The Road from Pathological Narcissism to Suicidality in Adolescence: An Empirical Study

Abstract

Background: Clinical and empirical research evidenced a complex link between pathological narcissism and the suicidal process in adulthood. Given the relevance of suicidality and the peculiar narcissistic vicissitudes of adolescence, the proposed research investigated the relationship between pathological narcissism analyzed from the multi-dimensional perspective of the Diagnostic Interview for Narcissism (DIN) and suicidal ideation conducted in a sample of Italian Adolescents. Methods: One hundred and three Italian male and female adolescents between 12 and 18 were administered the DIN, SCIDII, CSSRS, and Kiddie-SADS with six months follow-up. Results: The correlation, t-test, multiple regression analyses evidenced the association of narcissistic affective states and mood with both suicidal ideation and lethality of conduct. The increase in the dimension of grandiosity is associated with the passage to potentially highly lethal suicidal gestures. Conclusions: Suicidal ideation and conduct seem to serve the function of restoring a sense of control and self-esteem in narcissistic individuals experiencing a state of affective dysregulation. Narcissistic pathological functioning seems to play an important role in the adolescent suicidal process, quite like adulthood. Assessing an adolescent’s narcissistic functioning may provide useful clinical information in understanding and managing the suicidal risk in this phase of life.

Are PID-5 personality traits and self-harm attitudes related? A study on a young adult sample pre-post COVID-19 pandemic

“…It is possible that the age of the individuals involved (>18) influenced the results. Indeed, previous research that has identified a significant difference in pre-/post-pandemic self-harm attitude levels is predominantly conducted in samples of young adolescents or adults (Boldrini et al, 2021; Moselli et al, 2021a ; Lai et al, 2021 ; Schwartz-Mette et al, Williams et al, 2021 ; Iob et al, 2020 ).…”

From a Symptom-Based to a Person-Centered Approach in Treating Depressive Disorders in Adolescence: A Clinical Case Formulation Using the Psychodynamic Diagnostic Manual (PDM-2)’s Framework

“…Often, depressed adolescents fear the loss of approval and acceptance from significant others, engaging them in angry tirades. These internal fights against depressive affects and attempts to avoid feeling helpless by becoming angry instead can be viewed as efforts to again conquer a sense of superiority [69,70].…”

Patient personality and therapist responses in the psychotherapy of adolescents with depressive disorders: toward the <i>Psychodynamic Diagnostic Manual</i> - third edition

“…In adolescent patients with this personality subtype, depressive symptoms might reflect their inner experience characterized by a strong sense of failure and a deep vulnerability to shame and humiliation (Cheek et al ., 2018 ). These young people constantly strive for perfection and accomplishments and are plagued by oscillations between feelings of superiority and triumph over the other and a sense of worthlessness and inferiority, suicidal ideation, and even conducts which characterize the “introjective” depression of Blatt ( 2004 ) (Lingiardi & McWilliams, 2017 ; Williams et al ., 2021 ). Lastly, adolescents with an emerging borderline personality syndrome are mainly characterized by a pervasive sense of identity diffusion, primitive defense mechanisms, affective instability and impulsivity, often leading them to act self-harming behaviors or suicide attempts, as well as chaotic interpersonal relationships, which originate from the conflict between an intense desire for dependence and an equally deep fear of abandonment (Kernberg, 1967 ).…”

“…, insecurity, hypersensitivity to criticism) connected to low self-esteem (Ogrodniczuk & Kealy, 2013 ; Tanzilli et al ., 2021 ), as well as of the need for relatedness and dependence on others (Rost et al ., 2018 ). In the treatment, they feel exposed to the clinician’s scrutiny, which can make them feel small, dependent, and humiliated (Kernberg et al ., 2000 ), and may tend to use suicidal ideation and behaviors to exert their power over the therapeutic relationship (Tanzilli et al ., 2021 ; Williams et al ., 2021 ). Overall, depressed patients with marked narcissistic characteristics have more trouble fully engaging in the therapeutic process; therefore, they tend to have more difficulties in benefiting from therapeutic interventions (Gabbard, 2009 ), frequently cause impasses or alliance breakdowns (Ronningstam, 2019 ), and, more generally, show high levels of abandonment (Lamkin, 2018 ).…”