Vulnerable and Grandiose Narcissism

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The Pennsylvania State University
The Graduate School
Department of Psychology
INTERPERSONAL ANALYSIS OF
GRANDIOSE AND VULNERABLE NARCISSISM
A Thesis in
Psychology
by
Kelly A Dickinson
2001 Kelly A. Dickinson
Submitted in Partial Fulfillment

of the Requirements
for the Degree of
Doctor of Philosophy
August 2001
UM! Number: 3020441
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We approve the thesis of Kelly A. Dickinson.
Date of Signature
^ __________ li / ^ /z & e o
Aaron L. Pincus
Associate Professor o f Psychology
Thesis Advisor
Chair of Committee
uben Echemendia
Clinical Associate Professor of Psychology
William Ray
Professor o f Psychology
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Juaith
Juiitb Van Herik
Associate Professor o f Religious Studies
and Jewish Studies
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ofessor of Psychology
ead of the Department of Psychology
ABSTRACT
This paper examined the validity o f two subtypes of pathological narcissism, a
grandiose and a vulnerable subtype through an analysis of current interpersonal
functioning and parental representations. The grandiose personalities in this sample were
rated high in the dramatic traits associated with narcissistic, antisocial, and histrionic
personality disorders, and they reported interpersonal problems of the vindictive and
dominant nature. However, despite the observable traits consistent with character
pathology, they reported secure adult attachment orientations and denied interpersonal
distress related to their interpersonal problems. Vulnerable narcissistic individuals were
represented by high ratings on avoidant personality disorder and their self report of fearful
attachment. They reported high interpersonal distress, and greater interpersonal
difficulties than the control group in vindictive, dominant, cold, and avoidant interpersonal
patterns. An interaction effect occurred for participants ratings of the maternal
relationship, where grandiose males rated their maternal relationship as above average in
affiliation and grandiose females rated their maternal relationship below average in
affiliation. Vulnerable females generally rated their maternal relationships as more highly
affiliative than vulnerable males and grandiose females. The validity o f grandiose and
vulnerable narcissism based upon the results of this study was discussed in terms of clinical
theory and with reference to the implications of two subtypes of pathological narcissism
for diagnosis and treatment.
iv
TABLE OF CONTENTS
LIST OF FIGURES................................................................................................... vi
LIST OF TABLES...................................................................................................... vii
ACKNOWLEDGEMENTS...................................................................................... viii
Chapter 1: INTRODUCTION................................................................................. 1
Narcissism and NPD...................................................................... 3

H istory of Concept o f Narcissism and Its Pathology.................. 3
Narcissistic Personality Disorder.................................................... 12
Narcissistic Subtypes......................................................................... 15
A n Interpersonal Analysis o f the Two Narcissistic Subtypes................. 29
Hypotheses....................................................................................................... 34
Current Interpersonal Functioning................................................ 35
Parental Representations................................................................. 38
Chapter 2: METHODS AND PROCEDURES..................................................... 40
Group Selection M ethods............................................................................... 40

Selection: Narcissistic Personality Inventory................................ 41
Participant Characteristics................................................................ 43
Core Study Methods and Procedures.......................................................... 43
Research Assistant Recruitm ent and Training.......................... 43
Participant Recruitm ent and Procedures...................................... 45
M easures................................................................................................ 46
Chapter 3: RESULTS................................................................................................... 56
M anipulation Check Results......................................................................... 56

Group Selection Param eters............................................................ 56
Narcissism and Self-esteem M easures............................................ 57
Core Hypotheses Results................................................................................ 59
Current Interpersonal Functioning.............................. 60
Parental Representations................................................................... 68
V
Chapter 4: DISCUSSION.......................................................................................... 86
Selection/M anipulation Check...................................................................... 86

