Edited hy

Charles  G. Costello


A  Wilcy-lntcrscicncc Puhlication

John Wiley  &  Sons. Inc.

New York      •    Chichester        •     Brisbane       •     Toronto      •     Singarorc






The second half of this century  has witnessed an unprecedented  interest in narcissism. From its obscure origins, the legend of Narcissus has be­ come the myth for our times. Although the reasons for the recent rise in popularity of narcissism are complex and overdetermined, two develop­ ments are noteworthy. From the 1960s onward, the construct of narcis­ sism has played a vital role in metapsychological debates within the psychoanalytic community. At stake was the primacy of the self or the whole person over the tripartite structure comprising the id, ego, and superego (Stolorow, 1975). The debate was simultaneously fueled by the development of new therapeutic techniques that made it possible to treat. hitherto deemed untreatable, patients with narcissistic personality dis­ orders (Adler,  1986 ).

Although the psychoanalysts may have provided the necessary tools for the understanding of narcissism, its popularity within the mainstream culture was aided by a growing perception after World War 11 that. for helter or worse, Americans were becoming more and more self-oriented. According to Kohut (1977), the beginning of this century was marked hy the centrality of the “Guilty Individual.” a person who was typically brought up in an extended family system and who. because of overst im­ ulation in childhood. had to struggle as an adult with unresolved oedipal feelings and conflicts between the id, ego, and the superego. In contrast. the contemporary “Tragic Individual”-a product of the nuclear fam­ ily-is more susceptible to understimulation as a child and consequently in adulthood faces the ever-present danger of fragmentation of the self.

The writing of this  chapter  was  supported  in  part  by  a  Wellesley  College  Faculty Award. I would like lo thank Ashley Hull for  her  help in  researching  !he currenl  lilcr­ aiure   on narcissism.

In analogous terms. Masterson (1990) depicts a historical shift in psycho­ pathology from preoccupation with guilt and neuroses to a new concern with boredom. meaninglessness. and the search for a real or authentic sense of the self. Kohut ‘sand Masterson’s depiction of a person grappling with issues of fragmentation, authenticity, and meaning reflects well the plight of the postmodern individual. It challenges us with a vision of life in times when old truths arc being deccntered and where new meanings have to be actively constructed rather than accepted as a legacy of past gene rat ions.

In distinction to Kohut ( 1977). Lasch ( 1979) perceives  the societal turn toward narcissism as a sad reflection on American culture in the age of diminished expectations. For Lasch, the contemporary  emphasis  on the self is a defense against the threat posed by a dying culture, which has become devoid of old meanings and depicted by the abandonment of com­ munal values.

Irrespective of our ultimate explanation for the increase in preoccupa­ tion with the self, the rapid growth of interest  in narcissism  has resulted in a wealth of publications and review articles on the subject matter. Com­ prehensive reviews of psychoanalytic and psychiatric research on narcis­ sism arc provided by Akhtar (1989) and Volkan (1982). Ornstein (1978) and Baker and Baker (1987) offer excellent introductions to the, at times, daunting writings of Kohut, and Gunderson, Ronningstam, and Smith (1991) report on the recent psychiatric research on symptoms that differ­ entiate  narcissism  from other personality disorders.

111 distinction to past reviews. the focus of this chapter is on quanti­ tative rl·search  into narcissism construed  as a continuous dimension and a source of individual variation. Following a brief exposition of the com­ monly accepted, psychoanalytically based theory of narcissism and its development (the Received View).  I will  discuss issues  of assessment and symptomatology and then survey the imp) ications of narcissism for self-esteem. affect. real-life oufcomcs. childhood and adult  develop­ ment. and gender. Most of the work reviewed in this chapter comes from the field of psychology and relics on self-report  narcissism  scales  to study group and individual differences primarily in colle!!e populations. Just as 1-‘rcud assunwd that the study of ahnonnal  psychic  processes would shed light on healthy functioning. so. conversely. the present re­ view is based on the assumption that research on narcissism in the nonpsychiatric population will shed light on psychopathology.  This chapter asks these questions: How much empirical support does main­ stream academic psychology provide for the Received View? and, To what extent do quantitative studies of group and individual differences contribute to the broadening  of our  clinically  based  understanding  of the  narcissistic  personality?




Broadly defined, narcissism means a concentration of psychological  in­ terest on the self ( Bursten, 1982). Construed in this way, narcissism is de­ void of pathological significance and is an essential ingredient of healthy functioning.  Self-oriented   mental   activity   is  necessary   for  robust self­ esteem,  personal  cohesiveness,  and  stability  (Stolorow,  1975).  It is also a precursor to creativity, wisdom, and empathy (Kohut, 1966). Theim­ portant question then is not who possesses narcissistic characteristics, because we all do, but rather when, and why does the process of sci f­ investment go astray? Despite a history of heated theoretical  debates, there appears to have emerged a relatively consensual psychoanalytic for­ mulation of the origins and phenomenology of narcissistic pathology. I call this consensual characterization the Receil’ed Viel\’.

Pathological narcissism is the product of unempathic parenting ( Kcrn­ berg, I 975; Kohut, 1971, 1977; Miller, 1981 ). In the case of narcissism, unlike the case of borderline personalities, the lack of attuncmcnt is not catastrophic enough to prevent the development of a basic sense of sci for identity. Nevertheless, it is serious enough to result in the child’s. and sub­ sequently the adult’s, use of splitting (Kernberg, 1975). In other words, there is a lack of proper integration of positive and negative affect and a tendency toward self-fragmentation. Typically, the narcissistic individual has a history of being taken care of by a cold and vulnerable parent who uses  the  child  to regulate  his or  her own fragile  psychical  functioning ( Kohut, 1971 ). Alternatively, the child might identify strongly with a par­ ent who is quite narcissistic in order to escape from the other parent who is even more psychologically disturbed ( Masterson, 1990). In this in­ stance, once again, the child has to renounce his or her own” true” self and succumb to being used by the other. Narcissistic individuals are frequently treated as “special” by their parents because of their being firstborn, hav­ ing exceptional beauty or talent (Kernberg, 1975), or empathising with parental overt wishes and unconscious desires ( Miller. 1981 ). The out­ come of a prolonged (unmitigated by external sources such as grandpar­ ents or school teachers) history of lack of attunement to one’s childhood needs, is the simultaneous development of a grandiose sense of  the self and feelings of vulnerability and inferiority ( Kohut, 1977 ).

Although a broad consensus exists regarding the central place of grandiosity in narcissistic pathology,  there  is disagreement  concerning its origins. For Kohut ( 1977, 1984), it is a product of a developmental ar­ rest and reflects an only partially transformed grandiosity of the young child. According to Kernberg (1975), however, the narcissistic grandiose self is a pathological amalgam of psychic representations of the real self, the ideal  self, and the ideal  object  (other),  which  serves  the defensive

function of keeping at hay  feelings of  aggression  and envy.  Whichever way the grandiose self is construed, it is accompanied by split-off, or un­ intcgratcd, feelings of inf’criority and vulnerability that correspond to the narcissist’s awareness of a past history of misuse by the parent(s) (Kohut, 1971 ). Behind the grandiose  facade,  there  is a deeply  ingrained  concern by the narcissistic individual  of  being  ultimately  responsible  for  his  or her true sci f not  being accepted  and celebrated  by  the  parents.

In adulthood, narcissistic grandiosity is typically accompanied by impaired empathy, exhibitionism, a sense of entitlement, and exploita­ tivencss of others ( Kern berg. 1975. 1986 ). In interpersonal relations, nar­ cissism leads to the use of others to fulfill one’s own psychological needs and maintain stability of the self. At times, others are used to affirm or mirror the act ions of the narcissistic individual. On other occasions, nar­ cissistic needs may be met through a merger with an “all powerful” ide­ alized individual. In both instances, the other is related to as a self-object whose value is defined in terms of how well that person functions as a provider of comfort and emotional stability (Kohut, 1984). In addition, interactions with people may be detrimentally affected by projected feel­ ings of envy and aggression that prevent the narcissistic individual from forming deep and close attachments, and may lead him or her to withdraw into “splendid isolation” ( Kernberg. 1975).

In the area of work. the predominant feelings are boredom, dissatis­ faction, and lack of fulfillment and meaning. This attitude may reflect a basic misalignment between what inspires true enthusiasm and the goals or ideals that arc being actually pursued (Kohut, 1977). Alternatively, it may reflect the presence of a false self (Masterson. 1990; Winnicott, 1960/1965), or even a defensive need to devalue one’s own achievement and those of others to avoid overwhelming feelings of envy (Kernberg, 1975).

A final central feature of narcissistic pathology is  the  tendency  to  os­ cillate between feelings of  grandiosity and  those  of inferiority,   depres­ sion. and  depiction.  Usually,  the  1;1ttcr  surface  only  as  a  result  of  failure or slight. When they do emerge. the feelings of  inferiority remain  quite scparale from !he feelings of  grandeur and.  hence.  they  cannot he  inte­ graled i1110 a llcal11ty a11d well 111odula1cd sen<;c of cit. For 11arcis i!-.lie in­ dividuals. healing of the split between positive and negative affect  is  too painful   and   threatening   ( Kern berg. 1975).

From a developmental perspective. narcissism has been  associated with deterioration in midlife. The realization of mortality, physical aging, and the limits to accomplishments potcntiate in narcissistic individuals feelings of envy and resentment (Kernberg, 1980), and also elicit feelings of shame and self-mortification at not having lived a life that was true to their inner  hopes.  wishes, and aspirations (Kohut,  1977). The  resulting defensive devaluation of self and  others and  a sense of depiction  means that the narcissistic individual inhahits a world that is progressively more hostile, lonely, and devoid of meaning and nourisl1111cnt ( Kernhcrg, llJ80).



Several typologies of narcissism have been proposed in the past. Kohut and Wolf ( 1978), for example, distinguished between 111e1J?er-h1111!{ry individu­ als, who must continually attach and define themselves through others; co11tact-shu1111ing individuals, who avoid social contact because of a fear that their behaviors will not be admired or accepted; and mirmr-‘11111!{1″)’ individuals, who tend to display themselves in front of others. In contrast, Bursten ( 1973) proposed four types of narcissistic personalities differen­ tiated by the various strategies used in the process of self-regulation. The cravi11!{ individuals are clinging, demanding, and needy; the para11oid in­ dividuals are critical and suspicious; the manipulative individuals derive satisfaction from conscious and deliberate deception of others; and  the phallic narcissists are aggressive, exhibitionistic, reckless, and daring. This last group has been originally described by Wilhelm Reich  ( 1949).  Nei­ ther of the above two classifications has gained wide acceptance. Kohut’s distinction is too embedded  in  self-psychology,  and  Burstcn’s  schema seems overly  inclusive  of other  types of pathology.

A much wider acceptance has been gained hy the distinction  hctwccn overt (cxhihitionistic) and covert (closet) forms of narcissistic personality. This dichotomy draws on the aforementioned  tendency  of  narcissists  to hold contradictory views of the self (Akhtar & Thomson, 1982; Akhtar, 1989). The majority of narcissistic individuals “impress” others with their open display of grandiosity, exhibitionism, and entitlement. In their case, feelings of inferiority,  depression,  and depletion  surface only  infrequently. A   smaller   but   nevertheless   significant   group   of   “closet    narcissists” ( Masterson, 1981)  present  as  timid, shy,  inhibited,  and  ineffective,  only to reveal their exhibitionistic and grandiose fantasies  on  closer  contact. Their core narcissistic pathology is hidden by a defensive posture of inhi­ bition and passivity ( Masterson, 1990).  Interpersonally, such  individuals may tend more toward relationships based on idealization than mirroring. Gabbard (1989) comments on the DSM-Ill’s (American Psychiatric As­ sociation [APA], 1980) failure to include “the shy quietly grandiose nar­ cissistic individual whose extreme sensitivity to slight leads to an assiduous avoidance of the spotlight” (p. 527 ). The presence of covertly narcissistic individuals  has  been  acknowledged  by both  Kohut  ( 1971) and  Kcrnherg ( 1986).

A second classification of narcissism to gain wider acceptance is based on the severity of the condition. Roth Kernhcrg (1975, 1986) and Masterson ( 1990) divide narcissistic individuals into high-, middle-, and low-functioning groups. High-functioning narcissists rarely seek treat­ ment as they arc well able lo satisfy their needs through their professional careers and relations with others. Such individuals arc frequently  found in artistic and creative professions that allow them to sublimate their ex­ hibitionism and use productively their intellectual interests and  keen sense of empathy. The middle category consists of those narcissistic in­ dividuals whose grandiosity, impaired empathy, exploitativeness, hyper­ sensitivity, and boredom lead them to serious difficulties at  love and work. These individuals may benefit from psychotherapy, though their unique transferences and countertransferences need to be recognized by the therapist. At the bottom, arc those narcissists whose pathology re­ sembles that of borderline individuals.




