Elsevier

Psychiatry Research

Volume 256, October 2017, Pages 156-161
Psychiatry Research

Pathological narcissism and maladaptive self-regulatory behaviours in a nationally representative sample of Canadian men

https://doi.org/10.1016/j.psychres.2017.06.009Get rights and content

Highlights

  • Severity of pathological narcissism was found to be higher among younger men compared to middle-aged and older men.

  • Pathological narcissism was associated with alcohol and drug overuse, and aggressive and risk-taking behaviour.

  • The relationship between pathological narcissism and drug use was more pronounced among younger men.

  • The relationship between pathological narcissism and risk-taking was more pronounced among men with higher symptom distress.

Abstract

Clinical observation has linked externalizing coping strategies such as substance overuse and aggressive behaviours with narcissistic personality dysfunction. This study examined the relationship between pathological narcissism and maladaptive self-regulatory behaviours among Canadian men. An online survey was distributed among a stratified, nationally representative sample of 1000 men from across Canada. The survey included brief self-report measures of pathological narcissism, maladaptive externalizing coping behaviours, and general psychological distress. After controlling for the effects of age and general psychological distress, pathological narcissism was found to be significantly associated with alcohol overuse and aggressive behaviour. Significant though modest interaction effects were found between pathological narcissism and age – with regards to drug use – and distress – with regards to risk-taking behaviour. The findings point to the need for attention to narcissistic dysfunction as a clinical and public health issue among men.

Introduction

Narcissistic personality attributes continue to fascinate the public. The label “narcissistic” carries a profound stigma, often used to denote a self-absorbed and socially offensive individual who ultimately deserves rebuke. Yet a form of narcissism well-known to clinicians (Ogrodniczuk, 2013, Ronningstam, 2005) is associated with distress and impairment (Miller et al., 2007), and linked with other clinical concerns including interpersonal problems (Ogrodniczuk et al., 2009), depressive tendencies (Kealy et al., 2012), and suicidality (Ansell et al., 2015; Blasco-Fontecilla et al., 2009). This personality constellation, known as pathological narcissism, hinges upon distortions and fluctuations of self-image and admiration needs (Cain et al., 2008; Pincus et al., 2015; Ronningstam, 2011); severe clinical presentations are often diagnosed as narcissistic personality disorder. Where a stable but dynamic view of the self – including realistic positive appraisals – is a normal component of identity, pathological narcissism is defined by unstable and/or maladaptive regulation of self-image (Pincus and Lukowitsky, 2010, Ronningstam, 2011). Grandiose features – involving inordinate self-inflation and admiration-seeking – and vulnerable features – involving dysphoria and diminished self-esteem – often co-exist in a manner that can appear incongruous and perplexing. Indeed, while narcissistic subtypes have been described using various labels (see Cain et al. (2008) for a review), fluctuations between grandiose and vulnerable states are commonly observed (Gore and Widiger, 2016), and mixed presentations feature prominently in the clinical and theory-based literature (Caligor et al., 2015, Cooper, 2009; Kernberg, 2014; Kohut and Wolf, 1978; Kealy and Rasmussen, 2012; Levy, 2012; Pincus et al., 2014). This latter literature widely regards deficiencies and distortions of self-image as constituting the core of pathological narcissism: “narcissistic patients are desperately attempting to manage their vulnerability” (Gabbard and Crisp‐Han, 2016, p. 116).

The maladaptive self-regulatory strategies of those who suffer from pathological narcissism extend beyond fantasies of brilliance and admiration. Several authors have noted that narcissistic patients may turn to externalizing, sensation-seeking behaviours in order to diminish awareness of shame-related affects or combat feelings of emptiness (Grosch, 1994, Kernberg, 1984, Kohut and Wolf, 1978). Drugs or alcohol may be employed in an attempt to neutralize painful experiences of narcissistic injury, while risk-taking behaviour (e.g., reckless driving, risky sexual activity) may contribute a sense of aliveness during times when admiring responses from others are in short supply. Kohut also described the phenomenon of narcissistic rage, wherein the individual explodes with anger and/or aggression in response to feelings of inadequacy, shame, or humiliation (Kohut, 1972). Externally directed rage is thus thought to temporarily relieve the painful affects associated with a weakened self-representation and restore a sense of potency.

