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Despite putative gender differences in the expression of narcissism, prominent theories have virtually dismissed the role of females in the development and manifestation of narcissism. The contention that narcissism is a pathology of the self that may partly differ in males and females is further evident in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 reports that up to 75% of those diagnosed with Narcissistic Personality Disorder (NPD) are men. Such figures suggest that the representation of narcissism as codified in the DSM-5 may only be marginally applicable to females, given its prominent focus and nature on capturing grandiose themes which closely resemble commonly masculine norms. The overemphasis on grandiose features extends to the empirical literature which defines narcissism as a normative personality trait and is widely assessed using the Narcissistic Personality Inventory (NPI), on which males obtain significantly higher scores than females. As this review will demonstrate, one limitation frequently occurring in the literature is the attempt to comprehend narcissistic manifestations in females through the lens of what has commonly been defined as narcissism (DSM/NPI). In this review, the literature concerning the diagnostic assessment and conceptualization of narcissistic personality disorder, etiological factors, aggression, and partner violence perpetration will be discussed in relation to the importance of gender. This is followed by a review of existing gaps in theory and research, and suggestions for fruitful directions that can aid a richer and more meaningful literature on narcissism inclusive of gender issues.

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Addressing an underresearched aspect of narcissism, this study investigated subclinical "grandiose" and "vulnerable" narcissism within the context of domestic violence. Common triggers evoking narcissistic rage and differences in narcissistic injury response were explored. Qualitative semi-structured interviews with seven participants who reported being in a relationship with a narcissistic partner were thematically analyzed. Three overarching themes emerged: (a) overt and covert expressions of abuse, (b) challenge to self-perceived authority, and (c) fear of abandonment. Findings suggest both grandiose and vulnerable narcissists' reactions to narcissistic injury are most likely covertly and overtly aggressive and violent; however, the underlying motives for the behavior differed. For grandiose narcissists, violence was commonly triggered by threats to self-esteem, whereas vulnerable narcissists commonly experienced significant injury and rage from fear of abandonment. It is argued that attempts to regulate and restore self-esteem for the two subtypes of narcissistic presentation will differ, thus providing further support for theoretical distinctions between grandiose and vulnerable narcissists in intimate relationships. It is concluded that popular images of the narcissist are overly simplistic as the personality trait is more complex than the grandiose type typically presented. This study contributes new understanding to the nature of narcissism in domestic violence. Limitations and suggestions for future research are discussed.

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