A latent structure analysis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Narcissistic Personality Disorder criteria

Fossati, Andrea; Beauchaine, Theodore P.; Grazioli, Federica; Carretta, Ilaria; Cortinovis, Francesca; Maffei, Cesare

doi:10.1016/j.comppsych.2004.11.006

Cited by 91 publications

(77 citation statements)

References 14 publications

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“…The first model was consistent with prior research specifying a two-factor structure of narcissism including overt and covert narcissism (13). The first factor, labeled overt NPD, included the following DSM-IV NPD symptoms as manifest indicators: grandiosity, special and unique, entitlement, exploitative, lack of empathy, and arrogant behavior.…”

Section: Resultssupporting

confidence: 58%

“…There has been some debate as of late as to the nature of narcissistic personality disorder and the degree to which the DSM-IV construct: a) assesses only an overt, grandiose version of NPD (12), b) includes symptoms that are mainly overt but a description that integrates a description of covert, vulnerable narcissism (9), or c) includes symptoms of both an overt and covert nature (13). This debate is important as there is empirical data to suggest that these two variants, which have been found in a number of studies (9)(10)(11)(12), have substantially different nomological networks with regard to basic personality traits, psychological distress, and etiological factors such as parenting styles (9)(10)12,21,22).…”

Section: Discussionmentioning

confidence: 99%

“…The 2-factor model is specified on the basis of results from Fossati et al's study (13). We then examine the nomological network of these two models with regard to the factors' relations with other DSM-IV PD, as well as depression and anxiety scores.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…Empirically, only one study has examined this issue using explicit measures of the DSM-IV NPD criteria. Fossati et al (13) examined the factor structure of the DSM-IV NPD symptoms, as assessed by a semistructured interview, in a sample of 641 outpatients in Milan, Italy. Using confirmatory factor analysis, Fossati et al found that a 2-factor model with correlated factors best fit their data.…”

mentioning

confidence: 99%

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An examination of the factor structure of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, narcissistic personality disorder criteria: one or two factors?

Miller

Hoffman

Campbell

et al. 2008

Comprehensive Psychiatry

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A growing body of research has suggested that narcissistic personality disorder (NPD) contains two factors or types: overt/grandiose and covert/vulnerable. A recent factor analysis of DSM-IV NPD symptoms supported a similar two-factor model. The present research tested this proposed two-factor solution against a one-factor solution (N = 298; 72% patients) using both confirmatory factor analysis (CFA) and an examination of associations between the resultant factors and theoretically relevant criteria (other PDs; depression, anxiety). The results of the CFA supported a one-factor solution. Likewise, the two factors each yielded a similar pattern of correlations with relevant criteria. Together, these results argue against a two-factor structure for the current DSM-IV NPD symptoms. Given the broader research literature suggesting a two-factor structure of narcissism, strategies for assessing both overt/grandiose and covert/vulnerable forms of narcissism in DSM-V are discussed. Narcissistic personality disorder (NPD) is characterized by a "pervasive pattern of grandiosity, need for admiration, and lack of empathy" (1; p.714). While narcissism and NPD have attracted the attention of prominent personality theorists such as Freud (2), Kernberg (3), Kohut (4), and Millon (5), NPD has received little empirical attention. This is at odds with the sizable body of research that exists on the study of narcissism as a "normal" trait (e.g., 6-7). Unfortunately, the degree of concordance between these conceptually similar constructs (e.g., trait narcissism as measure by the Narcissistic Personality Inventory [NPI,8] vs. NPD, as assessed by the DSM-IV) is unclear (9). As a result, it is difficult to be certain that the substantial body of empirical work from the social-personality literature generalizes directly to the study of NPD.One specific area of interest with regard to NPD is its underlying factor structure. Research using alternative measures of narcissism has suggested that there may be two forms of narcissism, which have been labeled "overt" vs. "covert" or "grandiose" vs. "vulnerable" (9-12), that may primarily "share a cognitive orientation to pathological Correspondence: Address correspondence to: Joshua D. Miller, Department of Psychology, University of Georgia, Athens, 542-1173; Fax: (706) 542-8048; e-mail: jdmiller@uga.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. (12, p. 205). However, the two variants are thought to differ with regard to their relation to self-esteem, negative emotionality, and extraversion/dominance (9-12), with the overt/grandiose "t...

