not found for grandiosity. Study 3 assessed how grandiosity and entitlement, respectively, predicted popularity while accounting for characteristics of the social and cultural context. A key and consistent finding across our models was that entitlement more negatively predicted popularity in classrooms high in communal care, as well as in Barranquilla as compared to Montreal. The opposite pattern was observed for grandiosity in some of the models. Together, these studies provide support for these two dimensions of narcissism being distinct and that the social consequences of entitlement are of particular concern

A Model of Boys' Body Image in Early Adolescence

"Das Hauptziel dieser Studie galt der Identifizierung essentieller Faktoren der Körperbildentwicklung in einer nicht-klinischen Stichprobe von Jungen unter Berücksichtigung möglicher Einflüsse durch Peers, Familie und Medien. Es wurden semi-strukturierte Leitfadeninterviews mit 14 früh-adoleszenten Jungen (Altersrange von 10-12 Jahren) geführt, die zufällig aus den Teilnehmern einer größeren quantitativen Fragebogenstudie (N=167) an Grundschulen in Berlin ausgewählt wurden. Mittels thematischer Analyse konnten zwei Hauptthemen identifiziert werden: (1) sozialer Vergleich (beinhaltet die beiden Subthemen Selbst-Verbesserung und Selbst-Erhöhung) und (2) Internalisierung (beinhaltet die beiden Subthemen behaviorale und kognitive Dimensionen). An Hand der Ergebnisse wurde schließlich ein finales Modell erstellt, das die Konzeptualisierung des Körperbildes von Jungen in der frühen Adoleszenz abzubilden sucht." (Autorenreferat)"The major aim of this study was to explore and promote a deeper understanding of the essential contributing factors to body image development in a non-clinical sample of boys, including the roles played by peers, family, and media. In this study, semi-structured interviews were conducted with a sample of 14 adolescent boys (ranging in age from 10-12 years) who were randomly selected from the participant pool of a larger quantitative study (N=167) conducted in elementary schools in Berlin, Germany. By using thematic analyses, two major themes were identified: (1) social comparison (including two subthemes: self-improvement and self-enhancement), and (2) internalization (including two subthemes: behavioral and cognitive dimensions). On the basis of these results, a final model of how boys conceptualize body image in early adolescence was elucidated, and can be found in the study." (author's abrstact

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely