When grandiosity and vulnerability collide: Implicit and explicit self-esteem in patients with narcissistic personality disorder.
OBJECTIVE
Narcissistic personality disorder (NPD) is characterized by reports of grandiosity including exaggerated illusions of superiority and entitlement (DSM-IV-TR, APA, 2000). Based on clinical theories (e.g., Kernberg, 1975), many researchers argue that high explicit self-esteem in narcissists masks underlying implicit vulnerability (low implicit self-esteem). Conversely, based on social learning theories (i.e., Millon, 1981), people with NPD are characterized by implicit grandiosity (high implicit self-esteem). We test these competing hypotheses in patients diagnosed with NPD.


METHODS
The present study examined implicit self-esteem (using an Implicit Association Test) and explicit self-esteem (using a self-report questionnaire) in patients with NPD in comparison to non-clinical and clinical, non-NPD (Borderline Personality Disorder, BPD) control groups.


RESULTS
Patients with NPD scored lower on explicit self-esteem than non-clinical controls. In comparison to patients with BPD, NPD patients scored higher on explicit and implicit self-esteem. Moreover, within the group of NPD patients, damaged self-esteem (i.e., low explicit, high implicit) was associated with higher narcissistic psychopathology.


CONCLUSIONS
In both clinical groups we included participants seeking psychiatric treatment, which might influence explicit self-esteem. Longitudinal studies are needed to further assess self-esteem stability in NPD patients in comparison to the control groups.


CONCLUSIONS
Our findings are indicative of vulnerable facets in patients with NPD (i.e., low explicit self-esteem). Furthermore, damaged self-esteem is connected to specific psychopathology within the NPD group. Implications for research on NPD are discussed.
Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany. aline.vater@fu-berlin.de
Aline
A
Vater
Kathrin
K
Ritter
Michela
M
Schröder-Abé
Astrid
A
Schütz
Claas-Hinrich
CH
Lammers
Jennifer K
JK
Bosson
Stefan
S
Roepke
D000328:Adult; D003863:Depression / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010554:Personality Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology*; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D012649:Self Concept; D057566:Self Report; D011795:Surveys and Questionnaires; D055815:Young Adult