The recent growth of interest in narcissism  has resulted  in  the develop­ ment  of a  number of self-report  measures  of  the construct. The  majority of these scales were developed combining the DSM-III (APA,  I 980) cri­ teria for the narcissistic personality disorder and the internal consistency method of test construction. The internal consistency  method  produces scales with items that arc highly intercorrelated  with  each other and  with the total scale. The main advantage of measures developed in this way is clarity of interpretation. Their main disadvantage is an insensitivity to the potentially   multifaceted   nature  of  a construct.

The single most  widely  researched  narcissism  scale  developed  using the DSM-I II criteria and the internal consistency method  is  the  Narcis­ sistic Personality Inventory (NP!; Raskin  &  Hall,  1979,  1981).  Other scales developed  using  the  same’ methodology  arc  the  Wink  and  Gough ( 1990) California Psychological Inventory (CPI) and MM Pl Narcissism scales. Raskin and Novacck’s ( 1989) MMPI Narcissism scale, and the Morey.  Wa11,l.’.h. and  Blashficld  I I 1)85 )  Narcissi,111 scale. This  Inst scale wa developed as part ol a battery of’ measures assessing all 11 DSM-Ill personality disorders. All the preceding scales are  highly  intercorrelated, with rs ranging from .50 to about .80 and  each  scale  correlates  signifi­ cantly with observer ratings of narcissism (Raskin  &  Novacek,  1989: Raskin  &  Terry,  1988:  Wink, 1991a).

Although in general little attention has been paid in developing nar­ cissism  scales  to issues of discriminant  validity,  the  Morey  et al. ( 1985)

Narcissism scale and the NPI arc only moderately correlated  with  mea­ sures of other personality disorders. Both measures show highest positive correlation with Morey’s DSM-Ill  Hysterical  Personality  Disorder  scale and highest negative correlation with the Avoidant Personality Disorder scale. In addition. the Morey  Narcissism  scale correlates  positively  with the Antisocial Personality Disorder scale. On.the MMPI (Hathaway & McKinley, 1940), the NPI, the two Narcissism scales of Wink and Gough. and  Morey’s  scale  all  correlate  positively  with  Hypomania.  a  measure of ego inflation and energy, and correlate negatively with  the  Depression and Social Introversion scales (Morey ct al., 1985: Raskin &  Novacek, 1989;  Wink  & Gough, 1990).

A second group of narcissism scales was developed using an empirical method of scale construction. In the case of Ashby, Lee, and Duke’s ( 1979) Narcissistic Personality Disorder scale (NPDS). the criterion group con­ sisted of diagnosed narcissists in treatment. Both Serkownek’s ( 1975) Narcissism-Hypersensitivity scale and Pepper and Strong’s (1958) Ego­ Sensitivity scale were the result of a factor analysis of the MMPI Mas­ culinity/Femininity scale, which in its turn, was developed using a criterion group of creative, artistic, and presumably narcissistic individu­ als in psychotherapy with the MMPI’s author, Stark Hathaway. Once again, these three scales are highly intercorrelated (rs ranging from high 40s to low 50s) and are all significantly related to observer ratings of narcissism (Wink, 1991a; Wink & Gough, 1990). Nevertheless. several studies have shown them to be uncorrelated with the NPI and other narcissism mea­ sures developed using the internal consistency method ( Emmons. 1987: Mullins & Kopelman, 1988; Watson, Grisham, Trotter, & Biderman. 1984; Wink & Gough, 1990). Furthermore, the NPDS has very different per­ sonality correlates to the NPI. The nature and meaning of these differ­ ences is discussed in the next section.

Two other narcissism sci f-report scales were developed from a theo­ retical perspective other than the DSM-II I. The o·Brien ( 1987) Multi­ phasic  Narcissism  Inventory,  which  is based on Alice Miller’s  (1981)

view of narcissism, includes a Poisonous Pedagogy subscale reflecting  an unconscious need to control others. and a Narcissistically Ahused Per­ sonality suhscalc measuring the tendency to derive self-validation from the approval of others. Millon’s ( 1982) Narcissism scale. on the other hand, reflects the author’s unique brand of social learning theory. Both these measures correlate with the NPl, and the O’Brien scale is also pos­ itively correlated with the NPDS (Auerbach, 1984; Hibbard, 1992). On the MMPI, Millon’s scale shows the familiar pattern of a positive corre­ lation with Hypomania and negative correlations with  the Depression and Social  Introversion scales (Auerbach. 1984).

In the observer domain, Wink ( 1992a) developed a California Q-set (CA<)) ( Block, 1978) Narcissism prototype that allows for the scaling and aggregation of ratings made by judges and peers. The prototype allows for the scoring of three scales. The Willfulness scale includes items indica­ tive of undercontrol of impulses, self-indulgence, self-dramatization, and condescension. Items included in the Hypersensitivity scale suggest the presence of hostility and irritability, sensitivity to criticism and demands, and sci f-defensivcness. High scores on the Autonomy scale are indicative of high aspirations. independence, wide interests, unusual thought processes. and sensi Ii vi ty lo aesthetic experiences. A11 three scales corre­ late significantly with observer ratings of narcissism, but only Willfulness and Hypersensitivity are positively associated with ratings of pathology (Wink. 1991b). The Willfulness scale is correlated with the NPI and the Hypersensitivity scale correlates positively with the NPDS (Wink, 1991a). Also in the observer domain, Patton, Connor, and Scott ( I 982) devel­ oped IO observer rating scales to measure Kohut’ s formulation of narcis­ sism or sci f psychology. These scales were intended to measure therapeutic outcomes.  but so far they  have not been  widely researched.

Finally. Harder ( I 979) reports on the construction of projective nar­ cissism scales for the Early Memory Test, the Thematic Apperception Test. and the Rorschach. These three measures are significantly inter­ correlated with each other and show preliminary evidence of criterion­ related validity, hut once again have not gained widespread acceptance.


Symptoms, Types, and  Level  of Patholo y

As expected from scales developed using  DSM-I I I criteria, the personal­ ity correlates of the NPI, the Wink and Gough CPI and MMPI Narcissism scales, and the M MP! Narcissism scale of Raskin and Novacek include ego expansiveness, desire for attention. and disesteem for others.  Also evident arc conceit, exhibitionism, sclf-cepteredness, and impulsivity. These char­ acteristics   arc   present   both   in   the  self-report   and  observer   domains ( Raskin & Novacek,  I989; Raskin & Terry, 1988; Wink &  Gough, 1990). In addition. the NP! is associated  with daydreams and  fantasies indicative of the need  for  power  ((‘arroll,  1<)87;  Ra kin  &  Novacek,  1<)91).  All the preceding findings support psychiatric research on the differential di­ agnosis of personality disorders suggesting that a grandiose sense of self-importance, fantasies of  unlimited  success.  and  need  for  attention and admiration are central 10 the construct of narcissism (Gunderson, Ron­ ningstarn. & Smith.  I 99 I).