The Grandiose Narcissist................................................................................ 90
The Vulnerable Narcissist.............................................................................. 98
Diagnostic/Treatment Im plications................................................................ 105
A Clinical Example............................................................................................. 109
Lim itations and Future Directions................................................................. 114
Conclusions...........................................................................................................119
REFERENCES................................................................................................................. 120
vi
LIST OF FIGURES
Figure 1. UP-C Profiles o f Narcissistic Personalities........................................... 76
Figure 2. Attachment Styles and Narcissistic Personalities............................... 78
Figure 3. Interaction Effect for SASB Ratings for Mothers Affiliative
Actions Towards Participants.................................................................. 82
Figure 4. Interaction Effect for SASB Ratings for Mothers Affiliative
Reactions to Participants.......................................................................... 83
Figure 5. Interaction Effect for SASB Ratings for Participants Affiliative
Actions Towards M other.......................................................................... 84
Figure 6. Interaction Effect for SASB Ratings for Participants Affiliative
Reactions to M other................................................................... 85
LIST OF TABLES
Table 1. Univariate Analyses for Mean Differences in NPI-ADJ
and NPI-MAL Scores across the Four Sam ples................................. 72
Table 2. Percentages for Group Membership Across Samples and
compared with Hibbard & Dunces (1995) initial sample................ 73
Table 3. M anipulation Check Results for Narcissism and
Self-Esteem Data....................................................................................... 74
Table 4. Grandiose and Vulnerable Narcissism and Personality
Disorder Criteria M et............................................................................... 75
Table 5. Grandiose and Vulnerable Narcissism and
Interpersonal Problems............................................................................ 77
Table 6. Grandiose and Vulnerable Narcissism and
Adult Attachment Styles.......................................................................... 79
Table 7. M ultivariate and Univariate Results for
Participants Parental Representations................................................ 80
ACKNOWLEDGMENTS
For his wonderful mentorship, I wish to thank Dr. Aaron L. Pincus. Thanks also
to all individuals in the Department of Psychology at Pennsylvania State University (PSU)
from 1994 to 2001 for their support. Specifically, I thank my dissertation committee: Dr.
Aaron L. Pincus, Dr. Ruben Echemendia, Dr. William Ray, and Dr. Judith Van Herik. I
feel much gratitude to the research assistants who helped greatly with this project,
specifically Kelly Wilson, Cindy Keith, and Kathleen Fuhrer, and to the students at PSU
who participated in this study. I thank my clinical supervisors at PSU: Drs. Mary
Boutselis, Gowen Roper, Ruben Echemendia, Aaron L. Pincus, William Ray, Mary
McClanahan, Jill Morgan, and Patty Johnstone, M S. W. I am thankful for the training
experience I received on predoctoral internship at Northwestern Memorial Hospital
(NMH) in Chicago, Illinois. Thanks to the psychology interns, post-doctoral fellows, and
psychiatry residents at NMH 2000-2001 for their excellent contribution to my training
experience. I am grateful for the opportunity provided by my many clients at the
Psychological Clinic and Counseling and Psychological Services at PSU and at the
Outpatient Treatment Center at NMH who challenged me to leam how to be more helpful
to them. Finally, I wish to specifically thank my family and friends for their patience and
support through graduate school: Bob and Julie Dickinson, Jill Dickinson and Vipin
Singh, Allan Vives, Carole Bruschi, Kathleen Holden, and Tom Cates.
1
Chapter 1
INTRODUCTION
Over the past two decades, personality research on narcissism has advanced to an
increasingly active communion with theory on narcissism. Nonetheless, given its long
theoretical history stemming largely from the psychodynamic domain, theory on narcissism
continues to lead its empirical partner in the reciprocal dance. Empirical interest in
narcissism was incited from the addition o f one form of maladjusted narcissism to the
Diagnostic and Statistical Manual for Mental Disorders (DSM; American Psychiatric
Association, 1980, 1987, 1994) in its inclusion of Narcissistic Personality Disorder
(NPD), a category drawn mostly from the conceptual work o f Kemberg (1970, 1974,
1975). However, both contemporary theorists of narcissism (Akhtar & Thomson, 1982;
Cooper, 1981, 1998; Kohut, 1971) and clinicians who specialize in personality pathology
have delineated two different types o f narcissistic characters (Gabbard, 1989, 1998;
Gersten, 1991; Masterson, 1993). The first is a grandiose subtype, which is described as
an individual who is overtly arrogant and self-enhancing with the tendency to deny
personal weaknesses and negative emotional experience. This character is reflected in the
representation of NPD in the DSM (American Psychiatric Association, 1994), wherein
narcissistic pathology is described as grandiose, arrogant, entitled, exploitative, and
2
envious. The second subtype is regarded as a vulnerable narcissistic personality, which is
described as overtly self-inhibited and modest but harboring underlying grandiose
expectations for oneself and others (Gabbard, 1989, 1998). Unable to undertake the self
enhancing mechanism like his/her grandiose peer, the vulnerable subtype is alleged to be
more emotionally reactive to perceived slights and more aware o f his/her vulnerability
within relationships than the grandiose subtype.
While the vulnerable subtype has been increasingly identified and proposed as a
valid subtype of narcissistic pathology, this distinction has not been described in the
current diagnostic nomenclature. Likewise, there has been little research into the validity
of the second of the proposed subtypes while there has been considerable, albeit
equivocal, research on the grandiose subtype (Hilsenroth, Handler, & Blais, 1996). The
absence o f empirical research on vulnerable narcissism may be a factor in the current
problems with the diagnostic validity of NPD (Cooper & Ronningstam, 1992; Gunderson,
Ronningstam, & Smith, 1991), as the observation of these more vulnerable characters may
muddle the diagnostic conceptualization of the grandiose character. Furthermore, and
most importantly, the failure to appreciate the vulnerable subtype o f narcissistic pathology
may lead to false negative or false positive diagnostic errors, where narcissistic pathology
is not recognized or misdiagnosed as a different type of character pathology, respectively.
The current paper addresses this deficit by examining the validity o f the two narcissistic
3
subtypes through an analysis of their current interpersonal Sanctioning and their
representations of their early relationships with caregivers.
Narcissism and NPD
History of Concept o f Narcissism and its Pathology
The concept o f narcissism in clinical personality theory emerged principally from
psychoanalytic theory. Freud (1914/1957) designated primary narcissism as a normal
stage o f development, wherein there is a libidinal cathexis of the ego. Narcissism was
viewed in psychoanalytic theory as significant to the regulation of self-esteem through its
role in the development and regulation o f a positively-infused self-conception and in the
development of ideals. According to Freud, pathological narcissism involves the
defensive withdrawl from others into a state o f secondary narcissism, wherein there
emerges an exaggerated tendency towards self-focus, self-aggrandizement, and unrealistic
ideals. While Freud was primary in the introduction o f the concept o f narcissism to
clinical personality theory, he did not develop his ideas on narcissism as fully as he had his
anaclitic line of development. The articulation of the construct of narcissism was left
largely to psychodynamic theorists that would follow Freud, particularly Heinz Kohut
(1966,1971) and Otto F. Kemberg (1970, 1974, 1975).
4
Kohuts (1966, 1971) psychology o f the self involved the identification o f a
narcissistic line o f development that is separate from Freuds anaclitic (e.g. drives, object
as aim) line of development. His thesis rests in his assumption that in addition to the
evolution o f a drive-driven psychic structure that regulates tension and promotes the
attachment to objects, there arises a primary organismic structure called the self which is
the central nucleus of awareness and action. The self is viewed as bipolar, as it develops
along two narcissistic sectors, the grandiose pole and the idealizing pole. In normal
narcissistic development, the grandiose sector develops through stages ranging from
normal infantile grandiosity to mature ambitions, while the idealizing sector develops
through stages ranging from the idealization o f powerful others to a mature capacity for
realistic and appropriate ideals. While identified as separate bipolar lines in the
development of the sel the grandiose and idealizing poles are interdependent and
coalesce in a unified structure that propels self-interests and manages self-related afreet.
He proposed several needs that humans have beginning in early childhood and re-
occurring through adulthood as they are faced with normal threats to self-esteem inherent
in the reality of development across the lifespan. Mirroring involves the seeking of
another who will confirm the individuals conception of his or her self with empathy for a
childs natural grandiosity. Idealization involves seeking to connect with others the self
deems important and strong in order to further sustain ones self-experience o f integrity
and safety in light of the threats inherent to the dependent and immature self o f childhood.
5
These two needs of mirroring and idealizing are viewed as poles that parallel each
other in development of the sel and wherein a deficit could occur in either or both o f the
poles. Narcissistic pathology, according to Kohut, represents a defensive compensation
for a developmental arrest (e.g. deficit) due to unempathic parental responses to the child's
naturally-emerging grandiosity and need for idealization. A deficit in the grandiose pole
may be reflected in difficulties regulating self-esteem through realistic ambitions and their
goal-oriented pursuit. In contrast, a deficit in the idealizing sector is reflected in
difficulties in independently providing the self-soothing functions required for regulation of
self-related affects, weak ideals and standards, and the experienced need for a strong other
to provide the soothing functions and to impose the structure o f ideals. These deficits
result in the emergence of a defensive grandiose structure. This grandiose self-conception
is inappropriately self-enhancing, craving mirroring experiences that provide sustenance
for the deprived self-structure. While a continued need to be admired by others is viewed
as normal, the mirroring experiences that are desired by the pathologically grandiose self
occur at a level that would be considered age-inappropriate (e.g., expecting attention for
normal adult responsibilities such as cleaning or maintaining work), unrealistically entitled
(e.g., expecting others to view the self as important without proportionate achievements),
and overly reliant upon the environment as the source of provision (e.g., cohesiveness of
self-experience vulnerable to fragmentation without admiration and gratification from
others).
6
Kohut does not expand upon criteria for narcissistic pathology, as he believes the
diagnosis emerges within the observation of transference in relationship to the therapist,
wherein the individuals core deficit emerges in line with what needs are required to be met
by the therapist. A mirroring transference involves the need for confirmation of the self by
the therapist with the function of regulating self-esteem, whereas in an idealizing
transfere n c e involves experience of the self feeling special and cohesive in the relation to
an admired other that is perceived as stronger and wiser than the self.
Although Kohut did not outline specific criteria for narcissistic pathology, he did
outline a general configuration of experiences and observations consistent with the
narcissistic character. The goals of the self in narcissistic characters involve intense and
rigid attempts to avoid the experience of inadequacy, emptiness, shame, and depression.
Consistent with a mirroring transference, these individuals are often observed as holding
entitled expectations for others and as engaging actively in the exploitation of others in the
service of promoting the self. Their ongoing vulnerability through childhood often
emerged in interpersonal difficulties resulting in the absence o f positive peer experiences
and consequently a sense o f not belonging, an envious and competitive orientation to peer
relationships, an unregulated reliance on fantasy that is not channeled into realistic
activities, and difficulties in understanding and empathizing with others. According to
Kohut, narcissistic individuals are unusually sensitive to criticism, failures, and perceived
slights as these give rise to the experience of underlying inadequacy and its sequelae of
7
shame, humiliation, dysphoria and anxiety. In an attempt to disengage from these painful
emotions that they have not learned to appropriately regulate and tolerate, narcissistic
individuals have been observed to enlist a variety of strategies. These include the overt
experience of rage in the face o f perceived slights, the devaluation o f others that are
experienced as threatening, and the isolation o f the self in grandiose or retaliatory
fantasies. They further have been observed to align themselves with others whom they
admire for their status, power, or brilliance, using these idealized relationships to enhance
self-esteem in either its immediate personal gratification or through the social
advertisement of this connection (e.g. name dropping). Narcissistic entitlement and its
observable sequalae (i.e., rage) are interpreted by Kohut to be predictable byproducts of
the individuals unmet needs for confirmation and safety as a result o f early empathic
failures and failed idealizations.
Kemberg (1970, 1974, 1975) disagreed with Kohut in his placement of narcissism
as a significant line o f development, and rather views narcissistic pathology from within
the framework o f his drive-oriented object relations theory. So, like Freud, Kemberg
establishes narcissistic development within the structure o f drive theory, where the
aggressive drive becomes an important determinant o f narcissistic pathology. Unlike
Freud, however, Kemberg delineates the greater significance o f early interpersonal
relationships and the emotional experience attached to these relationships in the
structuring of the self. He describes the development o f a rich intrapsychic structure that
8
involves the internalization and integration of cognitive-emotional experiences of the self
in relation to important others. These internalized relations then provide the framework
for the experience o f the self and future relationships. His theoretical work on narcissism
is based largely on clinical observations and modem research on emotional development,
and are included as a part o f his extensive work on borderline personality organization.
According to Kemberg, the self is a substructure o f the ego that represents an
integration of self-representations that emerge from ones interactions with important
others. Normal adult narcissism is reflected in the positive libidinal investment in a
normally-integrated self that emerged from the fulfillment o f self-esteem needs and
relational needs occurring in an age-appropriate scheme. This normally-integrated self
involves an integrated perception of oneself based upon ones realistic positive and
negative aspects which is in accord with ones conceptions o f their ideal self (i.e. ego
ideal). Normal adult narcissism, then, involves a positive investment in an integrated self
through the engagement in age-appropriate channels to gratify self-esteem along with the
secure investment in interpersonal relationships. Thus, normal narcissistic functioning
involves viewing the self realistically, along with the ability to view others realistically in
their positive and negative attributes, along with experiencing them comfortably as
autonomous individuals with separate feelings and needs.
In contrast, narcissistic pathology is viewed as the libidinal investment in an
unintegrated and thus pathologically structured self. Kemberg proposes that narcissistic
9
pathology is a result of intolerable amounts of aggression emerging from early (oral) drive
frustrations threatening the individuals internal self- and object representations.
According to Kemberg, pathological narcissism is believed to develop as a defense
through which a child withdraws from external objects in reaction to parents who were
p red o minantly cold and rejecting, yet held certain expectations for their child for which the
child could earn their admiration. In an attempt to preserve the threatened self-object
representations, the extreme aggression that these individuals experience is projected
outward onto external objects. The grandiose self, according to Kemberg, reflects a
fusion of the images of the self that were admired by the parent, fantasized images of the
self that emerged due to early threats to self-integrity, and the idealized or fantasized
images of the parent. These three psychic entities come together to form the grandiose
self. Central to Kembergs theory is the notion that unacceptable experiences of the self
(e.g. needy child) and parents (e.g. harsh; withholding o f care) are split off or
dissociated from conscious experience and therefore not fully integrated. But,
nonetheless, this underlying structure that reflects the inadequate self continues to
influence the functioning o f the self and reveals its presence in the individuals chronic
boredom, depletion, and need for admiration.
According to Kemberg (1998), narcissistic pathology is expressed in the
observation of pathological self-love and object-love. The pathologically narcissistic
individual is overtly grandiose, which is indicated in a sense o f superiority, a proclivity
10
towards exhibitionism, and an incongruence between ambitions (e.g. ego ideal) and actual
abilities or inherent motivation. They display an inordinate and archaic attachment to
symbols (e.g. material objects) that reflect power, status, physical attractiveness,
independence, and wealth. While overtly grandiose, they are often viewed as
paradoxically dependent upon the admiration of others without requisite valuation of
others support or talents; indeed, there is a sense of being entitled to the admiration o f
others. They are observed to be extremely sensitive to slights by others, and often find
themselves either feeling superior or completely inadequate. Indeed, according to
Kemberg, their largest fear is to actually find themselves to be average or even
human. When not experiencing the gratification of success or admiration, pathologically
narcissistic individuals often reside in a state of emptiness or aloneness, typically, reporting
the experience of boredom and a hunger for excitement. Interpersonally, these individuals
exhibit a highly competitive orientation to others, and have been found to experience
inexorable feelings of envy for others. In an effort to regulate self-esteem and avoid the
experience of envy and its accompanying sense of inadequacy, these individuals will
devalue others that threaten self-esteem. At baseline, these individuals often appear
dismissive of relationships and blandly disparaging of others skills and efforts.
Pathologically narcissistic individuals, while dismissive and disparaging of others, are at
the same time overtly exploitative o f others. They have a remarkable incapacity to
empathize and invest emotion into other people. With their own neediness and inadequacy
11
unconsciously disavowed, these individuals have difficulties allowing themselves to
depend upon or even cooperate with others as it may lead to experiencing the underlying
inadequacy and envy that is so intolerable.
In both Kohuts and Kembergs conceptualization o f narcissistic pathology,
grandiosity is observed as an important characteristic. In both theories, entitled
expectations are the core cognitive orientation that influences observed grandiosity and
promotes an exploitative orientation within relationships. However, in Kohuts (1966,
1971) work, there is an emphasis upon the vulnerability inherent in narcissistic pathology.
Kohuts portrayal of the narcissistic character is marked by his/her tenuous self-esteem
and efforts to manage self-esteem either through grandiose self-enhancement and/or over
reliance upon others to soothe the vulnerable self. On the other hand, Kemberg describes
a character that is less vulnerable to interpersonal slights and more consistently able to
maintain a grandiose self, even under perceived self-esteem slights. Kerabergs narcissist
attempts to regulate self-esteem through the maintenance o f an overtly grandiose self-
image which is undertaken in overt self-enhancement and the projection of hostility upon
others. Both theories have influenced the diagnostic classification o f narcissistic
pathology, but Kembergs theory has been cited as having the most influence in the DSM
classification ofNPD (Akhtar & Thomson, 1982; Cooper, 1981, 1998).
12
Narcissistic Personality Disorder
NPD was first introduced in the DSM-HI (American Psychiatric Association,
1980) with the inclusion o f the multiaxial system that places personality disorders on Axis
n . The most recent edition, DSM-IV (American Psychiatric Association, 1994),
characterizes NPD as a "pervasive pattern of grandiosity (in fantasy or behavior), need for
admiration, and lack o f empathy, beginning by early adulthood and present in a variety of
contexts" (p. 351). A DSM diagnosis ofNPD is implied when an individual meets five of
nine criteria reflecting a long-standing pattern o f interpersonal exploitation, inflated and
grandiose sense of self, arrogant behaviors, need to experience one's uniqueness or see it
in reflected in another's uniqueness, preoccupation with grandiose or omnipotent fantasies,
a sense of entitlement, an unusual need for admiration in the maintenance of self-esteem, a
lack o f empathy, and the experience of envy. Consistent with the description of
personality disorder, this pattern of behavior must elicit clinically significant disruption in
occupational or social functioning or the subjective report of significant distress.
The prevalence o f individuals receiving an NPD diagnosis in recent studies utilizing
large community samples and structured interviews was less than 1% (Maier, Lichterman,
Klingler, Heun, & Hallmayer, 1992; Samuels, Nestadt, Romanoski, Folstein, & McHugh,
1994; Zimmerman & Coryell, 1990), while NPD diagnoses in clinical populations have
varied from 3% to 22% (Morey, 1988; Oldham, Skodol, Kellman, Hyler, Rosnick, &
13
Davies, 1992; Pfohi, Coryell, Zimmerman, & Stangl, 1986; Widiger, Trull, Hurt, Clarkin,
& Frances, 1987; Zanarini, Frankenburg, Chauncey, & Gunderson, 1987). Studies have
documented considerable comorbidity and overlap between NPD and other personality
disorders (Morey, 1988; Oldham, et. al., 1992; Pfbhl, et. al., 1986), particularly the other
cluster B diagnoses of histrionic personality disorder, borderline personality disorder, and
antisocial personality disorder. Utilizing a population of outpatients being treated for
personality disorders), Morey (1988) reported that individuals receiving an NPD
diagnosis overlapped most highly with histrionic personality disorder (53.1%), borderline
personality disorder (46.9%), paranoid personality disorder (35.9%), and avoidant
personality disorder (35.9%). NPD has also been shown to have high comorbidity with
antisocial personality disorder and passive-aggressive personality disorder (Oldham, et. al.,
1992).
Mixed results regarding sex differences in the diagnosis ofNPD have been
reported with a higher percentage of men receiving this diagnosis than women in one
study (Golomb, Fava, Abraham, & Rosenbaum, 1995), while there were no significant
differences with respect to sex in another study utilizing two large samples (Kass, Spitzer,
& Williams, 1983). There has been some evidence to suggest that sex differences in the
diagnosis ofNPD may be influenced by diagnostic bias in clinician's judgment with respect
to sex of subject, as when given the same clinical vignette, clinicians assigned a diagnosis
ofNPD to significantly more males and histrionic personality disorder to significantly
14
more women (Adler, Drake, & Teague, 1990). Additionally, there may be bias inherent
within the criterion items themselves, a question investigated by Lindsay and Widiger
(1995). In having participants rate specific personality disorder items from three self-
report inventories on their masculinity versus femininity, these investigators found
substantial evidence for a bias within 60% o f all criteria for the two DSM-based
narcissistic personality disorder scales. All of these criteria were significantly and
positively associated with masculinity.
While clinicians and personality theorists have long recognized the existence of a
grandiose narcissistic character, significant debate remains as to the relevant criteria for
NPD (Akhtar & Thomson, 1982; Cooper & Ronningstam, 1992; Gunderson,
Ronningstam, & Smith, 1991) and the validity of the diagnosis ofNPD has been equivocal
across both self-report and interview methods (Hilsenroth, Handler, & Blais, 1996).
Narcissistic pathology has generally been linked to the unrealistic enhancement o f the self
or overt grandiosity (American Psychiatric Association, 1980, 1987, 1994). Thus, the
hallmark of the DSM definition of narcissistic pathology is overt grandiosity, which is
reflected in at least four o f the nine criteria (i.e. grandiosity, grandiose fantasies, belief that
one is unusually special, and arrogant behaviors/attitudes) for the diagnosis ofNPD
(Ronningstam, 1988). While this conceptualization ofNPD has occupied its position in
the DSM system since 1980, it was devised conceptually rather than empirically relying
mostly on the theoretical work of Otto Kemberg (1970, 1974, 1975) whose theory
15
emphasized perceptible grandiosity as a central component in narcissistic pathology. Since
its inception, the DSM characterization o f NPD as anchored exclusively in overt
grandiosity has received substantial criticism by theorists (Cooper, 1981, 1998; Akhtar &
Thomson, 1982); clinicians (Gabbard, 1989,1998; Gersten, 1991; Masterson, 1993) and
researchers (Cooper & Ronningstam, 1992; Wink, 1991).
Narcissistic Subtypes
Beginning with Kohuts (1966, 1971) extensive elaboration on narcissism and its
pathology, several clinical theoreticians (Cooper, 1998; Gabbard, 1989, 1998; Gersten,
1991; Masterson, 1993) have argued for the acknowledgment of a broader range of
narcissistic pathology. It has been proposed that theoretically and clinically there exist
two distinct types o f pathologically narcissistic personalities, one of which would be the
overtly grandiose and aggressive character presented in the DSM. The second type that is
proposed to be overlooked by the DSM system has been garnished with a variety of labels
including the closet narcissistic personality (Masterson, 1993), hypervigilant narcissistic
personality (Gabbard, 1989), vulnerable narcissistic personality (Gersten, 1991; Hibbard &
Bunce, 1995; Wink, 1991), and covert narcissistic personality (Akhtar & Thomson, 1982;
Cooper, 1998). It is argued that unlike its overtly grandiose counterpart, the vulnerable
narcissistic personality is observed as overtly presenting with shyness, inhibition, humility,
16
and even the semblance o f empathy. Underlying this reticent public presentation,
however, lies a private core organized around grandiose expectations and entitlements,
competitiveness, devaluation of others, and fantasies o f grandeur, retaliation, and
exhibitionism. Similar to their grandiose counterpart, the vulnerable types often fail to
maintain lasting intimate relationships either through avoidance of relationships because of
their threat to self-esteem or as others disengage because they eventually recognize the
individuals core of self-absorption, competitiveness, and lack o f concern for others.
The grandiose types have also been labeled oblivious narcissists (Gabbard, 1989,
1998) because of their observed lack of insight into the impact they have on others. The
vulnerable types are more often recognized as being painfully aware of the conflict
between their overt presentation and the internal grandiose core that leads to a sense of
fraudulence and an overt experience of shame, guilt, and depression. The core
narcissistic element associated with both subtypes o f narcissistic pathology, according to
many theorists, is entitled or grandiose expectations for the self and others. However,
whereas the grandiose subtype is observably arrogant and demanding, the vulnerable
subtype harbors covert expectations that are grandiose in nature.
Both subtypes experience significant disappointment due to their entitled
expectations, but differ in the manner in which they regulate this disappointment and its
impact on the experience o f self-esteem. The grandiose narcissistic individual is more
likely to regulate self-esteem through overt self-enhancement and denial of weaknesses,
17
assertive and intimidating demands of entitlement, consistent anger in unmet expectations,
overt devaluation of people that threaten self-esteem, and active exploitation of others to
meet self-esteem needs. They are not aware of the dissonance between their expectations
and reality, along with the impact this has on relationships. Grandiose characters expect
their entitled expectations to be met without question and are more likely to demand this
overtly and punish harshly those who dont readily submit to his/her unrealistic needs.
The grandiosity is apparent and grandiose fantasies will be a part of the individuals overt
presentation, as they are not aware that their fantasies and reality are in conflict.
Grandiose personalities have little conflict over their grandiose expectations and thus
direct self-enhancement and overt devaluation is their method o f regulating any impact
their expectations have upon the environment. Accordingly, any conflict within the
environment is experienced as external to these individuals and not a measure of their own
unrealistic expectations.
On the other hand, the vulnerable narcissist is less equipped to use self
enhancement strategies to modulate self-esteem; rather, their self-esteem is often
experienced as dependent upon external feedback from others which promotes a greater
observed lability in self-esteem and affect than the grandiose character. Unlike the
grandiose character, the vulnerable character is more aware o f their own entitled
expectations, the divergence with reality, and the impact this has on their relationships.
The vulnerable narcissistic personality is more likely to experience extreme conflict
18
surrounding his or her entitled expectations, and is less likely to consistently assert
entitlements and expectations. Due to the inability to selfrenhance, the dependence upon
others, and the conflict around their grandiose experience, the vulnerable narcissist
experiences a greater sense of helplessness in getting what he or she expects from life.
Because o f this conflict, the vulnerable character attempts to disavow the underlying
entitlement and continual disappointments, often experiencing overt shame and depressed
affect vis a vis their underlying grandiosity. However, the disavowal of their own entitled
expectations leads to brewing anger and occasional hostile outbursts. The fluctuation
between shame/depression and overt anger influences the impression of a rather labile
emotional presentation as the individual attempts to manage their tenuous self-esteem.
Because of this history of disappointment and the noticeable impact this has on his/her
relationships, vulnerable individuals experience much ambivalence and anxiety in
developing relationships with others. In more vulnerable individuals, the consistent
disappointment is intolerable enough to promote greater withdrawal into solitary activity
and their hidden grandiose fantasies to the exclusion o f active involvement with others in
an attempt to temporarily manage self-esteem (Cooper, 1998; Cooper & Ronningstam,
1992, Gabbard, 1989, 1998; Gersten, 1991; Wink, 1991).
19
Diagnostic Dilemmas
There appears to be considerable confusion in the understanding, provision, and
communication of the diagnosis of NPD among clinicians (Gunderson, Ronningstam, &
Smith, 1991), which may be due in part to differing theories of narcissistic pathology that
guide the assessment of psychopathology (Cooper, 1998). If the recognition of two types
o f narcissistic disorders is valid, overlooking the vulnerable type could contribute to false
negative problems (i.e. narcissistic pathology not identified) and false positive problems
(i.e. narcissistic pathology misidentified as other pathology).
With regard to false positive diagnoses, there have been distinctions made between
the grandiose and vulnerable character that might lead to misinformed diagnoses of
vulnerable narcissism with at least two distinct personality disorders. The overt
representation of the vulnerable narcissistic character by theorists indicates an individual
who presents as shy and inhibited within relationships. The personality disorder diagnosis
that appears most closely characteristic of a shy and interpersonally anxious individual is
the avoidant personality disorder. In this diagnosis, there are several criteria that may
overlap with vulnerable narcissism. First, like vulnerably narcissistic individuals, avoidant
individuals are observed as appearing shy and being fearful of developing close
relationships with others. Second, individuals with avoidant personality disorder may
meet criteria for experiencing fears o f feeling humiliated, rejected, or embarrassed within
20
individual relationships, which is clearly a threat to self-esteem functioning. However,
apart from the expectation that others will reject or humiliate them, the DSM diagnosis of
avoidant personality disorder does not include reference to the individuals expectations of
others or the self. Another potentially corresponding area is the use o f fantasy in
individuals with avoidant personality disorder, which is not noted as a part of the diagnosis
for this disorder. However, Millon (1996), the forerunner in the conceptualization of
avoidant personality disorder, proposes that the use of fantasy in individuals with avoidant
personality disorder is a major element in the presentation and perpetuation of this
disorder. In his impressive theory on personality disorders, he proposes that individuals
with avoidant personality disorder utilize fantasy as the primary mechanism for dealing
with their interpersonal distress. Indeed, to the avoidant individual, fantasy is experienced
as safer than actual relationships with others. This is striking in the fact that the use of
unrealistic fantasy has long been denoted as the primary to the realm of narcissistic
pathology, where grandiose fantasy has been one o f the nine criterion in making this
diagnosis. I will therefore forward my belief that there is a subset of individuals who are
given the diagnosis of avoidant personality disorder that actually would meet criteria for
vulnerable narcissistic personality. The distinction to be made is with regard to whether
the individual exhibits a long-standing core o f entitled expectations that guide his/her
interpersonal anxiety and fantasy.
21
Another false positive diagnosis that may occur as a result of misinterpreting
vulnerable narcissism is in the diagnosis o f borderline personality disorder. Theorists o f
narcissism denote the observation of considerable emotional lability in the presentation o f
the vulnerable narcissistic character. The vulnerable character is recognized in his/her
greater vulnerability to the negative emotional experiences associated with entitled
expectations (e.g., shame, humiliation, depression, rage). Indeed, as mentioned before,
the vulnerable individual experiences great conflict about his/her entitled expectations.
Thus, he/she tends to fluctuate between extremes o f shame/disavowal and angry assertion
of his/her entitlements depending when these needs are experienced as unmet. Masterson
(1993) recently forwarded this issue in an elaborate discussion about the potential for
misdiagnosis of the closet narcissistic personality with borderline personality disorder. An
object relations theorist, Masterson explained that misdiagnosis occurs because of
attention to the overt presentation of the emotional lability of the individual to the
exclusion of an understanding of the cognitive and socio-emotional experience that guides
the lability. The emotional lability of the narcissist is influenced by their overt or
underlying difficulties regulating self-esteem in the face o f disappointment to their
unrealistically entitled needs. In contrast, the emotionally lability of the individual with
borderline personality disorder is a by-product of unrealistic anaclitic needs (e.g., the need
for a strong caretaker to manage their fears of being independent). Vulnerable narcissists
does not fear independently managing their adult lives. Rather, they fear losing important
22
people that aid them in managing their experience o f self and their tenuous self-esteem.
Similarly, another major theorist o f personality disorders has given voice to the
differentiation between narcissistic pathology and borderline pathology (Benjamin, 1996).
In her book on personality disorders, Benjamin asserts that the emotional expression of
anger that is an important element of both narcissistic and borderline pathology needs to
be assessed with regard to the social determinants o f the emotional expression. According
to her interpersonal theory o f personality disorders, the emotional expression of the
individual with borderline personality disorder occurs within the context of perceived
abandonment o f anothers caretaking responsibilities. In contrast, emotional lability in the
narcissistic individual occurs in the perceived abandonment o f anothers unrealistic
support of the individuals grandiose or entitled expectations. In both theorists
conceptualizations of the differentiation of narcissistic and borderline pathology, the
problem of misdiagnosis involves a misinterpretation of the emotional lability of the
narcissistic individual. In both theories, the diagnosis of borderline versus narcissistic
pathology has important implications for treatment decisions and goals. Researchers who
have focused on the diagnosis o f narcissistic pathology have empirically examined the
differentiation between narcissistic personality disorder and borderline personality disorder
in light o f its high comorbidity (Ronningstam & Gunderson, 1991). These authors
conclude that the differentiation of these two disorders rests most firmly in the thorough
assessment o f grandiosity, along with interpersonal entitlement.
23
Both false negative and false positive problems in the diagnosis of narcissistic
pathology are likely to have an impact upon the interpretation o f the individuals
experience and on treatment. Narcissistic pathology that is unidentified may contribute to
misinterpretation of the clients experience leading to misinformed interventions that do not
appreciate the clients primary difficulties in self-esteem regulation. The broader
conceptualization of narcissistic pathology outlined above may lead partly to the current
confusion in the diagnosis o f narcissistic pathology and contribute to lower validity for this
diagnosis outlined above. If a misdiagnosis is made o f avoidant personality disorder or
borderline personality disorder for an individual whose primary difficulty involves entitled
expectations, the core cognitive orientation will likely be misinterpreted. This
misinterpretation will lead to treatment decisions made with regard to the overtly
prominent feature of the individuals presentation (e.g., overt shyness, emotional lability)
that does not appreciate the core guiding factor of entitlement. It is likely then that
potential impasses will arise in treatment that might be due to the neglect of the
assessment of entitlement.
Because of the greater distress and difficulties in modulating self-esteem through
overt self-enhancement, it is also likely that clinicians would be more likely to come into
contact with vulnerable narcissists than grandiose narcissists. The differential presentation
o f vulnerable narcissists versus grandiose narcissists in treatment is an empirical question
that has not been answered to date. However, by virtue of their consistent use of self
24
enhancement, it is likely that grandiose narcissists are less likely to perceive that they have
any difficulties, experience less long-standing depression, and would be less likely to seek
support due to their overtly competitive orientation with others. Grandiose narcissists
would be more likely to seek treatment under conditions where their grandiose
expectations are severely compromised by the reality of the environment (e.g., losing a
mirroring relationship, difficulties at work). At this point, it is likely that the vulnerability
of these grandiose individuals is more overt compared to their more consistent impression
of oblivious grandiosity. It would be expected, however, that these individuals seek in
therapy the recovery o f their grandiose self-image and would be more likely to terminate
therapy once they have recovered the ability to self-enhance from the wake o f intolerable
disappointment. In contrast, the vulnerable narcissist is more likely to experience ongoing
conflict in their entitled experiences o f themselves and relationships that have a consistent
impact upon their lives. In the vulnerable individual, a therapeutic relationship is likely to
be experienced as threatening to their covert grandiose expectations much like the
grandiose individual. However, the vulnerable narcissist has experienced chronic conflict
about his/her entitled expectations and is more hopeless in feeling that he/she will get these
needs met. Further empirical investigation of the potential for different subtypes of
narcissistic pathology would be beneficial with regard to classification, assessment, and
treatment. However, vulnerable narcissism has largely been investigated theoretically and
25
clinically, whereas the study of grandiose narcissism has increasingly engaged empirical
researchers in clinical, personality, and social psychology.
Assessment of Narcissism
There has been little research on vulnerable narcissism, with much o f the empirical
literature devoted to the study o f grandiose narcissism. The study o f grandiose narcissism
as a trait, however, has led to very interesting and seemingly paradoxical results (Hibbard
& Bunce, 1995; Wink, 1991). The most widely-studied measure of narcissism is the
Narcissistic Personality Inventory, which is a self-report measure o f trait narcissism. In
several studies (Emmons, 1984, 1987), the NPI has been shown to have a complex
structure o f four factors: Leadership/Authority, Superiority/Arrogance, Self-
Absorption/Self-Admiration, and Entitlement/Exploitation. Examining the factors,
research into the relationships of these factors to other measures that assess adaptive or
maladaptive constructs have shown the Entitlement/Exploitation factor to be the only
factor that consistently relates to measures o f maladaptiveness, while the other factors
have been associated with reports of adaptiveness (Emmons, 1984, 1987; Watson,
Grisham, Trotter, & Biderman, 1984; Watson & Biderman, 1993). These results suggest
that the Entitlement/Exploitation element may indeed be the core of pathological
narcissism, with individual differences in the more adaptive components being predictive
26
o f how the individuals regulate the disappointment in light of this entitlement (Hibbard &
Bunce, 1995). This is consistent with theorists that recognize vulnerable narcissism, in
that both grandiose and vulnerable narcissists have entitled expectations as the core
element contributing to their difficulties. However, the grandiose narcissist is likely to
assert these entitlements, whereas the vulnerable narcissist experiences considerable
conflict tending to waver between disavowal and angry assertion (Akhtar & Thomson,
1982; Cooper, 1998).
Furthermore, a paradox in the empirical research on narcissism has been the
apparent orthogonality of several measures o f narcissism (Hibbard & Bunce, 1995; Wink,
1991). Wink (1991) examined the lack o f correlation between two measures of
narcissism: the widely-used NPI and an NPD scale created from items of the MMPI
(Ashby, Lee, & Duke, 1979). The orthogonal nature o f these two measures in past
research was investigated by examining the relations o f these two measures with other
measures o f narcissism. Interestingly, Wink (1991) notes that the MMPI scale was the
only scale that was produced empirically based upon the differential ratings o f individuals
diagnosed with narcissism versus the ratings of other patients. The NPI and two other
measures o f narcissism utilized in this study were developed conceptually from the
representation of NPD in the DSM system which is centered largely on perceptible
grandiosity. Two other measures were utilized in the principal components analysis. One
was a measure entitled Narcissism-Hypersensitivity (Serkownek, 1975) and the other was
27
a measure entitled Ego-Sensitivity (Pepper & Strong, 1958). Both were developed as
measures of narcissism and were derived from the items o f the MMPIs Masculinity-
Femininity scale. Winks (1991) principal components analysis yielded two orthogonal
dimensions, one that contained the scales developed from the representation o f NPD in the
DSM and the other that contained the other three scales. Wink interpreted the two
principal components by drawing from the psychodynamic theory that distinguishes
between overt and covert forms of narcissism (i.e. Kemberg, 1975; Kohut, 1977). The
component marked by the loadings o f the NPI and other measures of grandiosity were
labeled as a grandiosity-exhibitionism component. The two factors were associated with
convergent and divergent relationships with measures of personal and interpersonal
functioning. Both the grandiose and vulnerable dimensions were associated with lower
responsibility-taking, self-control, and the need to make a good impression. However, the
grandiose component was associated with dominant, self-accepting, and socially
comfortable interpersonal experiences, whereas the vulnerable component was negatively
related to the experience of dominance, self-acceptance, and sociability. Furthermore, the
grandiose component was associated with exhibitionism and aggression, whereas there
was no relationship between the vulnerable component and these interpersonal
experiences. The vulnerable component, however, was associated with lowered reports of
psychological health and adjustment, whereas there was no relationship between the
grandiose component and the self-reported experience of psychological distress. Spouses
28
of participants rated both grandiose and vulnerable partners as bossy, cruel, arrogant,
argumentative and demanding. In contrast, only the vulnerable subtypes were rated by
their spouses as dissatisfied, anxious, and bitter, whereas only grandiose subtypes were
rated by their spouses as aggressive, exhibitionistic, self-centered, and determined. In
sum, the overt form manifests itself with the boisterous, self-aggrandizing, and vain
characteristics associated with the DSMs conceptualization o f NPD. The covert form of
narcissism, on the other hand, manifests itself with symptoms o f vulnerability and
hypersensitivity to perceived personal slights.
Hibbard and Bunce (1995) also investigated the paradox of the empirical
orthogonality of various measures purporting to assess narcissism. In doing so, they
followed the suggestion of Wink (1991) that there may be two types of narcissistic
presentations, a grandiose type and a vulnerable type. While the NPI has largely been
used as a dimensional measure of grandiose narcissism, Hibbard & Bunce (1995)
suggested a procedure for locating the grandiose and vulnerable subtypes using the NPI.
The authors suggested that both of the subtypes would have in common significantly high
scores on the Entitlement/Exploitation factor, the scale o f the NPI that has been almost
entirely associated with maladaptive constructs. However, the grandiose narcissistic
character would further report a high score on the scales found to be correlated with the
more adjusted NPI constructs, which would be reflective of their tendency to self-enhance
and deny apparent weaknesses. Compared to the grandiose narcissists, their vulnerable
29
peers would endorse low scores in the more adaptive NPI factors due to their relative
inability to utilize self-enhancement in the maintenance of a positive self-image. These
authors proposed two NPI components, a maladaptive component composed of
entitlement/exploitation items and an adjusted component composed o f the rest of the NPI
items. Nine groups were selected based upon the variation in Low, Moderate, or High
scores on the two NPI components. Grandiose narcissistic personalities were high in
entitlement/exploitation and high in the more adjusted component, whereas the vulnerable
narcissistic personalities were high in the entitlement/exploitation component but low in
the adjusted component. Thus, in line with theory on narcissism, the golden thread of
narcissistic pathology is an entitled and exploitative orientation, according to these
authors. Individuals in the grandiose group were significantly higher on a measure of
Grandiosity than those in the vulnerable group. The vulnerable group reported the highest
scores on measures of vulnerability, dependent masochism, shame, and emotional lability.
An Interpersonal Analysis o f the Two Narcissistic Subtypes
The research reviewed above supports psychoanalytic theory compelling the
potential importance of distinguishing grandiose and vulnerable narcissistic subtypes in the
diagnostic nomenclature. Apart from the empirical studies reviewed above, there has been
little further empirical inquiry into the diagnostic validity of the vulnerable narcissistic
30
subtype. The present study focuses upon the examination of the diagnostic validity of
both subtypes of narcissistic pathology compared to a control group that is low in
narcissistic pathology (i.e., entitlement, exploitation). Based upon the theoretical and
empirical evidence, vulnerable and grandiose narcissistic pathology appear to have in
common one pathological element: entitlement/exploitation. The differences appear to
arise in whether this core pathological element influences overt or covert grandiosity. In
grandiose narcissists, grandiosity is overt and characterized by self-enhancement. In
contrast, vulnerably narcissistic individuals are not observed as having the consistent
ability to use self-enhancement, and rather, tend to report lower self-esteem, grandiosity,
and personal functioning (Hibbard & Bunce, 1995; Wink, 1991). Both individuals share
entitled expectations, but differ in their ability to utilize self-enhancement as a method of
supporting these expectations and modulating self-esteem.
The remainder of this paper presents the results of an experiment designed to
examine further the validity o f the grandiose narcissistic subtype and the vulnerable
narcissistic subtype. To do so, groups of individuals meeting Hibbard & Bunces (1995)
criteria for grandiose and vulnerable narcissistic subtypes were selected from a nonclinical
population, along with a group low in the maladaptive narcissistic element and moderate
in self-enhancement. For the purpose o f examining validity, these three groups were
compared across several domains that have theoretical and clinical relevance to the study
o f personality pathology.
31
First, as highlighted above, if the conceptualization of a vulnerable narcissistic type
is valid but not represented within personality disorder criteria, this neglect may lead to
diagnostic problems in either not recognizing vulnerable narcissism when it is present or
misdiagnosing vulnerable narcissism with another personality disorder diagnosis. While
past studies on vulnerable narcissism have looked at important variables related to
personal and social functioning (Hibbard & Bunce, 1995; Wink, 1991), there have been no
studies to date that have examined the differential diagnosis of personality disorders in
grandiose and vulnerable narcissistic types. Therefore, the present study was designed to
look at the question of personality disorder diagnosis among these two types with the goal
o f illum inating both whether there are valid distinctions between these subtypes in
personality pathology and whether these distinctions may be theoretically relevant given
the conceptualization of each of the subtypes.
Second, theory and research into personality pathology point to the significance of
interpersonal functioning in the diagnosis of personality disorders (American Psychiatric
Association, 1994; Benjamin, 1996; McLemore & Brokaw, 1987). One of the criteria for
personality pathology in the DSM (American Psychiatric Association, 1994) is that the
traits or behaviors must cause significant personal distress or disruptions in an individuals
social functioning across multiples social situations. Thus, because personality pathology
is defined in part by significant interpersonal difficulties, this study also examined current
interpersonal problems as reported by each o f the groups. The report of current
32
interpersonal traits and problems have been found to be significantly influential in
differentiating personality pathology (Pincus & Wiggins, 1990). This research suggests
that individuals with a DSM diagnosis of NPD tend to report interpersonal problems of
the domineering/vindictive nature. In light o f this research, it is likely that individuals with
grandiose narcissism will report more interpersonal difficulties related to this prominent
interpersonal style. However, there has not been research on the main interpersonal
problems reported by individuals with vulnerable narcissism. Therefore, the present study
will examine self-reported interpersonal problems in both narcissistic subtypes, with the
goal o f establishing validity for each diagnostic subtype.
Attachment styles is another area that has been of great importance in
understanding psychopathology, particularly personality pathology (Brennan & Shaver,
1998; Dickinson, 1997; Livesley, Schroeder, & Jackson, 1990; Paris, 1998; Sack,
Sperling, Fagen, & Foelsch, 1996; Sheldon & West, 1990, West, Rose, & Sheldon-Keller,
1994; West, Rose, Sheldon-Keller, 1995; Williams & Schill, 1993). With regard to
personality development and adult social functioning, attachment theorist propose that
within the context of early attachment relationships a working model o f the self and others
is formed that guides ones expectations and experience in adult relationships
(Bartholomew & Horowitz, 1991; Bowlby, 1969; Main, Kaplan, & Cassidy, 1985). Most
o f the research and theory on personality pathology and attachment has been undertaken
with disorders of the Anxious Cluster C o f DSM, with much of this work focused on
33
attachment representations in dependent personality disorder (Dickinson, 1997; Livesly,
Schroeder, & Jackson, 1990; West, Rose, & Sheldon-Keller, 1994). Grandiose narcissism
has largely been designated in theory as a disorder wherein emotional attachment to others
for reasons o f security is dismissed (Kemberg, 1975). However, recent research on
attachment in DSM-conceptualized narcissistic pathology indicates that individuals
endorsing a higher number of DSM NPD criteria report higher fearfulness and
preoccupation in their approach to relationships than individuals with low levels o f
personality pathology (Dickinson, 1997). There has been no research to date on
attachment in vulnerable narcissism, and the results o f this prior study may have been
influenced by the lack of agreement in the conceptualization o f narcissistic pathology
leading to a more heterogeneous sample than would be the case if these two subtypes
were differentiated. Therefore, this study examines self-reported adult attachment in
individuals with either grandiose or vulnerable narcissism.
Finally, parental representations have emerged in the literature as an important
construct related to both attachment (Diamond & Blatt, 1994; Levy, Blatt, & Shaver,
1998) and adult social functioning (Blatt, 1974; Blatt, Auerbach, & Levy, 1997; Blatt &
Lemer, 1983). According to theorists of the object relations domain, early relationships
with caregivers are internalized along with the emotions associated with these
relationships (Blatt, 1974; Blatt & Lemer, 1983; Kemberg, 1975). These representations
provide both a guide for ones expectations within the social environment (Blatt & Lemer,
34
1983), as well as maintaining the individuals familiar cognitive experience of being
attached to the caregiver (Benjamin, 1993, 1995; Blatt, 1974; Bomstein, 1987). Past
research on the parental representations of individuals who endorsed more DSM NPD
criteria have indicated that these individuals tend to report that they reacted with less
affiliation to both of their parents and experienced greater blame from their mothers
(Dickinson, 1997). This has been the only study to date that has examined parental
representations in individuals with narcissistic pathology; and, this study also did not
differentiate between grandiose and vulnerable narcissistic pathology, which may relate a
lack of clarity in the diagnostic representation of the group with NPD.
Hypotheses
As will be explained in the results section, analyses of group differences will be
examined across the dependent variables for differences related to group membership, sex,
and their interaction. I predict that group differences will occur across the three groups
for all dependent measures, where effects for Sex or Group X Sex Interaction will not be
significant. A general prediction is that the grandiose narcissistic group will report less
difficulties and interpersonal distress than the other groups on the self-report measures,
but they will be rated as high in personality pathology by the interviewers. It is expected
that the vulnerable group will report the greatest difficulties and interpersonal distress
35
compared to the other groups, which will be further verified in the personality disorder
interview. Specific hypotheses for each o f the dependent measures are as follows.
Current Interpersonal Functioning
Personality Disorder Criteria Met
The grandiose narcissistic subtype is expected to conform to the representation of
NPD in the DSM NPD has generally evidenced high comorbidity with the other
personality disorders in cluster B (Morey, 1988; Oldham, et. al., 1992; Pfohl, et. al.,
1986). Thus, it is expected that the grandiose narcissistic subtype in this study will be
rated higher than the vulnerable and control groups on the four sets o f personality disorder
criteria of cluster B: antisocial personality disorder, borderline personality disorder,
histrionic personality disorder, and narcissistic personality disorder. The vulnerable
narcissistic group, on the other hand, is less likely to consistently assert demands or
expectations according to theory, and is thus expected to be rated by the interviewers as
lower than the grandiose group in the criterion met for the following disorders: antisocial,
histrionic, and narcissistic personality disorder. Further, while the vulnerable narcissistic
type reports high entitlement and exploitation, these individuals are described as easily
threatened and embarrassed, uncomfortable socially, and emotionally labile. Because of
36
their observed emotional lability, the vulnerable group is expected to be rated as higher
than the control group in Borderline Personality Disorder. It is expected, however, that
the vulnerable narcissistic group will be best represented by avoidant personality disorder,
for which it is predicted that the vulnerable group will be rated higher than both the
grandiose and control groups. It is not expected that the dependent, obsessive-
compulsive, or passive-aggressive personality criteria ratings will differ between the
groups.
Interpersonal Problems
The measure to be utilized in the description of interpersonal problems in this
group provides both an analysis o f specific interpersonal problems along with the rigidity
of these problems and the interpersonal distress associated with these problems. It is
predicted that self-reported interpersonal problems of the grandiose narcissistic group will
be similar to past research on interpersonal problems in NPD, where the profile peaks in
the Vindictive octant of the Interpersonal Problems Circumplex (Pincus & Wiggins,
1990). However, it is expected that problems in vindictiveness will be associated with
high scores on the component o f pathological narcissism related to
entitlement/exploitation. Because both the grandiose group and the vulnerable group
report high scores in entitlement/exploitation, it is expected that they will not differ from
37
each other in interpersonal problems that seem to best represent pathological narcissism.
Therefore, it is predicted that the individuals in the grandiose and vulnerable groups will
report higher problems in the vindictive octant than individuals in the control group, but
that the grandiose narcissists will have a peak in this problem area. While it is expected
that individuals with vulnerable narcissism will have similar problems as their grandiose
peers with vindictiveness, it is further expected that the vulnerable group will report
greater problems in areas related to social anxiety and inhibition. Therefore, it is expected
that vulnerably narcissistic individuals while reporting higher problems in vindictiveness
will differ from the grandiose group and control group in their report of more problems in
the areas of cold and socially-inhibited interpersonal behaviors. Finally, in light of research
suggesting that vulnerably narcissistic individuals report higher levels of distress (Hibbard
& Bunce, 1995; Wink, 1991), it is expected that individuals in the vulnerable group will
report higher levels of interpersonal distress.
A d u lt A ttach m en t
There has been little research to date on the attachment orientations of individuals
with narcissistic pathology with the exception o f the study cited above (Dickinson, 1997)
that found individuals with narcissistic personalities reporting higher fearfulness and
preoccupation in their approach to relationships than the control group. With the
38
differentiation of the two subtypes of narcissistic pathology undertaken in this study, it is
expected that clear differences between the two groups will emerge that may shed light on
these past findings. It is anticipated that because o f their greater vulnerability to
interpersonal slight and greater social avoidance, the vulnerable group will report greater
fearfulness in their attachment relationships than the grandiose or control groups. Because
grandiose personalities are observed as being dismissive of personal difficulties and o f their
reliance upon others, it will be expected that they will report more security than the
vulnerable group and more dismissiveness than the control group in their approach to
interpersonal relationships.
Parental Representations
Hypotheses for the parental representations are guided by the model of assessment,
which places affiliation and autonomy in these representations as the main thematic
elements (Benjamin, 1974). Therefore, representations of participants early relationships
with both their mother and their father will be examined with regard to participants
memories of affiliation and autonomy in early relationships with parents. It is expected
that the grandiose group will report more idealized (i.e., high affiliation scores) memories
of their relationships with their parents than the other to groups. This prediction is in line
with Kembergs theory (1975) which suggests that the grandiose self-conception involves
39
a fusion of the idealized aspects of the self and others. It is expected that because o f the
higher distress and vulnerability of the vulnerable Group, these individuals will recall less
affiliative relationships with their parents. Kemberg (1975) suggests that cold or harsh
parenting influences the development o f narcissistic pathology, which is corroborated by
Benjamins (1996) proposal that these individuals received a mix of both unconditional
love and blame. It is expected that both the grandiose and vulnerable groups will
remember more blaming representations o f their relationships with their parents than the
control group. In this circumplex model o f the assessment o f parental representations,
active blame is a blend o f disaffiliation and active control. So, it is expected that memories
of autonomy by both the grandiose and vulnerable subtypes will be marked by experiences
of blaming control. With regard to the autonomy dimension, it is further expected that by
virtue o f their abilities to self-enhance and actively not acknowledge reliance upon others
(Kemberg, 1975), the grandiose group will remember that they asserted their autonomy in
their relationships with caregivers. Therefore, it is expected that grandiose narcissistic
individuals will assert more autonomy in reaction to their parents, while the vulnerable
group o f individuals will remember more ambivalence in their reactions due to the
dependency they experienced for others in their role o f self-esteem regulation.
40
Chapter 2
METHODS AND PROCEDURES
Group Selection Methods
Participants (n = 90) were undergraduate students from a large rural university in
the mid-Eastem United States. Students in large introductory classes in Psychology were
provided the opportunity to complete a large battery o f questionnaires for the attainment
o f extra course credit. Individuals who were not interested in participating in
psychological research were provided with alternative methods of earning extra credit.
These procedures were conducted in the psychology classes in both Fall and Spring
Semesters of the 1997 and 1998 academic years. Included in this large battery was the
Narcissistic Personality Inventory (NPI, Raskin & Hall, 1979), which was used for group
selection purposes in the present study. The order o f measures in the battery were
counterbalanced throughout each of the terms in order to account for any error that might
be due the placement o f the NPI within the sequence o f other measures.
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Selection: Narcissistic Personality Inventory
The Narcissistic Personality Inventory (NPI; Raskin & Hall, 1979) was used to
assess narcissism for group selection purposes in this study. The NPI is a 40-item
inventory in which each item consists of two statements, one with a narcissistic theme and
the other without. An example of two statements of an item from the NPI reflecting
narcissistic and nonnarcissistic content, respectively, is "I am an extraordinary person" and
"I am much like everybody else." Participants are instructed to endorse the statement that
best reflects their perception of themselves in the specific context of the statement.
Studies investigating the reliability of the total NPI scale have produced adequate
results for the use of the NPI as a research tool, but its value in the clinical decision
making realm remains unclear. Raskin and Hall (1979) reported a split-half reliability of
.80 (n = 71) on the initial 80-item version of the NPI. A study of 164 undergraduates
tested and retested with alternate forms of the 80-item version over an eight week period
produced an alternate forms reliability of .72 (Raskin & Hall, 1981). Reports of internal
consistency have produced coefficient alphas ranging from .80 to .87 across several
studies (Raskin & Terry, 1988; Emmons, 1984; Auerbach, 1984). Emmons (1984, 1987)
uncovered four dimensions accounting for 72% of the variance which from an analysis of
the items were labeled Exploitativeness/Entitlement (E/E), Leadership/Authority (L/A),
Superiority/Arrogance (S/A), and Self-Absorption/Self-Admiration (S/S). Internal
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consistencies for each of the scales have ranged from .68 to .74 for E/E, .69 to .79 for
L/A, .69 to .70 for S/A, and .69 to .81 for S/S (Emmons, 1984, 1987).
Selection of the grandiose, vulnerable, and control groups was based upon a
procedure developed and outlined by Hibbard & Bunce (1995) as outlined in the
introductory section. Participants NPI responses were separated to create a maladaptive
NPI component (NPI-Mal) of 11 items and an adjusted NPI component (NPI-Adj) of 29
items. The NPI-Mal consisted of the Entitlement/Exploitation factor of the NPI, while
NPI-Adj was constructed as the sum o f the remaining three factors of the NPI
(Leadership/Authority, Superiority/Arrogance, Self-Absorption/Self-Admiration). Cut-off
scores were computed that indicated a high, moderate, or low response for each
component utilizing the 33rd and 67th percentiles for each scale in each sample. Based on
Hibbard and Bunces (1995) selection procedures, participants who scored in the high
range on both NPI-Adj and NPI-Mal were designated as grandiose narcissistic
personalities, while those that scored low on NPI-Adj and high on NPI-Mal were selected
as vulnerable narcissistic personalities. Finally, a control group was selected based on
their scores on the NPI components with the aim to select a group that would be low in
narcissistic pathology (i.e., Entitlement/Exploitation). The control group consisted of
individuals moderate in NPI-Adj and low in NPI-Mal. Coefficient alpha in this sample (n
= 2532) for the total NPI was .83, where the alphas for the dimensions of NPI-Adj and
NPI-Mal in this sample were .80 and .59, respectively.
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Participant Characteristics
Three groups o f 30 participants were selected based upon their responses to the
NPI: grandiose narcissistic personalities (13 females, 17 males), vulnerable narcissistic
personalities (23 females, 7 males), and control personalities (21 females, 9 males). The
mean age of participants was 18.7 (sd = 2.09) overall.
Core Study Methods and Procedures
Research Assistant Recruitment and Training
Undergraduate research assistants were recruited for participation in the data
collection process in exchange for training in personality theory and research. These
individuals were advanced undergraduate students, all of whom had completed advanced
courses in abnormal psychology and personality theories at a large research university.
Research assistants were provided with extensive training in the administration of a
personality disorder interview and the interpersonal battery. With regard to the battery,
they were given an orientation to each o f the questionnaires through readings on the
questionnaires and each individual took the battery to orient themselves to what the
participants would be taking in order to anticipate and answer any questions that emerged.
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The training of the research assistants in the administration of the Personality Disorders
Interview-IV (PDI-IV; Widiger, Mangine, Corbitt, Ellis, & Thomas, 1995) was
undertaken in 10 weekly meetings designed to provide both an orientation to personality
disorder theory/research and to establish skill in the assessment o f personality pathology
using the PDI-IV. The first two meetings were focused on teaching the research assistants
general theory on the classification o f personality disorders. The second meeting was
focused on an orientation to the PDI-IV format and administration method. The final 8
meetings each focused on a DSM-IV personality disorder that would be assessed in this
study. In the latter meetings, research assistants read chapters from the PDI-IV manual
specific to each personality disorder, along with at least one other article that provided a
description of the theory and research on the personality disorder in question. Further,
during each session, research assistants watched a video-tape o f one of the leading
theorists on personality disorders discussing the conceptualization o f each personality
disorder along with a brief segment where an actor would portray a prototypical
representation of an individual with the personality disorder of focus. During these
meetings each o f the PDI-IV criteria for each personality disorder were discussed and
research assistants were provided with many examples of subthreshold and threshold
responses. Research assistants then participated in practice interviews with each other and
the primary investigator.
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45
Participant Recruitment Methods and Procedures
Participants who met criteria for group selection were contacted via the telephone
by the undergraduate research assistants. They were invited to participate in a study about
personality and interpersonal relationships that would take three hours. Participants
were told that they would be participating in a brief interview about themselves and
responding to several questionnaires focused on their experiences with themselves and in
interpersonal relationships. Only those participants that had indicated an interest in future
participation in research were contacted, and these individuals were offered further course
extra credit in exchange for their participation.
When participants arrived for their session, they were greeted by a research
assistant who introduced themselves and invited the participant to sit at a desk.
Interviewers were blind as to the participants NPI classification. Participants read a brief
letter from the investigators that described the study and were asked to provide their
signed consent to participate in the study. After completing the informed consent form,
participants were reminded that their responses to the questionnaires and interview would
be confidential. Participants were then informed that they would complete two
questionnaires concerning their relationships with their parents, participate in an interview
about themselves, and then finish with the completion of questionnaires regarding then-
current feelings about themselves and their experience in relationships. Prior to
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participating in the interview, participants were asked for their consent to audio-tape the
interview so that the interviews could be checked by the primary investigator for the
interviewers adherence to the format. In the advent that a participant did not want the
interview audio-taped, the research assistants were allowed to conduct the interview
without any recording procedures. There was only one participant in the sample that did
not give consent to the audio-taping procedures. All of the participants responses were
coded with a participant identification number that was confidential and not linked to
identifying information.
Measures
Manipulation Check Measures
Superiority and Goal Instability Scales (SGIS,
Robbins & Patton, 1985)
Robbins and Patton (1985) constructed the Superiority and Goal Instability scales
to operationalize the two poles of personality development that Heinz Kohut (1971, 1977)
postulated in his psychology of the self; the grandiose sector and the idealizing sector.
Each scale consists o f 10 items written in likert format from (1) strongly agree to (6)
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strongly disagree. Initially, twenty items were written to correspond to each of the two
poles o f grandiosity and vulnerability, and these scales were confirmed through factor
analysis (Robbins & Patton, 1985). These scales were labeled the Superiority and Goals
Instability scales, respectively. An example item from the Superiority scale is "I catch
myself wanting to be a hero." An example item from the Goal Instability scale is "After a
while, I lose sight of my goals." Test-retest reliabilities for 72 college students over a
two-week period were .80 for the Superiority scale and .76 for the Goal Instability scale.
Utilizing coefficient alpha statistics, internal consistency was estimated at .76 for the
Superiority scale and .81 for the Goal Instability scale. Utilizing canonical correlation
procedures, Robbins (1989) found the Superiority scale to relate positively to the MCMI
narcissistic and histrionic personality scales, the MCMI Hypomanic and Drug Abuse
clinical syndrome symptom scales, and therapists ratings of anger. The Goal Instability
scale was found to relate positively to the Schizoid, Schizotypal, and Borderline
personality scales and the Anxiety and Dysthymic clinical syndrome symptom scales o f the
MCMI, while also relating to therapists ratings of lowered ability to regulate self-esteem
and greater depression. Watson, Little, Sawrie, & Biderman (1992) reported positive
zero-order relationships of the Superiority scale with all four dimensions o f the NPI and
self-esteem, while the Goal Instability scale correlated negatively with self-esteem and
perspective taking. Coefficient alpha in this sample was .81 for the Superiority scale and
.79 for the Goals Instability Scale.
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Rosenberg Self-Esteem Inventory (RSI; Rosenberg,
1965)
The RSI is a 10-item questionnaire that is widely-used as a measure of global self
esteem (Rosenberg, 1965) that has been related to a facet of self-esteem reflecting self-
acceptance (Crandall, 1973). Each of the items reflects a statement general to ones
overall experience o f oneselfj two examples being On the whole, I am satisfied with
myself and At times I think I am no good at all. Participants rate each item on a scale
from 0 (Strong Agree) to 4 (Strongly Disagree). The RSI consists of 5 statements
reflective of greater self-acceptance and 5 statements reflective of lower self-acceptance.
Thus, in computing a total self-esteem score, 5 items required reverse scoring. A total
score for each participant was calculated and ranged from 0 to 40 with a higher score
reflecting greater self-esteem. Test-retest over a period of two weeks was .85 (Silber &
Tippet, 1965). Coefficient alpha for the RSE is this sample was .94.
Janis-Field Feelings o f Inferiority Scale (JFS; Janis &
Field, 1959)
The JFS is a 23-item test developed for use in social psychological studies of
attitudinal change (Janis & Field, 1959). However, the JFS has been shown to be fairly
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stable across studies and laboratory manipulations (Nisbett & Gordon, 1967), indicating
that it may better be viewed as a measure of stable trait self-esteem. Items are written in a
question format that invites the partipant to rate the degree to which he or she experiences
confidence versus vulnerability. For example, the following items are representative
samples of items o f the JFS: Do you ever think you are a worthless individual?, In
general, how often do you feel confident about your abilities?, and How often do you
feel self-conscious? Items are rated on a 5-point scale from 1 (Very Much) to 5
(Practically never). Total scores on the JFS are keyed such that higher scores are
reflective o f greater self-esteem and these scores range from 23 to 115. Across
independent samples, split-half reliabilities of .83 (Janis & Field, 1959), .72 (Eagly, 1967),
and .88 (Eagly, 1969) have been found. Reliability based on the Spearman-Brown
formula was found to be .91. Coefficient alpha for the JFS in this sample was .92.
Dependent Measures
Personality Disorder Interview-IV (PDI-IV:
(Widiger. et al.. 1995)
The Personality Disorder Interview-IV (Widiger, et al., 1995) was selected as the
measurement instrument for DSM-IV personality disorder dimensions. The PDI-IV is a
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relatively new semi-structured interview derived from its predecessor Personality
Interview Questions (PIQ-I, PIQ-II, PIQ-IU; Widiger, 1985, 1987; Widiger, Corbitt, Ellis,
& Thomas, 1992). The PDI-IV was a revision of PIQ-HI developed to parallel the 10
personality disorder conceptualizations included within the DSM-IV and including two
provisional personality disorder diagnoses, depressive personality disorder and passive-
aggressive personality disorder (i.e. negativistic). In utilizing the PDI-IV, two interview
formats are offered, organized by disorder or thematic content. Regardless of the chosen
format, each item (i.e. criterion) is rated on a 3-point scale that ranges from 0 to 2, where
0 equals not present, 1 equals present according to the DSM-IV definition of the item,
and 2 equals present to a more severe or substantial degree.
Given its fairly recent development, there is little research to date examining the
reliability and validity o f the PDI-IV. Initial research indicated kappas for interrater
reliability in the diagnosis of the presence versus the absence o f DSM-IV personality
disorders ranging from .37 (histrionic) to .81 (antisocial), with a median kappa of .65
(Corbitt, 1994). The kappa for the diagnosis of NPD according to the PDI-IV was .75.
The median kappas for the earlier versions of the PDI-IV .80 (PIQ-I with DSM-in
criteria; Widiger, Frances, Warner, & Bluhm, 1986) and .72 (PIQ-II for DSM -III-R
criteria; Widiger, Freiman, & Bailey, 1987). The interrater reliability for the diagnosis of
NPD for the PIQ-I and PIQ-II was .77 and .70, respectively. There has been no validity
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data to date on comparing the PDI-IV to other systems for diagnosing DSM-IV
personality disorders.
For the purposes o f the current study, this investigator chose to assess only
personality disorders in clusters B and C. Cluster A personality disorders were not
included in the assessment battery or the analyses for two reasons. First, the paranoid,
schizotypal, and schizoid personality disorders were less relevant to the hypotheses of this
study in that hypotheses for grandiose personalities were focused largely on Cluster B,
while hypotheses for the vulnerable personalities were centered on the prediction o f higher
scores on the avoidant personality disorder dimension. Secondly, for practical purposes,
cutting the PDI-IV interview down to two clusters allowed for reduction of time from
approximately 2 to 3 hours to 1 to 1 Vz hours. This allowed for an overall battery that was
less time-consuming for participants. Thus, 8 personality disorder criteria sets were
assessed in alphabetical order as outlined by the PDI-IV manual organized by personality
disorder antisocial, avoidant, borderline, dependent, histrionic, narcissistic, obsessive-
compulsive, and passive-aggressive. A sample of the interviews were coded for
convergence in personality disorder assessment. The primary investigator coded a
proportion (30%) of the research assistants taped interviews. A psychologist with 10
years of experience in the assessment of personality pathology coded a similar proportion
o f the interview tapes conducted by the primary investigator.
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Inventory of Interpersonal Problems- Circumplex
form (DP-C; Alden, Wiggins, & Pincus, 1990)
The Inventory of Interpersonal Problems (HP; Horowitz, Rosenberg, Baer, Ureno,
& Villasenor, 1988) was created to assess different types of interpersonal problems and
the level of interpersonal distress associated with the reported problems. However, in line
with the emergence and significance o f the Interpersonal Circumplex, the IIP items were
anchored empirically to the two orthogonal dimensions of the interpersonal circumplex
reflective of dominance (versus nonassertiveness) and Nurturance (versus Interpersonal
Coldness) (Alden, et al., 1990). The measure was reduced to a 64-item battery that is
now referred to as the DP-C (Alden, et al., 1990). The eight thematic dimensions
emerging around the dominance and nurturance dimensions are called Domineering,
Vindictive, Cold, Socially Avoidant, Nonassertive, Exploitable, Overly-nurturant, and
Intrusive. This procedure was further validated by the investigators utilizing a large
sample. The HP-C provides several means of analysis that provide information as the an
individuals report of interpersonal difficulties (Gurtman & Balikrishnan, 1998). First, an
individual or group can be located within the circumplex space by calculating the
angular displacement of the responses which is reflective the thematic octant (i.e., polar
coordinates of the circle from 0 to 360) in which the individual reports the most problems.
A further calculation of the vector length of the angular location (i.e., called amplitude) is
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calculated that indicates the degree to which the individuals peak problem is differentiated
from other problems (e.g., large vector length indicates that the individual is reporting
more problems in one area versus reporting a similar amount of difficulties across several
areas). There is further a score (i.e., elevation) calculated that reflects the individuals
overall interpersonal distress. In completing the questionnaire, participants are informed
