Body image concerns revolving around body ideals (thin ideal, muscular ideal) are widespread among women. Whereas a stronger preoccupation with ideal physical appearance is often assumed for narcissistic women, previous empirical findings have been mixed. Following a tripartite structure of agentic, antagonistic, and neurotic narcissism facets, we reexamined whether trait narcissism predicted drive for thinness and drive for muscularity. We further explored the role of importance of appearance as a mediator and moderator of the relation between narcissism and body image concerns. Latent structural equation modeling was applied to self-report data from two independent nonclinical female samples (NSample1 = 224, NSample2 = 342). Results underlined the importance of distinguishing between narcissism facets: Neurotic (but not agentic or antagonistic) narcissism uniquely predicted drive for thinness and drive for muscularity. Importance of appearance mediated but did not robustly moderate these relations. Hence, neurotic narcissistic women (characterized by hypersensitivity, shame, and a fragile self-esteem) are particularly prone to body image concerns. This vulnerability seems partly driven by how much importance they ascribe to their appearance. Future work might build on these insights to further unravel the processes linking neurotic narcissism to body image concerns and how these can be targeted in practical interventions.

Background/Objective: A detrimental impact of narcissistic personality traits on depressive symptomatology, therapeutic alliance, and treatment outcome, even in the absence of narcissistic personality disorder (NPD), has been theorized. However, the evidence base in clinical settings is lacking. As research classification systems such as the ICD-11 and DSM-5 are moving towards a dimensional operationalization of personality disorders, it appears imperative to examine narcissism as a multifaceted construct and its impact on depressive symptom severity across mental disorders and different treatment settings. Moreover, due to the common interpersonal challenges associated with narcissism, the therapeutic alliance might be a key mechanism to understand narcissism related poorer treatment response.Methods: We examined the effect of narcissism and its facets admiration and rivalry on baseline as well as post-treatment depressive symptoms in two independent samples: one sample from a cognitive behavioral treatment setting, pooled from an inpatient psychiatric clinic and a cooperating outpatient treatment service (CBT; n = 1569) and an inpatient clinic with psychodynamic treatment focus (PIT; n = 802). An additional mediation analysis for the effect of the therapeutic alliance on the association between narcissism and depression severity after treatment was conducted in the outpatient CBT subsample.Results: Narcissistic rivalry was associated with higher depressive symptom load at baseline, while narcissistic admiration showed the opposite effect in both samples. Core narcissism was not related to depression severity before treatment. Poorer treatment response was predicted by core narcissism and narcissistic rivalry in the CBT sample while no effect of narcissism on treatment outcome was discernible in the PIT sample. Therapeutic alliance mediated the effect of narcissism on post-treatment depression severity in the outpatient CBT sample.Conclusions: As narcissism affects depression severity before and after treatment across psychiatric disorders even in the absence of NPD, the inclusion of dimensional assessments of narcissism should be considered in future research and clinical routine. Building on this, the observed relevance of the therapeutic alliance and the therapeutic strategy might be leveraged to guide personalized treatment approaches.

Body image concerns revolving around body ideals (thin ideal, muscular ideal) are widespread among women. Whereas a stronger preoccupation with ideal physical appearance is often assumed for narcissistic women, previous empirical findings have been mixed. Following a tripartite structure of agentic, antagonistic, and neurotic narcissism facets, we reexamined whether trait narcissism predicted drive for thinness and drive for muscularity. We further explored the role of importance of appearance as a mediator and moderator of the relation between narcissism and body image concerns. Latent structural equation modeling was applied to self-report data from two independent nonclinical female samples (NSample1 = 224, NSample2 = 342). Results underlined the importance of distinguishing between narcissism facets: Neurotic (but not agentic or antagonistic) narcissism uniquely predicted drive for thinness and drive for muscularity. Importance of appearance mediated but did not robustly moderate these relations. Hence, neurotic narcissistic women (characterized by hypersensitivity, shame, and a fragile self-esteem) are particularly prone to body image concerns. This vulnerability seems partly driven by how much importance they ascribe to their appearance. Future work might build on these insights to further unravel the processes linking neurotic narcissism to body image concerns and how these can be targeted in practical interventions.

To what extent do individuals differ in understanding how others see them and who is particularly good at it? Answering these questions about the “good meta-perceiver” is relevant given the beneficial outcomes of meta-accuracy. However, there likely is more than one type of the good meta-perceiver: one who knows the specific impressions they make more than others do (dyadic meta-accuracy) and one who knows their reputation more than others do (generalized meta-accuracy). To identify and understand these good meta-perceivers, we introduce the Social Meta-Accuracy Model (SMAM) as a statistical and conceptual framework and apply the SMAM to four samples of first impression interactions. As part of our demonstration, we also investigated the routes to and the correlates of both types of good meta-perceivers. Results from SMAM show that, overall, people were able to detect the unique and general first impressions they made, but there was little evidence for individual differences in dyadic meta-accuracy in a first impression. In contrast, there were substantial individual differences in generalized meta-accuracy, and this ability was largely explained by being transparent (i.e., good meta-perceivers were seen as they saw themselves). We also observed some evidence that good generalized meta-perceivers in a first impression tend to be extraverted and popular. This work demonstrated that the SMAM is a useful tool for identifying and understanding both types of good meta-perceivers and paves the way for future work on individual differences in meta-accuracy in other contexts.