Personality & Its Disorders PSYU/X3336 Lecture 8 PDF

8/09/2024 Reading (suggested) PERSONALITY & ITS Foster, JD, Campbell, WK, & Twenge, JM DISORDERS PSYU/X3336 (2003). Individual d...

8/09/2024 Reading (suggested) PERSONALITY & ITS Foster, JD, Campbell, WK, & Twenge, JM DISORDERS PSYU/X3336 (2003). Individual differences in narcissism: Inflated self-views across the lifespan & Lecture 8: A culture of narcissism? around the world. Journal of Research in Personality, 37, 469-486 Yakeley, J. (2018). Current understanding of narcissism & narcissistic personality A/Prof Simon Boag disorder. BJPsych Advances, 24, 305-315 email: [email protected] 1 2 1 2 Readings (for interest) Outline Trzesniewski, et al. (2008). Is “Generation Me” 1. Introduction really more narcissistic than previous Overt/covert narcissism generations? Journal of Personality, 76, 903- 2. Subclinical narcissism 917 3. A culture of narcissism? Twenge, et al. (2008). Egos inflating over time: Is there a narcissism epidemic? A cross-temporal meta-analysis of the Narcissistic Personality Inventory. Journal of 4. Narcissism around the world Personality, 76, 875-901 5. Pathological narcissism Pincus, AL, & Lukowitsky, MR (2010). Narcissistic personality disorder Pathological narcissism & narcissistic personality disorder. Annual Review of Clinical Psychology, 6, 421-446 3 4 3 4 Learning objectives 1. Introduction Describe what is meant by narcissism & The boy Narcissus was thirsty & bending to discuss some of the challenges involved in drink from a pool of water he saw his studying the concept reflection & fell in love with his own image Transfixed to the image, he loses his beauty Describe & critically evaluate whether & he eventually dies from neglecting food & Western society is becoming more narcissistic water Describe what is meant by Narcissistic Personality Disorder (NPD) & critically discuss why therapy for NPD might be difficult 5 6 5 6  8/09/2024 Psychological narcissism Psychological narcissism Havelock Ellis (1898): auto-eroticism Love directed towards one’s self “There are at least two facts upon which Ernest Jones (1913): God-complex everyone agrees: first, that the concept of Freud (1914): On narcissism narcissism is one of the most important Primary narcissism & self-absorption contributions of psychoanalysis; second, that it Natural, developmental phase is one of the most confusing” Secondary narcissism & self-love/absorption (Pulver, 1970) Ego-libido & object-libido 7 8 7 8 Narcissism: modern conceptions Narcissism; healthy or unhealthy? Grandiose self view: Inflated self-importance “The study of narcissism has followed a rather Excessive need for admiration confusing course. In many cases it has reached Lack of both empathy & intimacy contradictory conclusions about the Sense of entitlement psychological costs & benefits associated with Using others for self-validation narcissism” (Rose, 2002) Associated with greater self-esteem, life- satisfaction, but also violence & aggression Different types of narcissism? 9 10 9 10 Narcissism: modern conceptions Narcissism: overt/covert Overt vs Covert narcissists (Wink, 1991) Both types self-absorbed & arrogant, but… Overt: grandiosity/exhibitionism Covert: hypersensitivity/vulnerability Overt: higher reported happiness, self- esteem Covert: lower happiness, self-esteem (Rose, 2002) Weikel, et al.(2010). College adjustment difficulties & the Wink, P. (1991). Two faces of narcissism. Journal of Personality & Social overt & covert forms of narcissism. Journal of College Psychology, 61, 590-597 Counselling, 13, 100-110 11 12 11 12  8/09/2024 Subclinical narcissism: 2. Subclinical narcissism some findings: ‘Normal’ narcissism (Overt) Self-perceived superiority on ‘super-hero’ Narcissistic Personality Inventory (NPI) (Raskin & traits such as intelligence, emotional stability Hall, 1979, 1981) but not morality, agreeableness, Meta-analysis: M > F (355 studies; N = 470,846) (Grijalva et al, conscientiousness (Vazire & Funder, 2006) 2015) Grijalva, et al.