Partial support for the association between narcissistic features and maladaptive self-regulatory strategies can be found in the empirical literature (see Dowgwillo et al. (2016) for a review). Among college undergraduates, grandiose narcissism has been found to be associated with alcohol and drug use (Buelow and Brunell, 2014; Hill, 2015; MacLaren and Best, 2013), including binge drinking (Luhtanen and Crocker, 2005), as well as aggressive and dangerous driving (Edwards et al., 2013; Hill, 2015) and risky behaviours (Buelow and Brunell, 2014, Foster et al., 2009). Pathological narcissism, encompassing both grandiose and vulnerable features, was found to be associated with substance overuse in a sample of Iranian undergraduates (Mowlaie et al., 2016). Among student samples, aggression has been linked with both vulnerable (Fossati et al., 2010, Krizan and Johar, 2015, Lobbestael et al., 2014) and grandiose narcissism, particularly in the context of ego threat experiences (Bushman and Baumeister, 1998; Fossati et al., 2010; Lobbestael et al., 2014). Among clinical samples, narcissistic grandiosity has been associated with aggressive behaviour among both inpatient (Goldberg et al., 2007) and outpatient samples (Ellison et al., 2013).

Studies investigating the relationship between narcissism and maladaptive self-regulatory behaviours in more representative community samples are comparatively scarce. Findings from the National Epidemiologic Survey on Alcohol and Related Conditions revealed associations between features of grandiose narcissism and substance use (Stinson et al., 2008), as well as reports of violent behaviour – particularly when combined with impulsive traits (Larson et al., 2015). Interestingly, community studies have found an inverse relationship between narcissism and age, with higher levels of narcissistic personality features observed among younger adults (Stinson et al., 2008). Identity-related maturational processes may contribute to reduced narcissistic dysfunction (Cramer, 2017), and perhaps to a broadening of self-regulatory strategies. Given the relatively limited perspective of narcissism assessed in previous studies, further research regarding these associations in large representative community samples is warranted. The present study examined pathological narcissism – including vulnerable elements – and maladaptive self-regulatory behaviours in a nationally representative sample of Canadian men. Examining this issue among men is particularly warranted given their higher rates of substance abuse and aggression compared to women (Archer, 2004, Brady and Randall, 1999).

Our first objective was to explore the severity of narcissistic tendencies among Canadian-based men in the general community. We included age in this exploration and in subsequent analyses, due to most previous narcissism research involving young adult samples, and given previous reports of significant age differences in narcissistic dysfunction. Our second objective was to investigate the relationship between narcissistic features and men's use of unhealthy coping strategies, including drug and alcohol overuse, angry and aggressive behaviour, and risk-taking behaviour. Since these coping responses are likely to be influenced by psychological distress, we sought to control for this when examining narcissism and maladaptive self-regulatory behaviours. We hypothesized that pathological narcissism would be significantly positively associated with each of the aforementioned maladaptive behaviour domains, even after controlling for the effects of general psychological distress. Finally, we examined potential interactions between pathological narcissism, age, and psychological distress. This was an exploratory investigation regarding the potential moderating effects of age and distress on the relationship between pathological narcissism and maladaptive behaviours.

Section snippets

Sample

The sample was a non-probability sample of 1000 Canadian men who took part in a national survey regarding men's mental illness, conducted in April 2016. Respondents were sourced from a Canadian online survey provider and screened regarding eligibility criteria, which consisted of being over the age of 19 years, being able to read English, and having access to the internet. Weighted randomization was then used to select respondents for the survey. Further screening was done to meet

Results

The mean K6 score for respondents was M = 7.51 (SD = 5.38). Scores on the MDRS-22 substance use subscales were M = 0.63 (SD = 1.51) and M = 1.12 (SD = 1.72) for Drug Use and Alcohol Use, respectively. Men's MDRS-22 Anger / Aggression scores were M = 1.39 (SD = 1.68), and Risk-taking scores were M = 0.99 (SD = 1.43). The mean pathological narcissism score is presented in Table 1, along with the results of t-test comparisons of the present sample (both overall and by age groups) with the

Discussion

The findings from this study provide evidence for the relationship between narcissistic dysfunction and men's use of unhealthy self-regulatory behaviours. Although general psychological distress accounted for a larger portion of the variance, pathological narcissism nonetheless emerged as being significantly related to several behaviours that often signify externalizing depressive symptoms among men. Narcissistic features were associated with substance overuse, angry and aggressive behaviours,

Acknowledgement

Thanks to Intensions Consulting (http://www.intensions.co/) for assisting with data collection and analysis.