that we all experience some interpersonal problems and were asked to rate the items as to
how problematic the interpersonal behavior has been for them in relation to others. Items
are rated from (1) not at all problematic to (5) extremely problematic. There has been
considerable research verifying the promising utility of the HP-C in differentiating
interpersonal problems across diverse psychopathology (Alden & Phillips, 1990; Pincus &
Wiggins, 1990).
Adult Attachment Questionnaire (AAQ;
Bartholomew & Horowitz, 1991)
Bartholomew and Horowitz (1991) recently proposed a model o f prototypic adult
attachment styles characterized by two internalized components: general perception of
self in terms of being able to evoke attachment responses and general perception o f other
in terms of their propensity for responsiveness. These two components are manifested in
a four-group model of adult attachment styles that reflects the combination of one's model
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of self and model o f other, each component denoted by the individual's general or
primitive perception o f the representation as either good or bad. Participants were
presented with the descriptions of the four adult attachment styles and asked to select the
style that best fit their own experience. Participants also rated themselves on each o f the
attachment styles from 0 (not at all descriptive) to 8 (Strongly Descriptive). Bartholomew
and Horowitz (1991) presented initial evidence in confirmation o f the validity o f this
model and its prototypic attachment categories.
SASB ENTREX Questionnaire- short form
(Benjamin, 1974, 1988)
The Structural Analysis of Social Behavior (Benjamin, 1974, 1984) was used to
operationalize the participants' representations of their early relationships with their
parents. The SASB is a circumplex model with three surfaces which are organized around
the orthogonal dimensions of affiliation (i.e. love-hate) on the horizontal axis and
interdependence (i.e. control-autonomy) on the vertical axis. The first SASB surface is
concerned with transitive actions, for which the focus is on another person acting toward
The second SASB surface refers to a focus on self with reference to a reaction to another
person, an intransitive state, and denotes more child-like states [e.g. Trust (2-4), Disclose
(2-2)] in reaction to perceived parental actions. Conceptualized as reactions, the
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horizontal axis comprises the spectrum of affiliation from "Reactive Loving" to
"Recoiling" and the spectrum o f Interdependence from "Separating" to "Submitting." The
third surface represents the intrapsychic domain, which in correspondence with
interpersonal theory, develops within an interpersonal context as significant interpersonal
relations are introjected into an individual's self-system and thus represent introjected
actions [e.g. Self-protect (3-4), Self-affirm (3-2)]. The SASB introject surface represents
an individual's self-concept along the two orthogonal axes from "Self-Loving" to "Self-
Attacking" and from "Self-Emancipating to "Self-Controlling." The SASB Intrex
Questionnaireshort-form (Benjamin, 1988) operationalizes this interpersonal model.
The participants were asked to rate the following relationships at age five to ten:
relationship with mother and relationship with father. A variety of variables reflecting
different levels of analysis can be calculated from the INTREX ratings for each SASB
surface (for a review, see Pincus, Newes, Dickinson, & Ruiz, 1998). In the present study,
the dimensions of affiliation and autonomy were calculated for each aspect o f the rated
relationship.
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Chapter 3
RESULTS
Manipulation Check Results
In order to seek evidence as to the validity o f group selection, two sets of variables
were investigated. First, if the group selection procedures were to be reliable, there would
be stability in the distributions of the two NPI components, and thus, in the selection
parameters across the samples. Secondly, along with the NPI, this study included
measures of narcissistic pathology and self-esteem in order to seek verification of the
validity of the group selection procedures.
Group Selection Parameters
During each semester, the groups were selected from a larger sample utilizing the
distribution o f the participants responses to the NPI. For each distinct sample, the criteria
for group selection were based on the actual distribution within the sample of scores on
both the NPI-Adj component and the NPI-Mal component. Criteria for high, low, or
moderate scores on each component were computed by calculating the 33rd and 67th
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terciles in scores. It would thus be expected that the means utilized in group selection
should be relatively stable across the samples with similar criteria o f group selection being
observed. Table 1 displays the mean score and standard deviation for the NPI-Adj and
Npi-Mal component across the four samples, along with the results of Univariate analyses
computed to test our hypothesis that the means are not significantly different. The
univariate results for differences across the four samples on the NPI-ADJ component [F =
.41 (3,2533)] and the NPI-MAL [F = 1.67 (3, 2556)] were not significant. This provides
evidence for stability o f selection criteria across the four samples from which the groups in
this study were selected. This is also reflected in the consistency of group percentages
across the four samples. Table 2 presents these percentages, along with the percentage o f
individuals for each group from Hibbard and Bunces (1995) original sample. The
percentage o f individuals selected for each group are similar to that of Hibbard and
Bunces (1995) undergraduate, non-clinical sample, wherein approximately 15.7% of their
sample are classified in the grandiose group and 2.6% o f their group were classified in the
vulnerable group.
Narcissism and Self-esteem Measures
I predicted that individuals in the grandiose group would report higher levels of
both adaptive and maladaptive narcissism and self-esteem than the other groups, while the
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vulnerable group would report the lowest levels o f self-esteem and higher levels of
maladaptive and vulnerable narcissism than either o f the other groups. MANOVAs were
carried out across the measures using both group membership, sex, and their interaction as
the independent variables. Across the dependent variables of narcissism and self-esteem,
their were non-significant results for the independent effects of Sex and for the interaction
o f Sex and Group Membership. With regard to a main effect for Group Membership,
there were significant multivariate results for all dependent measures. Table 3 presents the
results of between-group analyses of measures that assess narcissism and self-esteem.
Multivariate Lambda (A.) coefficients were significant for a main effect for the variables of
the NPI [F (6, 164) = 167.20, p < .001], the SGIS [F (4, 166) = 11.35, p < .001], and the
self-esteem inventories [F (4, 164) = 7.08, p < .001], Univariate analyses were conducted
for these variables followed by Student-Newman-Kuhls post-hoc tests for the significant
univariate results. Consistent with hypotheses, individuals in the grandiose group had
greater scores than the vulnerable group and control group on measures o f total narcissism
[NPI-total; F (2, 87) = 366.91, p < .001], adjusted narcissism [NPI-Adj; F (2, 87) =
255.50, p < .001], maladaptive narcissism [NPI-Mal; F (2, 87) = 271.29, p < .001], and
grandiose narcissism [Superiority, F (2, 87) = 24.53, p < .001], In contrast and as
predicted, individuals within the vulnerable group reported higher levels of maladaptive
narcissism than the control group. Contrary to expectations, however, the vulnerable
group did not report higher scores than either group on a measure o f vulnerable narcissism
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(Goals Instability; F = 2.20), although the resulting coefficient was nearing significance.
Results regarding self-reported self-esteem were also consistent with predictions with the
grandiose group reporting greater self-esteem across two different measures of global self
esteem: RSI [F (2, 87) = 9.87, p < .001] and the JFS [F (2, 87) = 12.73, p < .001]. The
results largely confirm my predictions, in that the grandiose groups reported high levels of
narcissism and self-esteem, while the vulnerable group reported high maladaptive
narcissism but low levels of self-worth or self-enhancement. In contrast to predictions, the
vulnerable group did not receive higher scores than the grandiose and control groups on
the Goals Instability scale of the SGIS. However, these results were nearing significance
in the direction of my predictions, which likely would have been borne out in a larger
sample.
Core Hypotheses Results
The core hypotheses of this study center upon an examination of the between-
group differences on variables reflecting current interpersonal functioning and parental
representations. In the service of our core interest in examining the validity o f the two
subtypes of narcissistic pathology, we will begin with the analyses o f group differences on
dimensions reflective of current interpersonal functioning: Personality Disorder Criteria,
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Interpersonal Problems, and Adult Attachment. This chapter will be concluded with the
results from the between-group analyses o f individuals early parental representations.
Current Interpersonal Functioning
Personality Disorder Criteria
My predictions were that the grandiose group would be rated higher than the other
two groups on all of the Cluster B personality disorders except Borderline Personality
Disorder. It was my belief that the grandiose and vulnerable groups would not achieve
any significant differences on the Borderline Personality Disorder Criteria, but would be
rated higher than the control group. Finally, I predicted that the vulnerable group would
be rated as significantly higher than the other two groups on the Avoidant Personality
Disorder dimension. As discussed, a proportion of the taped interviews were rated by an
independent rater in order to obtain an estimate of the inter-rater reliability. In comparing
the two separate raters of the interviews, the total scores for each personality disorder
criteria set were correlated using pearson coefficients. Table 4 displays the correlations
between two raters for each of the personality disorder criteria set and the between-group
analyses examining differences on the personality disorder criteria. As can be seen, when
the interviewers ratings were correlated with the reliability raters ratings o f personality
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61
disorder criteria met for each set, ail the of the personality disorder types evidenced good
to excellent correlations with a range from .64 (Passive-Aggressive Personality Disorder)
to .95 (Avoidant Personality Disorder). MANOVAs were carried out across the measures
using both group membership, sex, and their interaction as the independent variables. For
the Personality Disorder Criteria, there were non-significant results for the independent
effects of Sex and for the interaction o f Sex and Group Membership. With regard to a
main effect for Group Membership, there was a significant multivariate Lambda coeffcient,
F (18, 148) = 5.50, p < .001. Univariate analyses were conducted for each o f the
Personality Disorder types followed by Student-Newman-Kuhls post-hoc tests for the
significant univariate results. As indicated in Table 4, four of the Personality Disorders
achieved significant univariate results: Antisocial Personality Disorder [F (2, 85) = 3.20, p
< .05], Avoidant Personality Disorder [F (2, 85) = 4.75, p < .001], Histrionic Personality
Disorder [F (2, 85) = 6.29, p < .001], and Narcissistic Personality Disorder [F (2, 85) =
5.89, p < .001], As predicted with regard to the Cluster B Personality Disorders, the
grandiose group was evaluated by interviewers as meeting more criteria for the Antisocial,
Histrionic, and Narcissistic Personality Disorders than the individuals in the other two
groups. There were no significant between-group differences in Borderline Personality
Disorder Criteria rated by the interviewers. Finally, as predicted, individuals in the
vulnerable group were received higher ratings for Avoidant Personality Disorder than the
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individuals in the other groups, with no other between-group differences occurring for the
other Cluster C personality disorders.
Interpersonal Problems
It was predicted that the grandiose group would report a peak in problems of the
Vindictive octant, whereas the vulnerable group would peak in the Socially-Avoidant
octant. I predicted that both the grandiose and vulnerable groups would report more
problems in the Vindictive area than the control group. It was expected that the
vulnerable group would further report greater interpersonal problems of the Cold,
Socially-Avoidant, and Unassertive nature than the grandiose group. Finally, I expected
the vulnerable group to report greater interpersonal distress than the other two groups.
Procedures for evaluating HP-C data are based on circumplex logic and have been
well-articulated across several sources (Alden, et al., 1990; Gurtman, 1992, 1994;
Gurtman & Balikrishnan, 1998). Based on trigonometric procedures (Alden, et al., 1990),
summary scores can be calculated that reflect an individuals representation on each o f the
dominance and nurturance dimensions, respectively. Using the mean dominance and
nurturance scores for each o f the groups, the group can be located within the two-
dimensional space o f the circumplex. However, because these are summary scores that
reflect the nomothetic average o f the individuals responses, the goodness-of-fif of these
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summary scores for the overall group is highly influenced by within-group variability.
Thus, a more complex picture of the responses o f individuals within the group can be
elucidated through further analyses.
As outlined in Gurtman (1992, 1994), a profile o f standard scores on the eight IIP
octants can be calculated for each groups responses that represents a cosine curve.
Herein, for each o f the groups, it is possible to compute the interpersonal distress (i.e.,
elevation), interpersonal rigidity (i.e., amplitude), and preeminent interpersonal problem
area (i.e., displacement or peak) associated with the representative cosine curve.
Elevation is a score that is reflective of an individuals level of interpersonal distress across
all of the octant areas o f the HP. Amplitude is a measurement o f the rigidity of the
individual or groups reported interpersonal problems with high scores associated with a
rigid reliance on a set o f interpersonal behaviors across situations. Displacement is a score
that reflects the central tendency of the group across the interpersonal problems; that is, a
measure of the modal interpersonal difficulties. Finally, a goodness-of-fit (i.e., R2) ratio
can be calculated based upon the within-group variability. This score indicates whether
the general cosine curve calculated from the aggregation o f scores within a group is a
good predictor of individual responses curves within each group. A goodness-of-fit ratio
can range from 0 to 1 with scores closer to 1 indicating that the group curve is a good
estimate of the individual curves.
64
Figure 1 displays the cosine curves for the grandiose, vulnerable, and control
groups across the IIP octants. The degree of displacement for each group is listed below
the figure and the goodness-of-fit measure is displayed at the far right o f each groups
curve. The grandiose groups degree of displacement was at 100.67, indicating a peak in
interpersonal problems o f a vindictive nature. The goodness-of-fit measure for the
grandiose group is .89, which indicates that the cosine curve for the grandiose group is a
highly representative curve for the individuals within the group. The vulnerable groups
degree of displacement is at 180.00 degrees, reflecting a modal report of cold
interpersonal problems. However, in contrast to the grandiose group, the goodness-of-fit
statistic for the vulnerable group was .04, which indicates that the overall cosine curve for
the group would poorly represent the curves for each of the individuals within the group.
This would mean that either 1) individuals endorsed many interpersonal problems across
many different octants or 2) individuals tended to endorse specific types of interpersonal
problems but these differed across the group members. This can be differentiated by
looking at the average amplitude for individuals profiles, which will be looked at shortly.
Finally, the control groups displacement was at 320.91 degrees, which is representative of
interpersonal difficulties within the exploitable octant. The goodness-fit-statistic was .84
for the cosine curve of the control group, which indicates that like the grandiose group the
curve for the control group would be a good estimate o f the individual profiles within this
group.
65
MANOVA statistics were conducted with Group Membership, Sex, and Group
Membership by Sex as the independent variables. The dependent variables for these
procedures were the eight octant scores, the dimensions of Dominance and Nurturance,
and the IIP parameters o f amplitude and elevation, respectively. Significant multivariate
main effects emerged for the independent variable of Group Membership for the eight
octants [F = 5.96 (16, 134), p < .001], the Dominance and Nurturance dimensions [F =
13.66 (4, 152), p < .001], and for the Amplitude and Elevation parameters [F = 8.78 (4,
146), p < .001). Univariate analyses were then computed for Group Membership with
each o f the dependent variables, and significant univariate results were followed with
Student-Newman-Kuhls post-hoc tests. Table 5 displays the results o f the univariate tests
on the data. No significant multivariate effects were found for Sex or Sex By Group.
As can be seen in the table, all o f the IIP octants produced significant univariate
results except the Intrusive octant. The grandiose and vulnerable groups each reported
significantly greater interpersonal difficulties within the Domineering and Vindictive range
than the control group. The vulnerable group reported more difficulties with Cold and
Avoidant interpersonal problems than the grandiose group and the control group. Finally,
both the vulnerable and control groups reported significantly greater difficulties than the
grandiose group in interpersonal problems o f the Nonassertive, Exploitable, and Overly-
Nurturant variety. With regard to the dimensions, the grandiose group reported more
difficulties with Dominance than the vulnerable group, and both had higher Dominance
66
scores than the control group. Individuals within the control group had higher scores on
the Nurturance dimension than individuals in the grandiose group, and both o f these
groups did not differ from the vulnerable group on Nurturance.
There was no significant difference between the groups in amplitude o f cosine
curve and all groups were in the moderate to high range. This indicates that individuals in
all o f the groups reported interpersonal problems that peaked in at least one area.
Therefore, the grandiose group peaked in the range o f Vindictive interpersonal problems
and the control group peaked in the range of Exploitable interpersonal problems. In
contrast, individuals within the vulnerable group individually peaked in one octant area,
but there was significant within-group variability as to what typical interpersonal problems
were reported. Finally, the vulnerable group had greater elevation scores than the control
group and grandiose group, indicating that the vulnerable group reported greater overall
distress in their interpersonal interactions. The grandiose group reported significantly
lower interpersonal distress compared to both of the other groups.
Adult Attachment
I predicted that the vulnerable group would report greater fearfulness in their
attachment relationships than the other groups and that both the grandiose and control
group would report greater security than the vulnerable group. Furthermore, I predicted
67
that the grandiose group would report greater dismissive attachment than the other two
groups. Participants chose one of four attachment styles as best reflecting their current
experience in interpersonal relationships. Chi-square statistics were computed for
Attachment Style By Group Membership. A siginificant chi-square result was found, %2
(6)= 13.36, p < .05. Figure 2 displays a bar graph indicating the count of individuals in
the grandiose, vulnerable, and control groups that selected each specific attachment style.
As represented in the figure, more than half of the members of both the grandiose (60%)
and control (53%) groups selected the Secure Attachment Style as most reflective of their
interpersonal experience. This is compared with only about a quarter of the vulnerable
group (27%) choosing Secure Attachment. In contrast, 50% of the individuals in the
vulnerable group selected the Fearful Attachment orientation, compared to 23% o f the
control group and 13% of the grandiose group. Regarding Dismissive Attachment, 16%
of the grandiose group chose this orientation compared to 10% of the vulnerable group
and 7% of the control group. Individuals in all o f the groups comparably chose the
Preoccupied Attachment style with 17% of the control group, 13 % of the vulnerable
group, and 10% of the grandiose group reporting preoccupation in their attachment to
others.
The participants also rated each of the Attachment styles as to how representative
each style was to the individuals experience in interpersonal relationships. MANOVA
statistics were conducted with each o f the Attachment Styles as the dependent variables.
68
Group Membership, Sex, and Group X Sex interaction were the independent factors.
These results are shown in Table 6. A significant relationship emerged for Group
Membership [F (8, 162) = 2.61, p < .05]. Univariate analyses were then computed for
Group Membership with each of the Attachment Styles. The only significant univariate
result occurred for Fearful Attachment [F (2, 87) = 6.99, p < .01] and Student-Newman-
Kuhls post-hoc analyses were calculated to determine the significance of mean differences
between the groups. The mean rating for the Fearful Attachment style in the vulnerable
group was 5.20, which was comparably greater than the mean of 3.33 in the control group
and 3.13 in the grandiose group.
Parental Representations
I predicted that differences in the ratings o f parental representations would be
found across the three groups, with individuals in the grandiose and control groups
reporting higher affiliation than the vulnerable group in both relationships with mother and
with father when they were ages 5 to 10. I further predicted that the grandiose group
would report greater reactive Autonomy than the other groups; or more specifically, that
the grandiose group will report that they asserted greater autonomy in their relationships
with their parents. Differences with regard to the sex of the participant or the interaction
between Group Membership and Sex were not predicted. SASB dimensional variables of
69
Affiliation and Autonomy were computed for the participants ratings of their relationships
with their mother and their father. For relationship with mother and father, the dimensions
o f Affiliation and Autonomy were rated for each o f the following relational components:
parent acting towards participant, parent reacting to participant, participant acting towards
parent, and participant reacting to parent. Thus, there were eight SASB dimensions for
ratings of the maternal relationship and eight SASB dimensions for ratings of the paternal
relationship that were utilized as dependent variables. MANOVA statistics were
conducted with independent variables of Group Membership, Sex, and Group by Sex for
each set of variables. Table 7 presents these results. The MANOVA result for ratings of
the participants relationship with their father were significant for the variable of Sex [F (8,
76) = 3.94, p < .001]. Univeriate analyses indicated a significant effect of Sex for the
ratings of one variable: participants autonomous reactions to father [F (2, 85) = 4.41, p <
.05], Student-Newman-Kuhls post-hoc tests indicate that female participants reported
that they remember reacting to their fathers by asserting more autonomy at ages 5 to 10
than their male counterparts.
In contrast to participants ratings o f their paternal relationships, ratings of
mothers emerged with a significant multivariate effect for Group by Sex [F = 2.27 (16,
152), p<.01). Therefore, follow-up univariate analyses were conducted. None o f the
Autonomy dimensions were significant in the univariate analyses. Three o f the variables
emerged with significant univariate results for the dimension o f Affiliation: Mother acting
70
towards participant (F = 5.70 (2, 85), p < .01), Mother reacting to participant (F = 7.18
(2, 85), p < .001), and Participant acting towards mother (F = 3.79 (2, 85), p < .05). The
final Affiliation dimension, participant reacting towards mother, was found to be nearing
significance (F = 2.89 (2, 85), p < .07).
As suggested by Keppel (1982), these significant univariate interaction effects
were examined further to determine the effects that significantly contribute to the overall
interaction. The relevant groups were broken down into 6 groups: Grandiose Males
(GM), Grandiose Females (GF), Vulnerable Males (VM), Vulnerable Females (VF),
Control Males (CM), and Control Females (CF). For each maternal SASB variable,
oneway anovas across the six groups were conducted. Significant univariate results across
the 6-groups were found for the dependent variables o f mothers affiliative actions to
participants [F (5, 83) = 3.33, p < .01] and mothers affiliative reactions to participants [F
(5, 83) = 4.15, p < .01]. The univariate results for participants affiliative actions towards
mother [F (5, 83) = 2.22, p < .10] and participants affiliative reactions to mother [F (5,
83) = 1.96, p < .10] were nearing significance. Planned post-hoc comparisons were
conducted for the following comparison contrasts: GM to C M, GM to VM, GM to GF,
GM to CF, GM to VF, CM to GF, CM to CF, VM to GF, VM to VF, GF to VF, and CF
to VF. The results o f these planned comparisons are indicated in Table 7 by superscripts.
With regard to the interaction effect for the SASB variable of mothers affiliative actions
to participant, Grandiose males reported higher affiliation in their mothers actions toward
71
them than vulnerable males, grandiose females, and vulnerable females. For the variable of
mothers affiliative reactions to participants, grandiose males recall higher affiliation in
their mothers reactions to them than vulnerable males and grandiose females.
Furthermore, the control males, vulnerable males and control females also report higher
affiliative reactions from their mothers than the grandiose females. For participants
memories o f their own affiliative actions towards their mother, grandiose males, control
females, and vulnerable females recall higher affiliation than vulnerable males. The control
females recall greater affiliation in their actions towards their mothers than the grandiose
females. Finally, in participants affiliative reactions to their mother, grandiose males and
control females report greater affiliation than grandiose females.
Figures 3, 4, and 5 portray a pictorial representation o f the interaction afreet for
the 3 significant SASB Affiliation dimensions. Figure 6 displays the graph for the SASB
variable that was nearing significance, included to judge whether a similar pattern as the
others was evidenced. In order to portray the scores o f these groups relative a norm
group, z-scores were computed utilizing the means and standard deviations on each of the
maternal SASB variables computed from a large sample of college students (Pincus, et al.,
1998). In summary, males in the grandiose group had the overall tendency to report
memories of above-average affiliation in their relationships with their mother, whereas
vulnerable males and grandiose females tended to report below-average affiliation in the
maternal relationship.
72
Table 1. UnivariateAnalysesforMeanDifferencesinNPI-ADJandNPI-MALScores acrosstheFour