(2015). Gender differences in narcissism: A meta-analytic Grijalva & Zhang (2016): meta-analysis (36 review. Psychological Bulletin, 141, 261-310 studies, N = 6,423) Narcissists self-enhance agentic characteristics (eg. intelligence, power) but not communal ones (eg. agreeableness, honesty) 13 14 13 14 Some findings: narcissism related to… Is subclinical narcissism healthy then? Higher self-esteem & confidence (Baumeister et Rasmussen (2016): meta-analysis: narcissism & al, 2006; Campbell et al, 2000) provoked aggression/revenge (N = 11,297) Child/adolescent; prisoner; undergrad Higher psychological health, well-being, life samples satisfaction (Sedikides et al, 2004; Hill & Roberts, 2009) Narcissism positively related to provoked aggression across all studies Lower depression, anxiety, loneliness (Sedikides Strongest in child/adolescent samples; studies et al, 2004) assessing vulnerable narcissism Judged more charming (Back et al, 2010) Rasmussen, K. (2016). Entitled vengeance: A meta-analysis relating … at least at 1st acquaintance narcissism to provoked aggression. Aggressive Behavior, 42, 362-379 15 16 15 16 Subclinical narcissism: Subclinical narcissism & some findings aggression Aggression & ego-threats/social rejection (Stucke Kjærvik & Bushman (2021): meta-analysis: & Sporer, 2002; Twenge & Campbell, 2003) narcissism & aggression (437 studies; N = 123,043) All forms of narcissism associated with all forms of aggression (eg. physical, verbal, bullying, direct, indirect) Narcissism-aggression strongest under provocation compared to no provocation conditions Twenge JM, Campbell WK (2003). ‘Isn't it fun to get the respect that we're going to deserve?’ Narcissism, Social Kjærvik, S. L., & Bushman, B. J. (2021). The link between narcissism & rejection, & aggression. PSPB, 29, 261–272 17 aggression: A meta-analytic review. Psychological Bulletin, 147, 477-503 18 17 18  8/09/2024 “… narcissism is an important risk factor for both Subclinical narcissism: aggression & violence. People high in narcissism theories believe they are special people who deserve special treatment. They think they are the “center of the Grandiose but vulnerable self-concept… & low universe.” When they do not get the “expected” insight (Morf & Rhodewalt, 2001) special treatment they think they are entitled to, High explicit self-esteem but hidden sense of they tend to lash out at others in an aggressive worthlessness manner. Individuals high in narcissism also have Ego threat activates concepts of worthlessness “thin skins” (i.e., fragile egos). They are especially likely to aggress against others when they are Narcissistic defensiveness (Horvath & Morf, 2009) provoked, insulted, humiliated, criticized, or threatened by others. However, they are also prone Morf, CC & Rhodewalt, F (2001). Unraveling the paradoxes of to aggression when they are not provoked” narcissism: A dynamic self-regulatory processing (Kjærvik & Bushman, 2021) model. Psychological Inquiry, 12, 177-196 19 20 19 20 Narcissism & dissociation 3. Is there a rise in narcissism? “A central feature of narcissism is a dissociation Christopher Lasch (1978): The culture of between an unconscious sense of inadequacy & narcissism a conscious feeling of superiority…, more ‘Social invasion of the Self’ recently thought of in terms of low implicit self- Permissive parenting esteem & high explicit self-esteem” US culture & individualism (Lambe et al, 2018) Violence is used to protect the self & restore narcissistic pride Lambe, et al. (2018). The role of narcissism in aggression & violence: A 21 DEPARTMENT OF PSYCHOLOGY 22 systematic review. Trauma, Violence, & Abuse, 19, 209-230 21 22 Cult of celebrity A rise in narcissism? “Thriving on the adulation of the masses, these Twenge et al (2008) celebrities set the tone of public life & or private Cross-temporal meta-analysis life as well… The beautiful people … live out the 85 samples of uni students completing the fantasy of narcissistic success, which consists of NPI b/w 1979-2006 (N = 16,475) nothing more substantial than a wish to