On the positive side. high scorers on the NP! and the two scales of Wink  and Ciough arc characterized  by assertiveness, social  poise, and assurance (Wink, 1991a). The NPI is also associated with leadership po­ tential and achievement orientation ( Emmons, 1984; Rask in & Terry, 1988). Overall. the personality correlates of these reviewed self-report narcissism scales indicate that they measure overt  narcissism.

In contrast to measures of overt narcissism, the personality correlates of Ashby, Lee, and Duke’s ( 1979) NPDS, the second most widely re­ searched narcissism scale, and of the MMPI Narcissism-Hypersensitivity (Serkownek, 1975) and Ego-Sensitivity (Pepper & Strong. 1958) scales indicate sensitivity to slight and a lack of social presence, sociability, and dominance (Graham, 1987; Graham, Schroeder, & Lilly, 1971; Wink, 1991a). In addition, the NPDS is associated with depression (Watson, Taylor, & Morris, 1987) and inadequacy, unhappiness, and worry ( Mullins & Kopelman, 1988). All these characteristics arc congruent with covert narcissism. Taken on their own, however, they may also be indicative of other personality disorders such as paranoid, avoidant, and schizoid. Be­ cause the NPDS and the two other narcissism scales related to it were de­ veloped either directly or indirectly using as a criterion patients in psychotherapy, it is also possible that they measure the sensitive and vul­ nerable side of overt narcissism that becomes activated in response to slight or injury to the self. Factors in favor of the NPDS and the MMPI scales of Serkownek (1975) and Pepper and Strong (1958) being measures of narcissism are that, just as the NPI, they are correlated with (a) ob­ server ratings of narcissism, (b) spouse perceptions of being bossy. in­ tolerant, cruel, conceited, arrogant, and demanding, and (c) hostility and undercontrol of aggressive and erotic impulses (Wink, 1991a). In addi­ tion, the lack of interpersonal poise and confidence associated with the NPDS is reflected in CPI (Gough, 1987) scales that measure stable per­ sonality traits rather than states. lt is unlikely, therefore, that this scale re­ flects a transient  response to slight or injury.

In summary, empirical research using the NPl, the NPDS, and narcis­ sism scales associated with them offers support for the psychoanalyti­ cally based distinction between overt and covert narcissism. Although these two forms of the disorder share several underlying features, they re­ main uncorrelated or independent of each other in self-report and ob­ server ratings.

In terms of level of pathology, covert narcissism appears to be more dysfunctional than the overt form of the disorder. Only covert narcissism is associated with lack of well-being, competence, and personal adjust­ ment (Wink, 1991a), depression and low self-esteem (Watson, Taylor, & Morris, 1987), disturbed object-relations and masochism  (Hibbard. 1992). and deterioration in the course of adult life (Wink, 1992b, in  press) (see section on Childhood and Adult Development). It may he that internality associated with covert narcissism is indicative of a lack of ego strength, whereas the strong sense of agency associated with overt nar­ cissism  points to a well integrated, albeit grandiose. sense of the self.

Within the domain of overt narcissism, research on factor analytically based suhscalcs of the NPI suggests that self-reported exploitativcness and entitlement have more pathological implications than a sense of leadership and authority, self-absorption, or vanity, and  feelings  of superiority. Only the Exploitativcncss/Entitlemcnt subscale of the NPI correlates with sus­ piciousness. anxiety, and neuroticism (Emmons, 1984), lack of empathy ( Watson  ct  al.,  I984 ). depression,  and  the  NPDS ( Watson  et  al.,  I 987 ). Compared with the other factors of the NPI. it also shows a stronger rela­ tionship with presence of irrational beliefs (Watson & Morris, 1990) and cynicism ( Watson. Sawrie, & Biderman.  1991 ).

In dist incl ion to overt and covert narcissism, which in the observer do­ main arc measured by the CAQ Willfulness and Hypersensitivity scales (Wink, 1992a), the CAQ Autonomy scale measures a healthy sense of self-dircctcdness characterized by a sense of personal autonomy, high aspirations. and intellectual and aesthetic interests. As discussed in the following section, healthily self-directed individuals share with overt narcissists a sense of social poise and assurance, but in addition,  their lives are characterized by success at work, creativity, and positive per­ sonal growth in adulthood (Wink, 1991 b, I992b).


Self, Self-Esteem,  and Self-Enhancement

As expected. high scorers on the NPI arc characterized by· self-focus (Gra1111ow & Tangney, 1992) or “sci fism” ( Emnwns, 1987 ); they bcl ievc that their needs arc best met by adopting an egocentric orientation to life. They also show a self-referential attitude as exemplified by greater fre­ quency in the use of the pronoun “I”  (Raskin & Shaw, 1988).

On the Received View, narcissistic individuals are thought to possess a defensively  inflated  sense of sclf-e;,tccm.  Narcissistic  grandiosity  is both a sign of ego-inflation and an attempt to deny feelings of vulnerability and self-depreciation that result from the use of the child by  primary  care givers. From the point of view of empirical  research. the preceding  claim can he broken down into two questions: Is narcissism associated with high sclf-cstcc,11′! and, Is this high esteem the result of pathological sclt’­ enhanccmcnt’!

Numerous studies report a positive relationship between overt narcis­sism. as measured by the NPI, and self-esteem (e.g., Emmons, I 984; Raskin & Terry. 1988; Watson et al., 1987). Understandably, the reverse is true of covert narcissism where the external manifestations of self­ dcplct ion arc accompanied  by rqmrt  of  lowered  self-esteem  (Watson ct al .. 1987) and l’cclings of inadequacy (Mullins & Kopelman. 1988).