Samples
Fall 1997 Spring 1998 FaU1998 Spring 1999 Anova
t" (N=604) (N=981) (N= 185) F df P
8

/
i
S
NPI-ADJ 12.50(5.15) 12.39(5.14) 12.43(5.26) 11.97(5.19) .41 (3,2533) n.s.
NPI-MAL 3.59(2.22) 3.36 (2.16) 3.46(2.24) 3.27 (2.20) 1.67 (3,2556) n.s.
73
Table2. PercentagesforGroupMembershipAcross SamplesandcomparedwithHibbard&Bunces

(1995) initial sample
Grandiose Vulnerable Control
Fall 1997 IN=7901 17.3% 3.7% 11.7%
Snrine 1998(N=604) 18.2% 2.3% 14.6%
Fall 1998(N=981) 18.3% 3.2% 13.3%
Serine 1999(N=185) 18.7% 1.6% 11.8%
Hibbard& Bunce(1995: N=701) 15.8% 2.6% 10.6%
74
Table 3. Manipulation Check Results for Narcissism and Self-Esteem Data
Grandiose Vulnerable Control ANOVAResultsa

(n=30) (n= 30) (n=30) F SNKb
NPINARCISSISM
NPI-TOTAL 29.30 13.20 12.73 366.91*** G> V, C
NPI-ADJ 21.23 7.53 11.47 255.50*** G>C> V
NPI-MAL 7.73 5.63 1.27 271.29*** G>V> C
SGISNARCISSISM
Superiority 31.98 20.29 26.25 24.53*** G>C> V
GoalsInstability 15.25 21.63 18.48 2.20 n.s.
SELF-ESTEEM
Rosenberg 35.28 26.87 30.73 9.87*** G>C> V
Janis-Field 65.83 49.73 56.50 12.73*** G>C>V
Note. ***p< .005, G=GrandioseGroup, V= VulnerableGroup, C=Control Group