be vastly 30% increase in NPI scores b/w 1979-2006 admired, not for one’s accomplishments but simply for oneself, uncritically & without reservation” (Lasch, 1978) 23 24 23 24  8/09/2024 ‘Generation me’ 1950s: 12% teenagers agreed with “I am an important person” Late 1980s: 80% agreed Teens also more confident, assertive, entitled & more miserable (Twenge, 2006/2014) Childhood dependence & difficulties with transition to adulthood Keith Campbell: The narcissism epidemic http://www.youtube.com/watch?v=Iv2LkA Wc7Tk 25 DEPARTMENT OF PSYCHOLOGY 26 25 26 Possible causes: Cultural shift Is there really a rise in narcissism? Parenting culture & emphasis on ‘self-esteem’ Recent increase in volunteering (Bachman et al, over accomplishments 2006) Social media & self-promotion Twenge et al: possibly for self-serving http://www.youtube.com/watch?v=HXbeKKhQXKA advantage Narcissism increase found in US undergrad samples Failure to replicate in non-uni samples (Trzeniewski et al, 2008) Self-report cohort differences Flynn effect (Flynn, 1984) DEPARTMENT OF PSYCHOLOGY 27 28 27 28 Is there really a rise in narcissism? 4. Narcissism around the world Wetzel et al. (2017): Compared Foster, Campbell & Twenge (2003) narcissism scores across 3 US 3,445 Ss (75% Female) responded to NPI Sig diff on NPI scores b/w US, Canada, student cohorts (1990s: N = 1,166; 2000s: N = 33,647; 2010s: N = 25,412) Europe, Asia & Middle east US > Europe > Canada > Asia > Middle East Apparent decrease in narcissism Higher individualism associated with higher narcissism Means: 15.3 - 14.2 Wetzel, et al. (2017). The narcissism epidemic is dead; long live the narcissism epidemic. Psychological science, 28, 1833-1847 29 30 29 30  8/09/2024 Narcissism around the world Narcissism around the world Narcissism in China (Cai et al, 2012) Narcissism in China (Gao et al, 2019): Cross- Internet survey (N = 10,655). Narcissism: temporal meta-analysis b/w 2008-2017 (N = I. Younger > Older 14,795) II. Higher SES > Lower SES Decrease in narcissism III. Persons from only-child families > those Hamamura et al (2021): cross-temporal meta- from families with multiple children analysis (N = 24,990) IV. Urban areas > rural areas No evidence of rising narcissism in Australia & V. Individualistic values predicted narcissism Canada; ↓ of narcissism in Canada around 2008 “… the most likely to be narcissistic are those Gao, et al. (2019). Recent changes in narcissism of Chinese youth: A who are only-child, rich, lives in urban cross-temporal meta-analysis, 2008–2017. Personality & Individual environments & individualistic” Differences, 148, 62-66 Hamamura, et al. (2020). Narcissism over time in Australia & Cai, et al. (2012). A sociocultural approach to narcissism: The case of Canada: A cross-temporal meta-analysis. Personality & Individual modern China. European Journal of Personality, 26, 529-535 31 32 Differences, 155, 109707 31 32 5. Narcissistic Personality Disorder Pathological (clinical) narcissism NPD: “The essential feature of narcissistic personality disorder is a pervasive pattern of grandiosity, need for admiration, & lack of empathy that begins by early adulthood and is present in a variety of contexts” (DSM-5) Maladaptive: involves impairment &/or distress High functioning vs dysfunctional NPD 50-75% male Prevalence: 0-6.2 % (DSM-5) 33 34 33 34 Narcissistic Personality Disorder The many faces of Narcissistic (NPD) Personality Disorder DSM-III (1980): NPD first included “Individuals with narcissistic personality disorder DSM-5: suggestion of excluding NPD but then can be competent & high functioning with included (Miller et al, 2010) professional & social success, while others can have various levels of functional impairment. “… rationale to remove NPD was a perceived lack of empirical support evidenced by a sparse Professional capability combined with self-control, literature” stoicism, & interpersonal distancing with minimal (Paris, 2014) self-disclosure can support sustained life One of the least studied PDs engagement & even enable marriage & social Paris, J. (2014). Modernity & narcissistic personality disorder. Personality affiliations” Disorders: Theory, Research, & Treatment, 5, 220-226 35 (DSM-5) 36 35 36  8/09/2024 The many faces of Narcissistic The many faces of Narcissistic Personality Disorder Personality Disorder “Individuals with narcissistic personality disorder may be grandiose or self-loathing, extraverted or socially isolated, captains of industry or unable to maintain steady employment, model citizens or prone to antisocial activities. Given this heterogeneity, it is far from self-evident what such individuals could have in common to justify a shared diagnosis” Caligor, et al. (2015). Narcissistic personality disorder: diagnostic & clinical (Caligor et al., 2015) challenges. American Journal of Psychiatry, 172, 415-422. 37 38 37 38 The many faces of Narcissistic Personality Disorder 39 40 39 40 Pathological narcissism dimensions (Pincus et al. 2009) NPD & vulnerable self-esteem Narcissistic grandiosity: characterised by an overvalued, entitled self-image; exploitative, “Vulnerability in self-esteem makes individuals exhibitionistic behaviours; absorption in with narcissistic personality disorder very idealised fantasies; & other maladaptive self- sensitive to criticism or defeat. Although they enhancement strategies may not show it outwardly, such experiences may Narcissistic vulnerability: characterised by a leave them feeling ashamed, humiliated, depleted, enfeebled self-image; angry, degraded, hollow, & empty. They may react with shameful, & depressed affects; self-criticality disdain, rage, or defiant counterattack” (DSM-5) & suicidality; interpersonal hypersensitivity & social withdrawal 41 42 41 42  8/09/2024 NPD & vulnerable self-esteem Assessing pathological narcissism Lambe et al. (2018): systematic review (25 samples) Pathological Narcissism Inventory (PNI) NPD associated with 3- to 11-fold increase in 52 items; 7 dimensions of pathological violence narcissism NPD strong predictor of more severe Narcissistic grandiosity: Entitlement Rage, violence (eg. homicide) Exploitativeness, Grandiose Fantasy, Self- sacrificing Self-enhancement Exposure to imperfection & failure associated Narcissistic vulnerability: Contingent Self- with ↑ suicide risk (DSM-5) esteem, Hiding the Self, Devaluing Higher lethality compared to other PDs Pincus, et al. (2009). Initial construction & validation of the Pathological Narcissism Inventory. Psychological Assessment, 21, 365-379 43 44 43 44 Can we distinguish normal & PNI items pathological narcissism? 45 DEPARTMENT OF PSYCHOLOGY 46 45 46 Can we distinguish normal & Treating NPD: challenges pathological narcissism? “Questions remain regarding optimal interventions & conditions that can promote & implement change in treatment of patients with NPD” (Ronningstam, 2016) Lack of RCTs, systematic treatment reviews Mentalisation-based; transference- focussed; schema-focussed therapies Ronningstam, E (2016). Pathological narcissism & narcissistic personality disorder: recent research & clinical implications. Current Behavioral 47 48 Neuroscience Reports, 3, 34-42 47 48  8/09/2024 Treating NPD: challenges A risk with treating NPD? Highly co-occurring with substance use “ Talking about oneself to a therapist who listens disorder (esp. cocaine), depression, carefully & offers support might even be anorexia nervosa (DSM 5) considered a narcissist’s dream. In this way, Highly co-occurring with Antisocial, some forms of psychological treatment risk Histrionic, Borderline, & Paranoid PDs supporting the very traits that lead to dysfunction” Poorest treatment success when co- (Paris, 2014) occurring with Antisocial PD NPD & ↑ treatment dropout rates 49 50 49 50 Treating NPD: challenges Thanks… Yakeley, J. (2018). Current understanding of narcissism & narcissistic personality disorder. BJPsych Advances, 24, 305-315 Weinberg, I., & Ronningstam, E. (2020). Dos & don'ts in treatments of patients with 51 52 narcissistic personality disorder. Journal of Personality Disorders, 34 122-142 51 52