title: Pathological narcissism and depressive symptoms in psychiatric outpatients: mediating role of dysfunctional attitudes.
abstract: OBJECTIVE
  The aim of this study was to examine the relationships between pathological narcissism (narcissistic grandiosity and narcissistic vulnerability), dysfunctional attitudes (perfectionism and dependency on other people), and depressive symptoms in psychiatric outpatients.
  
  
  METHODS
  A sample of 234 adult psychiatric outpatients (57.3% male; mean age 44.39 years) completed the Pathological Narcissism Inventory, the Dysfunctional Attitudes Scale-Form A, and the Depression, Anxiety, Stress Scales-21.
  
  
  RESULTS
  Narcissistic vulnerability exhibited unique positive correlations with depressive symptoms, whereas narcissistic grandiosity showed substantially weaker correlations with depressive symptoms. Perfectionism partially mediated the relationship between narcissistic vulnerability and depressive symptoms. The mediating role of dependency was not confirmed.
  
  
  CONCLUSIONS
  Among adult psychiatric outpatients, narcissistic vulnerability is more strongly related to depressive symptoms than narcissistic grandiosity, and dysfunctional perfectionism represents one of the underlying mechanisms of this relationship. The implications of these findings are discussed in relation to the Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria and the treatment of pathological narcissism.
authors.affiliation: University Hospital Center Zagreb.
authors.forename: Darko
authors.initials: D
authors.lastname: Marčinko
authors.forename: Nenad
authors.initials: N
authors.lastname: Jakšić
authors.forename: Ena
authors.initials: E
authors.lastname: Ivezić
authors.forename: Milena
authors.initials: M
authors.lastname: Skočić
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Surányi
authors.forename: Mladen
authors.initials: M
authors.lastname: Lončar
authors.forename: Tomislav
authors.initials: T
authors.lastname: Franić
authors.forename: Miro
authors.initials: M
authors.lastname: Jakovljević
mesh_terms: D000328:Adult; D001290:Attitude; D003863:Depression / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000503:physiopathology*; D008875:Middle Aged; D009289:Narcissism; D010045:Outpatients; D010554:Personality Disorders / Q000145:classification / Q000503:physiopathology*
keywords: dependency; depression; dysfunctional attitudes; mediation; narcissistic grandiosity; narcissistic vulnerability; pathological narcissism; perfectionism