References (59)

  • M. Mowlaie et al.

    Pathological narcissism, brain behavioral systems and tendency to substance abuse: the mediating role of self-control

    Pers. Individ. Differ.

    (2016)
  • J.S. Ogrodniczuk et al.

    Interpersonal problems associated with narcissism among psychiatric outpatients

    J. Psychiatr. Res.

    (2009)
  • S.M. Rice et al.

    Development and preliminary validation of the male depression risk scale: furthering the assessment of depression in men

    J. Affect. Disord.

    (2013)
  • E.B. Ansell et al.

    Personality disorder risk factors for suicide attempts over 10 years of follow-up

    Pers. Disord.

    (2015)
  • J. Archer

    Sex differences in aggression in real-world settings: a meta-analytic review

    Rev. Gen. Psychol.

    (2004)
  • H. Blasco-Fontecilla et al.

    Specific features of suicidal behavior in patients with narcissistic personality disorder

    J. Clin. Psychiatry

    (2009)
  • R.P. Brown et al.

    Of tails and their dogs: a critical view of the measurement of trait narcissism in social-personality research

  • B.J. Bushman et al.

    Threatened egotism, narcissism, self-esteem, and direct and displaced aggression: does self-love or self-hate lead to violence?

    J. Pers. Soc. Psychol.

    (1998)
  • E. Caligor et al.

    Narcissistic personality disorder: diagnostic and clinical challenges

    Am. J. Psychiatry

    (2015)
  • A. Cohn et al.

    Effects of masculine identity and gender role stress on aggression in men

    Psychol. Men. Masc.

    (2006)
  • A.M. Cooper

    The narcissistic-masochistic character

    Psychiatr. Ann.

    (2009)
  • E.A. Dowgwillo et al.

    The dark side of narcissism

  • B.D. Edwards et al.

    The validity of narcissism and driving anger in predicting aggressive driving in a sample of young drivers

    Hum. Perform.

    (2013)
  • W.D. Ellison et al.

    The impact of pathological narcissism on psychotherapy utilization, initial symptom severity, and early-treatment symptom change: a naturalistic investigation

    J. Pers. Assess.

    (2013)
  • A. Fossati et al.

    Relations of proactive and reactive dimensions of aggression to overt and covert narcissism in nonclinical adolescents

    Aggress. Behav.

    (2010)
  • G.O. Gabbard et al.

    The many faces of narcissism

    World Psychiatry

    (2016)
  • B.R. Goldberg et al.

    Predictors of aggression on the psychiatric inpatient service: self-esteem, narcissism, and theory of mind deficits

    J. Nerv. Ment. Dis.

    (2007)
  • W.L. Gore et al.

    Fluctuation between grandiose and vulnerable narcissism

    Pers. Disord.

    (2016)
  • W.N. Grosch

    Narcissism: shame, rage and addiction

    Psychiatr. Quart.

    (1994)
  • Cited by (26)

    • Development and validation of the super-short form of the Five-Factor Narcissism Inventory (FFNI-SSF)

      2021, Personality and Individual Differences
      Citation Excerpt :

      Narcissism is a personality construct with a long history in multiple subfields of psychology and is associated with dysfunction in several realms, such as impaired relationships (e.g., Miller et al., 2007), cognitive biases (e.g., Rhodewalt & Morf, 1998), alcohol and drug overuse (Kealy et al., 2017), aggressive and risk-taking behavior (Kealy et al., 2017), and psychopathology (Pincus et al., 2009).

    • Narcissism and devaluing others: An exploration of impaired control over drinking as a mediating mechanism of alcohol-related problems

      2019, Personality and Individual Differences
      Citation Excerpt :

      In contrast, higher levels of devaluing were also indirectly linked to more alcohol-related problems, through more IC and more heavy-episodic drinking [mediated effect = 0.018, Z = 3.437, p < 0.001, 99% C.I. (0.007, 0.035)]. According to the Ego-Threat-Hypothesis (Baumeister, 1997), those with vulnerable self-concepts have more to lose (Kernis et al., 1993), which may be associated with individuals turning to externalizing behaviors, such as drinking, to temporarily assuage the pain of a weakened self-representation (Kealy et al., 2017). While we did find evidence that vulnerable facets (i.e. entitlement-rage and devaluing) were associated with drinking outcomes, contingent-self-esteem was not.

    View all citing articles on Scopus
    View full text