As indicated by Raskin, Novacek, and Hogan (1991a). defensive self­ esteem or self-enhancement can take the form of social desirahility (sclf­ validation through the extraction of  favorahle  evaluations  and  approval from others) or, alternatively. it can he linked to grandiosity (a con1hi11a­ tion of exhibitionism and the expectation ofheing admired hy others). Both overt (Raskin et al., 1991a) and covert (Watson ct al., 1984) measures of narcissism correlated negatively with social desirability, which means that pathological narcissists generally have little regard for the impression they make on others. Self-ingratiation is not a narcissistic way of regulating self-esteem.  The  NPI  is,  however,  associated   with  grandiosity  ( Raskin et al., 1991a). This suggests  that self-display  in the hope of  being admired by others is important for the self-esteem of  the  overt  narcissist.  Addi­ tional evidence for self-enhancement  bias associated  with overt  narcissism is provided by John and Robins ( 1994) who found the tendency among nar­ cissistic individuals to overestimate, compared  with  ratings  of  observers, the quality  of  their  performance  in  leaderless group discussion.

Just as not all forms of self-enhancement are maladaptive, so some forms of narcissistic self-biases appear related to healthy adjustment. In particular, the NPI subscales measuring leadership, self-absorption, and vanity are all associated with an adaptive, if somewhat exaggerated, ex­ pectation  of  personal  control  over events and a sense of invulnerability ( Watson et al., 199 I). The preceding components of the NPI retain a pos­ itive correlation with self-esteem even after social desirability and grandiosity have been partialed out (Raskin et al., 1991a). The same is  not true, however, of the more pathological Entitlemcnt/Exploitativcncss dimension, which loses its positive association with self-esteem after grandiosity is controlled for. Entitlement/Exploitativeness is also related to an unadaptive sense of cynicism and perception of being victimized (Watson et al., 1991).






Both overt and covert forms of narcissism have hcen associated with the undercontrol of hostile and negative impulses ( Wink, 1991 a). The ex­ pression of hostility is likely to take on, however, different forms in the two types of narcissistic individuals. In the case of overt narcissism, it tends to be expressed directly without  particular concern  for the setting or target. In support of this conjecture, Wink ( 1992b) found that high scorers 011 the observer-based CAQ Willfulness scale reported conflict in their relations  with friends. In the case of covert  narcissism,  the hostile

impulses arc likely to he held hack and may  be more evident in marriage and family relations (sec Life Implications section).  Another  factor  that may  affect  the  expression  of  hostility  is  gender.  McCann  and  Biaggio ( 1989). for example, reported that the NPI was correlated with general, though possibly unacknowledged, feelings of anger in both  men  and women. In the case of men. however, the anger was expressed more in physical  terms  than  was the case for women.

In his research on the NPI, Emmons ( 1987) found that whereas the over­ all score on the total scale correlated positively with negative affect, the more pathological Exploitativeness/Entitlcment subscalc correlated with both positive and negative affect and the intensity of affective experience. Emmons suggests that the extreme mood swings of overtly narcissistic in­ dividuals may he the result of their relatively simple self-representations. The tendency toward rapid oscillations in mood may also he indicative of the use  of  the defense  mechanism  of splitting,  which  is characteristic of narcissism.

How can overtly narcissistic individuals simultaneously report feel­ ings of hostility and still maintain high self-esteem? According to Raskin, Novacek, and Hogan ( 1991 b). the answer to this question once again in­ volves a grandiose sense of self. Although hostility and self-esteem  do not appear to he directly related, when grandiosity and narcissism are partialcd out, their relationship becomes negative. In other words, in the absence of grandiosity and narcissism, people who express high hostility also report low self-esteem. In the presence of grandiosity as a modera­ tor variable, the connection between hostility and self-esteem becomes positive.


Shame and Shyness

The connection between narcissism and shame can be construed  in one of two ways. According to Lewis ( 1971 ), the entire narcissistic personal­ ity structure serves as a defense against profound feelings of shame that originate in childhood. For Lewis, narcissism is a consequence of shame. It could be argued. however, that the arrow of causality points the other way and that it is narcissistic exhibitionism and the tendency!() set un­ realistic goals that produces sha1nc as a response to tile experience ol slight, injury, and  disappointment  (Morrison, 1989).

Initial empirical research using the NP! revealed, contrary to expecta­ tions, a negative rather than positive correlation between narcissism and shame (Wright, O’Leary, & Balkin, 1989). Gramzow and Tangney ( 1992) partialed out healthy subscales of the NPI from the Exploitativeness/ Entitlement suhscalc and found a significant, hut low, correlation between pathological  overt  narcissism  and  shame. Such  a connection between Exploitativeness/Entitlement and shame was not found hy llihhard ( 1992) who, however, reported a strong positive association hetween Ashby. Lee. and Duke’s ( 1979) NPDS and O’Brien’s ( 1987) Multiphasic Narcissistic Inventory and two measures of shame and a measure of masochism. The propensity toward feelings of shame appears to he confined to covertly narcissistic individuals, and it tends not to he consciously experienced hy overt  narcissists.

Since covert narcissists experience shame, arc they also prone to shy­ ness? Cheek and Melchior ( 1985) found this to he the case, although the relationship hetween narcissism as measured hy Murray’s ( 1918) Narcis­ sism scale, and shyness. as measured by the Cheek and Buss Shyness scale (Cheek & Melchior,  1990), was stronger for women  than  men.  In support of Cheek and Melchior, Wink ( 1991a) reports  a strong  negative associa­ tion he tween self-reported covert narcissism and CPI (Gough, 1987) mea­ sures of social presence, externality. and assurance. If indeed there is a relationship between narcissism and shyness, this raises the possibility of there being two distinct types of shy individuals. In particular. narcissis­ tically based shyness seems to be more ominous  and different  in  its ori­ gins and implications compared with the more anxiety-driven shyness characteristic of  social  phobias  and  avoidant  personality disorders.


Boredom and Sensation Seeking

Narcissistic feelings of boredom serve potentially two different functions. First. they serve as markers of a false sense of self (Svrakic, 1985). Not having been allowed as children  to experience  and develop their authen­ tic sense of self (Masterson, 1990; Miller, 1981 ), narcissistic adults pur­ sue life goals that feel alien and imposed, and  that, therefore,  lack meaning and fail to energize and vitalize. Second, boredom serves a de­ fensive function of blocking intensive feelings of envy and aggression that threaten the narcissistic individual’s equilibrium of the self (Kernberg, 1975). The reverse side of boredom is the propensity toward sensation­ seeking undertaken in the hope of coming to life and  revitalizing the self. In a study using the NPI. Emmons (1981) found a  relationship  he­ tween rwn:issism and susceptibility to horedom and experience seeking. with men  reporting  greater feelings of  boredom  and  wornen i11dicat ing a stronger sensation-seeking tendency. A risk-seeking factor was also uncovered   by  Wink  and  Gough  ( 1990)  in  their  principal  components analysis of  the CPI and MMPI  Narcissism scales.