Alldf(2, 87)
b Student-Newman-Kuhlspost-hoctest, alpha= .05
75
Table 4. Grandiose and Vulnerable Narcissism and Personality Disorder Criteria Met
Inter-Rater Grandiose Vulnerable Control ANOVAResults'5

PDI-IV Correlations11 (n=30) (n=29) (n=29) F SNKC
ClusterB
Antisocial .7 5 * * * 1.56 .83 .37 3.20* G>V, C
Borderline .85*** 1.28 2.06 .92 1.15 n.s.
Histrionic .87*** 2.96 .53 1.17 6.29*** G>V, C
Narcissistic .88*** 4.14 1.85 1.28 5.89*** G> V, C
ClusterC
Avoidant .95*** .75 4.05 1.93 4.75*** V> C, G
Dependent .81*** .69 1.58 1.54 .89 n.s.
Obsessive- .74*** 2.74 2.22 1.86 1.09 n.s.
Compulsive
Passive- .64*** .88 1.04 .91 .87 n.s.
Aggressive
Note. *p< .05 ***p<.001; G=GrandioseGroup, V=VulnerableGroup, C=Control Group
a PearsonCorrelationCoefficients
b MultivariateResults, X.F(18, 148)=5.50, p< .001; UnivariateResults, all df(2, 85)
c Student-Newman-Kuhlspost-hoctest, alpha=.05
76
Figure 1. IIP-C Profiles of Narcissistic Personalities
0.6
0.4
0.2
- 0.2
- 0.4
- 0.6
R =.89
- 0.8
- 1.2
- 1.4
OLM 4SNO 90PA 135BC 180DE 225FG 270HI 315JK OLM
Grandiose (100.67) Control (320.91) Vulnerable (180.00)
77
Table 5. Grandiose and Vulnerable Narcissism and Interpersonal Problems
Grandiose Vulnerable Control Xa ANOVAResultsb

IIP-C (n=26) (n=26) (n= 28) F F SNK
IIP-COctants 5.96***
Domineering .22 .01 -.56 8.27*** G, V>C
Vindictive .08 .08 -.73 14.10*** G, V>C
Cold -.27 .29 -.40 9.89*** V>G, C
Avoidant -.99 .27 -.28 20.26*** V>C>G
Nonassertrve -1.28 .17 .10 21.33*** V, C> G
Exploitable -1.03 -.21 .06 9.57*** V, C>G
Overly-Nurturant -.61 .37 .23 6.58** V, C> G
Intrusive -.10 .11 -.18 1.17 n.s.
IIP-CAxes 13.66***
Dominance .69 .00 -.26 28.51*** G> V>C
Nurturance -.13 -.05 .32 3.42* C>G
CurveParameters 8.78***
Amplitude .92 .88 .74 1.09 n.s.
Elevation -.56 .34 -.28 15.29*** V> C>G
Note. ***p<.005, G=GrandioseGroup, V= VulnerableGroup, C=Control Group
aMultivariatedf: Octants, (16,134), Axes, (4, 152); CurveParameters, (4,146)
bUnivariate, All df(2,74)
Student-Newman-Kuhlspost-hoctest, alpha.05
Figure 2. Attachment Styles and Narcissistic Personalities
Grandiose
Vulnerable
Control
Fearful Preoccupied Secure Dismissive
79
Table 6. Grandiose and Vulnerable Narcissism and Adult Attachment Styles
Grandiose Vulnerable Control ANOVAResults8

(n= 30) (n=30) (n= 30) F SNKb
Fearful 3.13 5.20 3.33 6.99* V> C, G

Preoccupied 2.23 3.20 2.80 1.33 n.s.
Secure 5.30 3.87 5.07 3.03 n.s.
Dismissive 3.73 3.87 3.73 .04 n.s.
Note. *p< .05; G=GrandioseGroup, V=VulnerableGroup, C=Control Group

aMultivariateresults, XF(8, 162) =2.61*; UnivariateResults, all df(2, 87)
b Student-Newman-Kuhlspost-hoctest, alpha= .05
80
Table 7. Multivariate and Univariate Results for Participants Parental Representations
Particinants MemoriesofRelationshinwithMother
A.F=2.27(16,152), p<.01 (GROUPXSEX)
AFFILIATION
Grandiose Vulnerable Control ANOVA
M F M F M F FStatistic
MotherActive 184.44*bc 120.23 112.77 145.67 155.17 177.38b 5.70**
ParticipantReactive 126.93b 73.10 89.52 108.48 119.00 134.73b 2.89+
ParticipantActive 127.52 100.53 76.23 118.86 104.79 138.16*b 3.79*
MotherReactive 149.39*b 84.23 102.86 127.86b 132J21b 153.81b 7.18***
AUTONOMY
MotherActive -39.29 -48.41 -45.38 -29.42 -31.75 -14.27 n.s.
ParticipantR e a c t i v e -25.46 7.73 1.98 -16.81 -7.17 3.57 n .s .
ParticipantActive 42.40 53.05 31.98 61.90 74.29 56.45 n.s.

MotherReactive -24.49 2.25 -9.00 1.93 -20.79 11.09 n.s.
81
Table 7 fcontinuedt
Particinants MemoriesofRelationshinwithFather
A.F=3.94 (8,76), p<.001 (SEX)
AFFILIATION
FatherActive 154.57 134.17 82.93 131.70 127.09 152.93 n.s.
ParticipantReactive 124.81 111.41 76.13 99.43 110.00 117.34 n.s.
FatherReactive 140.51 95.17 63.22 96.28 131.79 121.09 n.s.
AUTONOMY
FatherActive -28.61 -27.09 -9.75 -23.52 -33.92 -28.54 n.s.
ParticipantReactive -27.22 -1.56 -23.84 -2.49 -22.25 3.09 4.41*
FatherReactive -1.11 17.51 52.29 14.74 21.04 49.88 n.s.
Note. +p<.07, *p< .05, **p<.01, ***p< .001; SNK=StudentNewmanKuhlspost-hoctests,
F=Females, M=Males
agreaterthanvulnerablemales
bgreaterthangrandiosefemales
0greaterthanvulnerablefemales
82
Figure 3. Interaction Effect for SASB Ratings for

Mothers Affiliative Actions Towards Participant
0.8
CONTROL
0.6
0.4
0.2
VULNERABLE
< 0.2
GRANDIOSE
-0.4
- 0.6
- 0.8
Male F e m a le
83
Figure 4. Interaction Effect for SASB Ratings o f

Mothers A ffiliative Reactions To Participant
0.8
7 0.6
CONTROL
S 04 VULNERABLE
C 0-2
O 0
R -0.2
GRANDIOSE
E -0.4
S -0.6
- 0.8
Male Female
84
Figure 5. Interaction Effect for SASB Ratings of

Participants Affiliative Actions Towards Mother
0.8
0.6
WW!OOMN
CONTROL
0.4
0.2
VULNERABLE
GRANDIOSE
- 0.2
-0.4
- 0.6
- 0.8
Male Female
85
Figure 6. Interaction Effect for SASB Ratings of

Participants Affiliative Reactions To Mother
0.8
0.6
CONTROL
w W^OO>N
0.4
0.2
VULNERABLE
- 0.2
-0.4
GRANDIOSE
- 0.6
- 0.8
Male Female
86
Chapter 4
DISCUSSION
The present study provided evidence for the validity o f grandiose and vulnerable
narcissistic personalities through an analysis of personality disorder criteria, current
interpersonal functioning, and representations of early relationships with parents. The
ensuing section discusses the validity of the selection o f the two subtypes and summarizes
the findings with regard to each subtype. This is then followed by a discussion of the
implications of the validity of two narcissistic subtypes for clinical theory, assessment, and
future research.
Selection/Manipulation Check
Important to the present study was the ability to adequately select groups of
individuals with grandiose and vulnerable narcissistic character styles. To date, while the
objective assessment of the grandiose narcissistic style has aroused much effort in
theoreticians and researchers (Hilsenroth, et al., 1996), there has been less work aimed at
developing methods of assessing vulnerable narcissism (Wink, 1991). In this study,
87
grandiose and vulnerable narcissistic personalities were operationalized by the use of a
newer method for their assessment (Hibbard & Bunce, 1995). This method defined
pathological narcissism in both its grandiose and vulnerable forms as anchored in entitled
expectations. Hibbard & Bunce (1995) defined the grandiose and vulnerable character
types in extreme responses to the component of Entitlement and Exploitation of the NPI
with the grandiose types also reporting high levels of the more adjusted components o f the
construct of narcissism. This is consistent with theory that suggest that pathological
narcissism rests in a cognitive schema that is entitled, but that individuals may differ in
how they regulate the self-esteem threat associated with this entitlement (Cooper, 1981,
1998). In grandiose characters, self-enhancement (i.e., grandiosity) is the primary strategy
for regulating self-esteem in view o f entitlement and its consequence of chronic
disappointment vis-a-vis reality. They thus would be expected to report enhanced scores
on the adjusted component of the NPI as well as entitlement and exploitation. Unable to
utilize self-enhancement strategies, vulnerable narcissistic individuals are left at the mercy
of the emotional consequences of their entitled expectations. This results in chronic
disappointment, depression, and shame and consequently a low endorsement of the
adaptive NPI component (Hibbard & Bunce, 1995). Theoretically, entitlement is the
golden thread of narcissism that ties both subtypes together, whereas they differ in self
esteem management strategies. Thus, a method of selection that focuses upon entitlement
would be the optimal method o f assessment.
88
An important question o f this study is whether this method was adequate in
discriminating and selecting individuals with grandiose narcissism and vulnerable
narcissism. The results for the manipulation check variables supported the use of the
present selection procedures in distinguishing individuals with grandiose and vulnerable
narcissistic personality styles. There was stability in selection criteria and group
percentages over the four selection periods and different populations. Further, the groups
differed on measures of narcissism and self-esteem in predicted patterns. The grandiose
group reported high levels of grandiose narcissism and self-esteem, while the vulnerable
group reported high maladaptive narcissism but low levels of self-worth or self
enhancement.
The one exception was for a scale purported to measure vulnerable narcissism (i.e.,
SGIS Goals Instability Scale), where the vulnerable group did not receive higher scores
than the grandiose and control groups. I feel this may be misleading for a number of
reasons. First, the results neared significance (i.e., p < .08) and means were in the
direction of the predictions for the three groups, and it is thus expected that with a larger
sample this prediction would have been confirmed. Second, as mentioned, the criteria for
assessing vulnerable narcissism is still in debate and different measures tend to highlight
different aspects. The Goals Instability Scale was created to assess narcissistic
vulnerability in identity within the context o f career development (Robbins & Patton,
1985). It is thus expected that because o f the young age of this sample, instability in
89
identity and goals may be a part o f the normal developmental experience in a college
student sample as they consider life decisions. Further, the Goals Instability Scale focuses
on insecurity in identity and life decisions, but it does not include items that directly
measure exploitation or entitlement. Therefore, possible divergence in the definition of the
core component of vulnerable narcissism across these two measures may be questionable.
The method utilized in this study highlights entitlement as the important core of
narcissistic pathology that leads to vulnerability across realms of experience, which may
include life goals. Indeed, the control group scores on the SGIS were not significantly
different than the vulnerable group. An explanation o f this finding may be that the control
group was chosen for low scores in Entitlement/Exploitation, but while they may not have
narcissistic pathology, they may experience other difficulties that lead to vulnerability in
life goals.
The current method o f selection discriminated groups of individuals with either
grandiose narcissistic or vulnerable narcissistic personality styles in a non-clinical sample
of young adults. The results o f the present study thus provide further evidence to both
support the validity of narcissistic subtypes and this method o f distinguishing grandiose
and vulnerable narcissistic subtypes. Before proceeding to a discussion o f the results, it is
thus important to highlight that our selections procedures were aimed at selecting
individuals with narcissistic character styles, in contrast to personality pathology (or
personality disorders). The groups were not selected based upon personality disorder
90
criteria and thus are best assumed to be less pathological character styles. For example,
while the grandiose individuals in this sample may be related to the representation of NPD
in the DSM, they are best considered to be self-enhancing narcissistic subtypes. Indeed,
17.7% o f individuals in this non-clinical population individuals met NPI selection criteria
for the grandiose narcissistic subtype. This is considerably higher than the base rate for
NPD in a community population that neared 1% (Maier, et al., 1992; Samuels, et al.,
1994; Zimmerman & Coryell, 1990). Thus, in the following discussion, it is important to
keep in mind that the grandiose and vulnerable narcissistic individuals are not considered
to be representations of personality disorders. Rather, they are to be considered
individuals with a prominent character style reflective of grandiose or vulnerable
narcissism.
The Grandiose Narcissist
The current findings concerning the overt social presentation o f the grandiose
narcissistic subtype are consistent with both theory (Kemberg, 1975; Kohut, 1971, 1977)
and research (Hibbard & Bunce, 1995; Pincus & Wiggins, 1990; Wink, 1991) on this
character style. In summary, grandiose narcissistic characters tended to dismiss
interpersonal difficulties on self-report measures, while concurrently being rated more
highly than both groups on personality disorder criteria o f an arrogant, aggressive, and
impulsive nature. Grandiose narcissistic individuals were reported entitled, vindictive, and
91
aggressive interpersonal behaviors within relationships, but reported little distress about
these types of interpersonal problems. That is, while they reported problems related to
vindictiveness and dominance, they expressed little distress or concern about how this
pattern affects others and their ongoing relationships. They reported security in their
attachments to others, experiencing themselves as comfortable initiating relationships and
relating to others, while also experiencing others as readily available and interested in
engaging in relationships with them.
Grandiose participants were rated as higher in the personality disorder criteria for
Narcissistic Personality Disorder, Antisocial Personality Disorder, and Histrionic
Personality Disorder. With regard to Narcissistic Personality Disorder criteria, this finding
is consonant with the background o f the development of this DSM category, which was
based mostly on the work of Kernberg (1975) who conceived grandiosity as the primary
overt characteristic in narcissistic pathology. As mentioned before, NPD criteria are
anchored in the assessment of grandiosity (American Psychiatric Association, 1994) so it
was not surprising that our self-enhancing narcissistic characters would be rated higher in
grandiosity than the other groups. The higher ratings on the criteria for Antisocial
Personality Disorder and Histrionic Personality Disorder were in line with past research
that indicated considerable comorbidity of these Cluster B personality disorders with
Narcissistic Personality Disorder (Morey, 1988; Oldham, et. al., 1992; Pfohl, et. al.,
1986). The antisocial, narcissistic, and histrionic personality disorders have criteria that
92
belie a dramatic interpersonal presentation, with a tendency towards exhibitionism,
exploitation, and difficulties empathizing with others. Thus, the self-enhancing grandiose
characters in our samples were overtly perceived as just that: grandiose, arrogant, and
exploitative.
Predictions for the measures of current interpersonal functioning were also
confirmed, wherein the grandiose narcissists reported interpersonal difficulties o f the
dominant/vindictive nature, low interpersonal distress, and secure experiences in
attachment relationships. Grandiose individuals reported interpersonal problems that
peaked in the vindictive and domineering quadrant o f the UP-C, while they acknowledged
significantly lower difficulties than both groups with being submissive, exploited or overly-
nurturant in relationships. Past research has indicated that individuals who meet criteria
for NPD report problems with dominance and vindictiveness in their relationships (Pincus
& Wiggins, 1990). Regarding adult attachment styles, the only study found to investigate
attachment styles in individuals who report significant NPD criteria found these individuals
to endorse higher fearfulness and preoccupation in their relationships (Dickinson, 1997).
As highlighted, there may be problems with diagnostic clarity in the DSM diagnosis of
NPD given the potential for a broader conceptualization of narcissistic pathology.
Therefore, this prior sample may have been more heterogeneous than intended.
Furthermore, this prior study utilized a self-report measure for the assessment of
personality disorder criteria. Based upon theory on grandiose narcissism, the endorsement
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of highly secure attachment styles in the present study makes sense given their tendency to
dismiss personal and interpersonal difficulties (Kemberg, 1975; Kohut, 1966).
Furthermore, a higher number o f grandiose narcissistic individuals than the other groups
selected a dismissive attachment orientation, which is consistent with theory that suggests
that they dismiss, and at times, disparage their need to rely upon others (Kemberg, 1975).
The results for grandiose narcissistic subtypes attest to no apparent differences
related to the sex o f the participant in the aspects of current experience measured in this
study. In contrast, in the ratings of their early relationships with their parents, an
interaction was indicated in that grandiose males generally tended to report significantly
higher affiliation in relation to their mothers than grandiose females and vulnerable males.
Conversely, female grandiose narcissists reported significantly lower affiliation in their
early relationships with their mothers than the male grandiose narcissists and the control
females. This is an interesting and surprising finding that suggests that while grandiose
males and females presented similarly as adults, grandiose females report significantly
lower affiliation in their early relationships with their mother.
One implication of this finding is the possibility o f different developmental
pathways to grandiose narcissism related to the sex of the participant. Of course, the
actual developmental experience of each of these individuals was not assessed in this
study, so this discussion is speculation based upon individuals crystallized memories of
their early experience. Benjamin (1996) suggests that most important with regard to
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current adult interpersonal functioning is how relationships were perceived and
experienced in contrast to an objective assessment o f what occurred. Moreover, she
denotes participants memories o f their mothers reactions to them as one the most
important variables that guides individuals experience o f themselves in the world, a
variable that was found to be significant within the present study. Thus, a hypothesis that
emerges from this finding would be the possibility that grandiose males and grandiose
females experienced differing levels of affiliation based upon their gender within their early
social environments. If children experienced their mother differently based upon their sex,
grandiose narcissism may have different courses of development based upon divergence in
the experience of affiliation with the mother. Two divergent models o f the development
o f grandiose narcissism may be used to speculate upon the possible differences in the
experience of male and female grandiose narcissists.
An explanation of the finding of higher reported affiliation in the maternal
relationships of grandiose males emerges from Benjamins (1996)
interpersonal/psychodynamic theory of grandiose narcissism. This is a social-learning
theory that incorporates the evolution of an intrapsychic structure from early relationships
that then guides an individuals expectations and experience within adult relationships.
Grandiosity evolves from parents who provide unconditional affiliation (i.e., love) to their
child at a level that is not a realistic or age-appropriate response to a childs grandiose
behaviors. Kohut (1971) has suggested that the mirroring o f age-appropriate grandiose
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experience in a child is vital to the development and regulation of self-esteem. However,
Benjamin (1996) asserts that rather than providing realistic mirroring of the childs
grandiosity, the parents of budding grandiose narcissists consistently submitted to their
childs grandiose and entitled needs at a level that is unempathic to the reality of the
childs needs. From this perspective, the child then internalizes this unconditional positive
affiliatio n for the self in a manner that does not appreciate the limits o f reality nor the
realistic expectations of developing relationships with others. The child then to continues
to display entitled and grandiose expectations that are not appropriate with maturation,
and further, he or she expects (and often demands) automatic compliance from others in
the maintenance of these wishes. Because of parental submission to infantile grandiosity,
the child does not learn to set appropriate goals for him- or herself and has unrealistic
expectations for others. The child also does not develop the capacity to empathize with
others and modulate disappointment. Thus, early parental affiliation reinforces the childs
entitlement and his/her unrealistic expectations of receiving unconditional affirmation from
the social world. In contrast to Kohut (1971) and Kemberg (1975), the grandiosity of the
individual is not defensive or compensatory, but rather reflective of the parents actual
early and inappropriate idealization o f the child and the childs learned response to this.
Grandiose females reported significantly lower affiliation in their maternal
relationships than grandiose males and lower than the average undergraduate student. The
developmental pathway to female grandiose narcissism may differ from the social learning
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hypothesis for grandiose males that focuses upon overindulgence o f grandiose
expectations. In contrast to grandiose males, it may be hypothesized that grandiose
females experience negative maternal relationships when they are young. It may be that
the pathway to grandiose narcissism in females is more resonant with theories of Kohut
(1966) and Kemberg (1975). Grandiose narcissism, in psychodynamic theory, is believed
to evolve from the childs perception of their mother as inappropriately unresponsive or
punishing to the childs natural grandiosity (Kohut, 1971).