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Section: Resultssupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

mentioning

confidence: 99%

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An examination of the factor structure of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, narcissistic personality disorder criteria: one or two factors?

Miller

Hoffman

Campbell

et al. 2008

Comprehensive Psychiatry

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“…The few empirical studies of NPD that have used clinical samples and DSM based measures have focused on the underlying factor structure and item content (6)(7)(8). In particular, there is a striking lack of data regarding the impairment and distress associated with NPD.…”

mentioning

confidence: 99%

Narcissistic personality disorder: relations with distress and functional impairment

Miller¹,

Campbell²,

Pilkonis³

2007

Comprehensive Psychiatry

252

146

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This study examined the construct validity of Narcissistic Personality Disorder (NPD) by examining the relations between NPD and measures of psychological distress and functional impairment both concurrently and prospectively across two samples. In particular, the goal was to address whether NPD typically "meets" Criterion C of the DSM-IV definition of Personality Disorder, which requires that the symptoms lead to clinically significant distress or impairment in functioning. Sample 1 (N =152) was composed of individuals receiving psychiatric treatment, while Sample 2 (N=151) was composed of both psychiatric patients (46%) and individuals from the community. NPD was linked to ratings of depression, anxiety, and several measures of impairment both concurrently and at 6-month follow-up. However, the relations between NPD and psychological distress were (a) small, especially in concurrent measurements, and (b) largely mediated by impaired functioning. NPD was most strongly related to causing pain and suffering to others, and this relationship was significant even when other Cluster B personality disorders were controlled. These findings suggest that NPD is a maladaptive personality style which primarily causes dysfunction and distress in interpersonal domains. The behavior of narcissistic individuals ultimately leads to problems and distress for the narcissistic individuals and for those with whom they interact. Narcissistic Personality Disorder: Relations with distress and functional impairmentNarcissistic personality disorder (NPD), despite substantial interest from a theoretical perspective, has received very little empirical attention (1). In fact, some have concluded that "most of the literature regarding patients suffering with narcissistic personality disorder is based on clinical experience and theoretical formulations, rather than empirical evidence" (2; p. 303). A large majority of empirical studies on narcissism come from a social-personality psychology perspective which, while methodologically sophisticated and important, may not pertain to Narcissistic PD given the reliance on undergraduate samples and the use of the Narcissistic Personality Inventory (NPI, 3). Trull and McCrae (4) have noted that narcissism measured by the NPI appears to be made up of high Extraversion, low Agreeableness, and low Neuroticism from the Five-Factor Model of personality (5), while DSM definitions suggest low Agreeableness, high Neuroticism and no relation with Extraversion. These authors suggest that "most narcissistic scales do not square well with DSM-III-R criteria for NAR" (4; p.53).1 Correspondence concerning this article can be addressed to Joshua D. Miller, Ph.D., Psychology Building, Department of Psychology, University of Georgia, Athens, GA 30602. Fax: (706) 542-8048 E-mail: jdmiller@uga.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will un...

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Assessment of Narcissistic Personality Disorder

Watson¹,

Bagby

2011

The Handbook of Narcissism and Narcissistic Personality Disorder

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A latent structure analysis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Narcissistic Personality Disorder criteria

Cited by 91 publications

References 14 publications

An examination of the factor structure of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, narcissistic personality disorder criteria: one or two factors?

An examination of the factor structure of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, narcissistic personality disorder criteria: one or two factors?

Narcissistic personality disorder: relations with distress and functional impairment

Assessment of Narcissistic Personality Disorder

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