Similarly to their overt counterparts, covertly narcissistic individuals report feelings of boredom across the major adult social roles of partner. worker. parent, and friend  ( Wink,  in  press). These  feelings of  horedom do  not  reflect  objective evidence  of  failure  to maintain  a  work career or develop long-term relationships. Rather, they indicate feelings of hostil­ ity and resentment that arc turned inward and that pervade the lives of covertly narcissistic individuals.



Although an impaired sense of empathy is one of the symptoms of nar­ cissism listed in the DSM-I II (APA, I980), its relationship to narcissism is far from straight forward. On the one hand, a grandiose sense of self in­ hibits genuine capacity for empathy and, parenthetically, elicits feelings of boredom in interactions with others. On the other hand, however, the narcissistic tendency toward merger with others and toward the regula­ tion of self-esteem by eliciting admiration from others requires consid­ erable empathy, even if it happens to be put to manipulative use. Further, Kohut ( 1966) argues that healthy empathy in adulthood has its roots in developmentally early relationships based on merger with, and idealiza­ tion, of the other.

In  my  research  on  middle-aged  women  (Wink,  1992b),  I found that across the first half of their adult life, hypersensitive or covertly narcis­  sistic women were less empathic than other women. The autonomous or healthily narcissistic women were, however, consistently  more empathic than others, and willful or overtly narcissistic women showed empathy in their late 20s. Gough and I (Wink & Gough, 1990) also found a positive correlation hetween overt narcissism and empathy. Watson et al. (1984), however. report the NPI to he negatively correlated with two of three em­ pathy scales used in their study. The verdict on the relationship  between overt narcissism and empathy is still open. It is likely though that overt narcissists possess the kind  of empathy  that  allows  them  to  manipulate and elicit admiration from others. In distinction, healthily narcissistic individuals  arc capable  of  mature  empathy,  which  is used  in  the service of  understanding  self  and others.,




lkc:111,t· IIH>\I ol !he l’lllpir ical rc,earch 011 11:irci\\i,111 i\ performed IHI col­ lege stutlL’nts. relatively little is known about its L’ffccl on real-life out­ comes such as the quality of interpersonal relations, success at work, and personal adjustment. In this and the next section. I will rely largely on my own research to flush out some concurrent and developmental implications of  narcissism  in  a group of close  to  I00 Mills College  women  graduates (classes of 1958 and 1960) who were initially studied as seniors in college and  then  followed  up at the average ages of 27, 43, and 52 ( Helson,  I967; Helson & Wink, 1992). I have investigated  narcissism  or self-directedness in these women with the three narcissism scales  discussed  earlier  and scored from observer CAQ-ratings of the rich, open-ended questionnaire responses  provided  by the participants  at age 43.

Among the Mills women, those who scored high on hypersensitivity showed signs of psychological distress at midlife, and lacked enjoyment and engagement  in their work careers. They also reported home conflict, a lack of family cohesion, dissatisfaction as partner and parent, and prob­ lems with  children  (Wink, 1991b).  Marital  dissatisfaction was evident in follow-ups at both age 43 and age 52 (Wink, 1992b: in press). Problems of covertly narcissistic individuals in maintaining satisfactory love rela­ tionships have been also reported by Solomon ( 1982) in a study using Ashby, Lee, and Duke’s NPDS. In stun, midlife covert narcissism ap­ pears to affect detrimentally both areas of work and love and leads  to poor psychological adjustment.

In contrast, willful or overtly narcissistic women at midlife were char­ acterized by high energy level and enjoyment of work ( Wink, 1991 b), and perceived themselves as stimulating and creative across major social roles (Wink, in press). This optimistic, if not grandiose, self-perception  was not matched however, by any objective signs of success or achievement in the realm of work or interpersonal relations. Although women classified as willful at midlife showed signs of investment in their mid-20s in an up­ wardly mobile work career, these commitments were not sustained through to the early 40s. A low but significant correlation between will­ fulness nnd drug use (Wink. 1991b) suggests that the personal adjustment of the overtly narcissistic women at midlife may be more conflicted than it would appear at first glance.

High scorers on Autonomy or healthy narcissism were not correlated with any measures of interpersonal adjustment, but were associated pos­ itively with virtually all measures of success at work. The autonomous women who embarked on an upwardly mobile career in their mid to late 20s tended to achieve high status level at work by midlife. All the psy­ chotherapists and most of the artists in the Mills sample scored high on the CAQ Autonomy scale. This finding supports Kohut’s (1966) contention that empathy and creativity arc the results of a healthy transformation of childhood narcissism and are, therefore, related to the self-directed  line of development.

More direct evidence  of  a  link  between  narcissism  and  creativity  in the Mills study is that the Autonomy scale correlated  positively  with  the CPI Creative Temperament scale (Gough, 1987) and two Adjective Check List  (Gough   &  Heilbrun,   1983)  creativity   scales.   In  addition,   Raskin ( 1980) found a positive relationship between the NP! and the Symbolic Equivalents  Test,  a  measure  of  creativity  developed   by  Frank   Barron ( 1974 ). Solomon ( 198.’i) noted a correlation between the NPDS and a sci f­ rcport creativity scale. It may he that the connection  between  narcissism and creativity transcends the distinctions between  healthy  and  patholog­ ical  narcissism.




 Empirical research on the origins and development of narcissism includes studies or family dynamics and early  relations  with  parents,  research  on the special status of narcissistic adults as children, and inquiry into per­ sonality  change  in adulthood.


Childhood Origins

There is little direct description of narcissism in children. Most psycho­ analytic work on childhood origins of narcissism, including the writings of Kem berg ( 1975) and Kohut (1971, 1977), are based on inferences drawn from the analysis of transference and regression of adults seen in treatment.

Clinical observations of  children  indicate  that  narcissistic  vulnerabil­ ity is already evident in children of 3 or 4 years of age (Noshpitz, 1984). Once in school, narcissistic children develop a posture  of arrogant  isola­ tion (overt narcissism) or, alternatively, appear  shy  and  awkward,  and cager to please in order to avoid shame and humiliation. These covertly narcissistic children relegate  their grandiosity  and entitlement  to the world of fantasy ( Blcibcrg, 1988). Clinical studies of severely disturbed and abused young children link narcissism to an unusual sensitivity, respon­ siveness, and ability to anticipate the needs  of  others,  which,  however, mask a core sense of aloofness and fear of dependency (Yates, 1981 ). Fre­ quently, the  precocious,  and defen,sive  in  nature, empathic  ability is used to obtain gratification through the self-serving manipulation of the outside world,  which  is  perceived  as threatening  and  hostile (Tooley, 1975).

In a retrospective study of early parenting styles among college undergraduates. Watson. Little. and Biderman ( 1992) found NPI’s Exploitativeness/1:ntitlcmcnt suhscale to he negatively correlated with the mature authoritative parenting style and positively correlated with parental permissiveness. In the Mills Longitudinal study, Wink ( 1992b) found that in midlife. hypersensitive or covertly narcissistic women characterized their early relations with both their mothers and fathers as lacking in warmth and caring. The mother was also reported as in­ spiring distrust and lack of security. Women with high scores on will­ fulness or overt  narcissism  expressed, on the other hand, a dislike of their mothers hut indicated a liking and pride of their fathers. who themselves showed narcissistic personality traits ( Wink.  1991 h).  Evi­ dence of an early identification with a narcissistic father among overtly narcissistic women is also provided hy  Block  ( 1971)  in  his analysis  of data from two longitudinal studies. As argued hy Masterson ( 1990). one route  toward  adult  narcissism  appears  to  involve  an  identification  with a narcissistic parent in order  to  escape  from  the  even  more  disturbed other  parent.

In my research, I have found no relationship between Autonomy or healthy narcissism and retrospective accounts of early  relations  with parents. Mills women with high scores on  Autonomy  did,  however,  re­ port being involved in artistic, creative, and agenetic childhood activities (Wink,  1992b).


Special Status

Do narcissistic adults possess special characteristics as children that pre­ dispose them to differential treatment by parents’/  Empirically,  this ques­ tion has been addressed primarily through research on the relationship between narcissism and birth order. The results are mixed. Joubert ( 1989) reports a positive relationship between birth order and scores on the NPI. Narayan ( 1990), however, failed to replicate this finding. and Watson and Biderman ( 1989) obtained no support for  the  hypothesis  that  being  an only child relates to narcissism. It is likely  that  birth  order on  its own  is not a sensitive enough criterion for the multiplicity of  reasons  why chil­ dren may be selected as special by parents  who  need  them  to  maintain their  own  frail  psychological equilibrium.


Adult Development

As will be recalled, the Received View assumes that narcissism leads to deterioration in midlife. The signs of aging associated with middle adult­ hood and the growing realization that there are limits to one’s accom­ plishments, are supposed to potentiate narcissistic feelings of envy and resentment that. in turn. result in depression and a sense of depiction.

In the Mills Longitudinal Study, the preceding pattern of adult de­ velopment was evident in personality changes associated with Hyper­ sensitivity. In their early 40s, hypersensitive women scored lower than the rest of the Mills women on CPI measures of social poise and assur­ ance, normative control of impulse, and achievement (Wink, 1992b). When still in college, however, the same women were virtually indistin­ guishable from their classmates.  Evidently, hypersensitivity at  midlife is the product  of deterioration  that starts  in the  mid-20s as individuals confront the challenges of establishing a work career and maintaining long-term relationships. Although from early 40s to early 50s, the hy­ persen\itive women  gained  somewhat  in impulse control, they continued to  be more  troubled  than  the  rest of the Mills  women  (Wink. in  press).

A very different pattern of adult personality change was evident among the Mills women classified at 111idlife as willful. The willful women in­ creased in social poise, confidence, and level of effective functioning during the first few years after graduation from college, a time of nov­ elty and excitement associated with the formation of the first adult life­ structure. In their early 40s, however, high scorers on Willfulness showed very little difference from college days. At both ages, they were more im­ pulsive and self-indulgent than the other Mills women. The same findings continued to be true in the· early 50s (Wink, 1992b, in press). The Mills findings regarding the long-term stability of personality in overtly nar­ cissistic women agree with Block’s ( 1971) account of personality devel­ opment of the dominant narcissist.

From the early 20s to the early 50s, the autonomous or healthily nar­ cissistic women scored higher than the rest of Mills women on CPI mea­ sures of tolerance, psychological mindedness, creativity, and intellectual achievement. Unlike  high scorers on  Willfulness,  who were at  their  best in their late 20s, for the autonomous women  the late 30s and early  40s were  a  time  of  growth   in  confidence,  social   poise,  and  understanding of self and others (Wink, 1992b). From  the 40s  to early  50s, autonomy was associated with increases in responsibility  and  the  ability  to  main­ tain friction-free relationships with others that arc character’istic of indi­ viduals in positions of social  and  personal  dominance  and  power (Wink, in press).

The different patterns of change associated with Hypersensitivity, Willfulness, and Autonomy highlight, once again, the importance of the distinction between overt and covert and healthy and less healthy forms of narcissism.




The main body of psychoanalytic re-.earch on narcissi-.111 docs not take into acrnunt issul’s of gender. ;\It hough Kohut ( I t)77, I tJ84) dist i nguishl’s between two types of narcissistic relationships, those based on mirroring and exhibitionism and those involving merger with  the idealized other.  they arc not seen as gender speci fie. As early as the 19.’i0s, however, the psychoanalyst Annie Reich ( 1953) argued that women narcissists, in con­ trast to their male counterparts, were much 111ore likely to be involved in relationships based on idealization. Such relations take on either the form of dependent subservience to a strongly admired partner or.alternatively. involve  short-lived  infatuations  that  lead  to inevitable disappoirltrncnl.

More recently, Phillipson ( 1985) has applied Chodorow’s ( 1978) theory of gender differences to  narcissism.  Because  in  our  society  women  arc the primary caregivers. girls tend to be brought up by a parent of the same gender. whereas boys are not. According to Phillipson, this produces very different kinds of faulty empathy in the mother-daughter and mother-son dyads. In the case of the boy, mother’s lack of empathy leads to an exag­ gerated sense of otherness. and a need  for admiration  and  mirroring  that are characteristic of phallic narcissism. A daughter exposed to faulty ma­ ternal empathy, on the other hand, can  gain  self-worth  through  acting as an extension of her mother. In adulthood, this leads  to merger  relation­ ships based on idealization that, according to Phillipson. should riot be viewed as narcissistic. Similar considerations have led Haaken ( 1983) to postulate that early parental lack of empathy results in borderline symp­ tomatology  in women and narcissism  in men.

Most researchers who have used the NPI to analyze gender differences report significantly higher mean scores for  men  than  women  (Carroll. 1987; Joubert, 1989; Watson et al., 1984; Watson et al.. 1987 ), though there are some exceptions (Auerbach, 1984; Rask in & Hall, 1981 ). The presence of mean differences does not preclude, however, the possibility that high scores on measures of narcissism have similar implications for both gen­ ders. In fact, in the research on the Mills Longitudinal sample described earlier, I found that predictions drawn from a general. and gender undif­ ferentiated theory of narcissism were  applicable  to  women.  Similarly. Wink and Gough ( 1990) found that although men scored  significantly higher than women on both the CPI and MMPI Narcissism scales, the pat­ tern of correlations between these two scales and other self-report per­ sonality  measures  were virtually  identical  for both genders.

Even though women and men with high scores on narcissism scales may have many characteristics in common, this does not mean that there are no important gender differences. As discussed earlier, the  relationshir  be­ tween narcissism and shyness is stronger for women (Cheek & Melchior. 1985), and narcissistic women tend to be less prone to physical aggression than narcissistic men (McCann & Biaggio. 1989). In addition. in a study using the NPI and the Thematic Arperception Test (TAT. Murray, 1943). Carroll (1987) noted a positive correlation between overt  narcissism  and  the need for power in men and a negative correlation between  narcissism and the need for intimacy in women. Watson et al. (1987) report that fem­ ininity, as measured by the Bern (1981) Sex Role Inventory, was inversely related  to exploitative narcissism.

The relationship between narcissism and gender obviously raises the issue  of  social  and  cultural   influences  on  personality  structure and psychopathology. We have 110 research data 011 how the changing role of worne11 in our socicly i111pacts narcissism. We may expect, however, that as worncn hegi11 to occupy positions of privilege and power in the work­ place and as men become more involved in the care of children, gender differences  in  narcissism  should  gradually disappear.




 The quantitative research on narcissism reviewed in this chapter con­ tributes in an important way to our understanding of the construct. It is quite evident that research on individual differences plays an important role in testing and extending theories of narcissism derived from quali­ tative. clinically based case studies. As has been amply documented, re­ search using self-report scales such as the NPI and NPDS, and the three observer-based CAQ narcissism scales, confirms the psychoanalytically based hypothesis that grandiosity,  egocentricity, and self-enhanc ment are central features of narcissistic pathology. The presence of negative af­ fect. in particular hostility, feelings of boredom, problematic relation­ ships with others. and a deterioration  at midlife, at least in some forms of narcissism. have al I been confirmed in studies of group and individual differences.

Perhaps the most salient insight into narcissism to emerge from this review pertains to the complexity and multidimensionality of the con­ struct. /\n obvious manifestation of this complexity is the distinction be­ tween overt and covert narcissism. Although uncorrelated with one another. the sci f-report NP! and NPDS, as well as the observer-based Willfulness and Hypersensitivity scales, are all associated with external ratings of narcissism and underlying attitudes of arrogance and exploita­ tiveness. Yet. on the surface, overtly narcissistic individuals present as domineering. assertive, and exhibitionistic, whereas covertly narcissistic persons strike us with their sense of shyness, inadeq acy, and depleti n. Both types of narcissism show important differences Ill terms of real-hfe outcomes and patterns of adult development.

Equally important as the distinction based  on  type. is  the differentia­ tion of narcissism according to level of pathology. Among the two more pathological forms of the disorder. only covert narcissism  is  linked  t_o lack of empathy. poor personal adjustment in love and work, a_nd deteri­ oration  in  personality  functioning  at midlife. Within  the domarn of overt

narcissism, the NPl’s exploitativeness/entitlement dimension is related to cynicism. a fragile sense of self-esteem, and extrem_ity_of mood sw_ing , whereas  the self-reported  sense of authority, superiority, and vamty 1s not Indistinction to pathological narcissism, healthy self-directedness is associated with creativity, emrathy, an upwardly mobile work  career, and personality growth in adulthood.

Another manifestation  of  the  colllplexity  surrounding  narcissism  has to do with the meaning of symptoms. For example, feelings of elllpathy characterize both healthy and more pathological overt narcissists. Yet, al­ tlwugh feelings of empathy associated with healthy narcissislll have their roots in altruism, the empathy related  to  pathological  narcissism  serves the purpose of manipulation and exploitation. Similarly, feelings  of shy­ ness associated with covert narcissism  are  probably  quite different  from the social anxiety found among individuals with an avoidant personality disorder.

Finally, gender provides an additional source of variation affecting narcissistic symptomatology. Narcissistic women have been reported, for example, to be less physically aggressive, less power oriented, and more prone to idealization than men. Although virtually no research exists on the relationship between narcissism and ethnicity and social class, they are also likely to affect narcissistic symptomatology. Smith ( 1990), for example, found Caucasian women to be more narcissistic than Asian women.

A model of narcissism that takes into account type, level of pathology, gender, ethnicity, and class has important implications for both the cli­ nician and researcher. From a clinical perspective, narcissistic fantasies of power and grandeur, for example, can equally well lurk behind a bom­ bastic and exhibitionistic facade as one of shyness, vulnerability, and de­ pletion. Clinicians should also keep in mind that narcissistic clients have the potential to transform or channel their self-invested energy into cre­ ativity, empathy, and wisdom. Conversely, individuals who initially im­ press us with their sensitivity to others, and understanding of the world may turn out ultimately  to be quite egocentric and grandiose.

From a research perspective, the different patterns of adult develop­ ment associated with type and level of narcissistic pathology are important to the study of aging. Equally, the relationship between overt narcissism and self-enhancement and the self-concept in general should be of interest to both personality and social psychologists. In general, psychological re­ search into the real-life implications of narcissism supplements rsychiatric rcsean.:h into the construct that thus far has focused primarily on symproms and differential diagnosis, and has neglected issues of construct, rnncur­ rent, and predictive validity (Gunderson et al., 1991 ).

More research is obviously needed into the relationship between the various types of narcissism and their concurrent and developmental im­ plications. Direct research on childhood antecedents of narcissism is sadly lacking. In distinction to psychiatric research,  psychological studies of  narcissism  have neglected  the issue of differential diagnosis

(discriminant validity). We need to study the relationship between mea­ sures of overt narcissislll and those of histrionic and antisocial rerson­ ality disorders. Research is also required on the relationship between self-reported covert narcissism and schi1.oiJ, avoidant, and passive­ aggressive personality disorders. Both types of pathological narcissism need to he related to the borderline personality. Research efforts in all these areas need to he sensitive to issues of gender, ethnicity, and class, as well as to the impact of changing sociocultural contexts on the preva­ lence and manifestations of healthy and more pathological levels of self­





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