Grandiose narcissism in the females in our sample may have developed as a
defensive or compensatory structure against cold mothering, which would be resonant
with both object relations (Kemberg, 1975) and self psychological (Kohut, 1971)
perspectives on the development of grandiose narcissism. Kemberg (1975) clearly
suggests that grandiose defenses are bom from a childs attempts to deal with early
frustrations with the mothering figure, wherein the parts of the self the mother responds
positively to and the positive aspects of the mother coalesce into the grandiose self. The
experience of inadequacy and self-hatred at the core of this defense is then projected unto
others, wherein the grandiose narcissist perceives others as withholding admiration which
they feel entitled to. Kohut (1971, 1977) also regards grandiose narcissism to be a
derivative of harsh mothering. He focuses upon the importance o f infantile grandiosity in
the development o f mature self-esteem, where he views affiliative mirroring o f the mother
to be essential to the childs development. According to Kohut, as the child matures, the
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mother gradually begins to be less empathic to grandiosity that is not age-appropriate and
fails to mirror the child, which allows for the child to gradually internalize a more realistic
self-image and the ability to manage disappointments. He suggests that when mirroring of
age-appropriate grandiosity is not undertaken successfully or if mirroring is suddenly
withdrawn, the child will develop a grandiose self to compensate for the deficit in
mirroring. To compensate for the absence of mirroring of archaic grandiosity, the child
will unconsciously seek this from the world in order to repair the deficit and move forward
developmentally.
In summary, the current findings for the grandiose characters in our sample are
consistent with recent research (Hibbard & Bunce, 1995; Pincus & Wiggins, 1990; Wink,
1991) that suggests that these individuals are actively self-enhancing, vindictive,
aggressive, exhibitionistic, and exploitative, while denying significant emotional or
interpersonal stress. Thus, while they perceive themselves positively with regard to their
experience in relationships and are likely to be dominant and assertive, others would likely
describe their impact upon others more negatively than they themselves would perceive.
This overall finding confirms past theory and research that suggests that these individuals
lack knowledge of the impact they have upon others, and thus, have an unrealistic view of
themselves in relation to others (Gabbard, 1989, 1998; Kemberg, 1975; Kohut, 1971,
1977). Indeed, this very lack o f insight into their impact upon others is what incited
Gabbard (1989) to enlist the label oblivious narcissists to describe their social
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presentation and distinguish them from their vulnerable counterparts. Grandiose
narcissistic individuals expect anothers immediate and undivided attention, and are
oblivious to their egotistical needs and lack empathy with regard to the effect their direct
demands of entitlement have on others. And, by virtue of their ability to maintain the
grandiose self through self-enhancement, grandiose narcissistic individuals are less
susceptible than their vulnerable peers to the chronic emotional consequences (e.g.,
shame, depression embarrassment) of threats to entitlement. Our picture of grandiose
narcissism in the present study reveals a convergence for grandiose males and females in
their current social presentation that may be based on significantly different early socio-
emotional experiences.
The Vulnerable Narcissist
The results o f the present study also provided further confirmation for the validity
of the vulnerable narcissistic subtype with convergence to both theory (Kemberg, 1975;
Kohut, 1971, 1977) and current research (Hibbard & Bunce, 1995; Pincus & Wiggins,
1990; Wink, 1991). In summary, vulnerable narcissistic characters reported high
entitlement, but tended to overtly dismiss personal worth and healthy self-esteem,
particularly as it relates to the confidence about getting their needs met within
interpersonal relationships. Like their grandiose peers, they report significant
interpersonal difficulties o f vindictiveness and dominance related to an entitled orientation,
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but appeared unable to regulate their continual disappointment by promoting themselves in
the face of a perceived failure of the self or other. Rather, because of difficulties self
enhancing, they are prone to experience the distress associated with the dissonance
between their expectations and reality, indicated in this study by low self-esteem, high
interpersonal distress, broadband interpersonal problems, and fearfulness in relationships.
Vulnerable narcissistic individuals, overwhelmed with their hypersensitivity to perceived
threat in interacting with others, tend to utilize avoidance as a primary method of
attempting to manage their tenuous self-esteem. The consistent disappointment in the face
of their entitled expectations appears to have left them hopeless and fearful about getting
their needs met within relationships.
As predicted on the basis of the clinical descriptions of the vulnerable narcissistic
subtype (Cooper, 1981, 1998; Gabbard, 1989, 1998), the vulnerable narcissists in this
sample were rated significantly higher than both groups on Avoidant Personality Disorder
criteria. This suggests that while these individuals report high entitlement and exploitation
on the NPI, they present overtly with considerable fears o f relating to others, lack of
confidence in their ability to initiate and maintain social relationships, and fears of being
humiliated or embarrassed within relationships. Vulnerable narcissistic individuals are
painfully sensitive to perceived criticism that threatens their tenuous self-esteem
management processes, and thus will often avoid social interactions as a method of
protecting themselves and their covert grandiose expectations. This finding provides
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evidence that confirms the clinical observations of individuals who present as shy and
anxious, but who harbor feelings o f entitlement and engage in interpersonal exploitation
over time within relationships (Cooper, 1981, 1998; Gabbard, 1998). This finding has
significant diagnostic and therapeutic implications in highlighting the potential of false
positive diagnosis o f avoidant personality styles for individuals who actually have
narcissistic pathology of the vulnerable type.
With regard to vulnerable narcissism, further confirmation o f the impact of
entitlement and the difficulties in dealing with self-esteem threat are found in the results
for the measures of current interpersonal functioning. Vulnerable narcissistic individuals,
like their grandiose peers, reported more problems with vindictive and domineering
interpersonal behaviors than the control group. This may be linked to the similarity of the
vulnerable and grandiose groups in their high endorsement of entitlement and exploitation,
which is the important link between the two subtypes that defines narcissistic personality.
However, in contrast to their grandiose counterparts, vulnerable narcissistic individuals
also reported greater difficulties in interpersonal coldness and social avoidance than the
other groups. Interpersonal coldness and social avoidance, again, may be related to the
difficulties these individuals have managing their vulnerability within relationships causing
them to withdraw socially either in avoidance or a cold, distanced presentation (Cooper,
1981, 1998). Vulnerably narcissistic individuals reported greater interpersonal distress,
which can be interpreted to represent their agonizing awareness o f their vulnerability
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within relationships. Interestingly, the vulnerable narcissistic group peaked in the cold
octant o f the IIP-C, but this did not reflect a good representation o f the area of the
greatest interpersonal difficulties across the members in the group. Rather, the vulnerable
narcissistic group exhibited significant variation across individuals, where each group
member peaked with interpersonal problems in a specific interpersonal octant, but the
octant differed across the members o f the group.
Social avoidance was expected to be the primary interpersonal problem that
vulnerable narcissistic individuals would report and which would be consistent with their
being rated higher in avoidant personality disorder criteria (Cooper, 1981, 1998).
However, results indicate a broader range of interpersonal difficulties that are related to
vulnerable narcissism. While social avoidance (i.e., avoidant personality disorder criteria)
may be a primary method that these individuals use to protect their self-esteem, vulnerable
characters may differ in which interpersonal behaviors they experience as most
problematic for them. Vulnerable individuals report a broad range o f interpersonal
problems that center most generally within the dominant, vindictive, cold, and avoidant
areas of social functioning. This may accurately display their general vulnerability within
relationships, wherein they acknowledge a range of difficulties as they attempt to both
meet their needs within relationships and protect their fragile experience of self-esteem.
Theoretically, the vulnerable narcissist is observed as fluctuating from a state of
demanding entitlement and narcissistic rage to a state o f disavowal o f their entitled
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expectations and the presentation of overt shame, depression, and diffuse anxiety (Kohut,
1977). It may be that the primary experience of some vulnerable narcissists is a sense of
hopelessness and profound disappointment in being able to get ones needs met by others,
causing them significant distress and the impulse to avoid relationships.
Finally, the results for adult attachment styles supported the hypothesis that
vulnerable narcissistic individuals would report higher fearfulness in their approach to
relationships. The vulnerable narcissistic personality is aware of their tormenting
hypersensitivity within relationships, expecting and fearing that they will experience
criticism and humiliation by others. For narcissistic individuals, relationships would be
experienced with fear to the degree that they highlight the individuals vulnerability and
sense of depletion vis-a-vis his or her grandiose expectations. Whereas the grandiose type
may be able to modulate their vulnerability by promoting themselves, the vulnerable type is
not able to self-enhance, experiences anxiety, and is thus more prone to avoid
relationships.
Both narcissistic subtypes were expected to be rated higher than the control group
on borderline personality disorder, particularly the vulnerable subtype due to their greater
experiences of emotional vulnerability. This hypothesis was not verified in this sample,
although the means were in the direction of predictions. This may be due to the fact that
this was a nonclinical sample of undergraduate college students. Borderline personality
disorder has been found to be overdiagnosed in this population (Johnson & Bomstein,
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1992). This has been attributed to criteria in the borderline personality disorder diagnosis
that involve an assessment of identity diffusion as well as interpersonal difficulties (e.g.,
idealization and devaluation, impulsivity) that may be attributed more accurately to the
developmental stages of late adolescence and early adulthood. Moreover, borderline
pathology has been denoted as a severe form o f character pathology by many theorists
(Kemberg, 1975; Millon, 1996), and it would be expected that differences would be borne
out in the direction of the predictions o f this study if a clinical population o f individuals
with personality pathology had been utilized. Nonetheless, it was predicted that
individuals at extremes on the NPI related to pathological narcissism would evidence
significantly greater borderline pathology than their average peers, and this was not the
case in this sample. Greater ratings on borderline personality disorder were particularly
expected for the vulnerable narcissistic personalities in this sample, because o f their
expected presentation of greater emotional vulnerability than the other groups. However,
this hypothesis was based upon the contention made by theorists that vulnerable narcissism
is often misdiagnosed as borderline personality pathology (Masterson, 1993). The lack of
statistical convergence of our vulnerable characters with borderline personality disorder is
actually meaningful to our assertion that significant differences exist between the two
distinct personality styles. Both personality styles present with greater emotional
vulnerability than average, which may prove confusing to the clinician based on a lack of
diagnostic clarity for the vulnerable narcissist. But, despite the overt emotional lability,
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there are meaningful differences in the types o f problems these individuals would be
expected to experience based upon their intrapsychic framework (Kemberg, 1975;
Masterson, 1993).
In contrast to perceptions of current functioning, reports by vulnerable narcissistic
characters on their parental representations did not reveal an outstanding pattern of
statistically significant differences. For vulnerable narcissistic individuals, a pattern
opposite of the grandiose participants emerged and was nearing significance.
Interestingly, the vulnerable narcissistic individuals by virtue of their difficulties in self
enhancement and the lability of their emotional experiences were expected to report lower
affiliation in their parental relationships. While the means for vulnerable narcissistic
individuals were lower than controls, this difference did not produce a main effect. Quite
clearly, though, male vulnerable narcissistic individuals did fair poorly in their reports of
affiliation with their mother, but the vulnerable females reported affiliation with their
mothers at a level that was generally consistent with grandiose males and control
participants reports. Male vulnerable narcissists tended to report below-average affiliation
with their mothers as did grandiose females. In contrast, vulnerable females appeared to
have a tendency to report higher affiliation in their early relationships than the vulnerable
males and the grandiose females, a finding that might have been accredited with a larger
sample. Thus, consistent with the implications for the development of grandiosity in
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childhood, it may be that these individuals experienced more or less affiliation in relation
to their sex.
The overt picture of an inhibited, anxious, and hypervigilant character is consistent
with prior research (Wink, 1991) that found this group to be hypersensitive in both self-
report and observer ratings. Vulnerably narcissistic individuals appear to report a broad
range o f focal difficulties and distress within relationships. While being rated higher in
Avoidant personality disorder criteria, vulnerable narcissists may report that other
interpersonal behaviors, such as vindictiveness and dominance, may be more troublesome
and problematic to them than avoidance. However, regardless of which problem is the
focus, vulnerable narcissists reported elevated interpersonal distress. Relationships are
consistently disappointing and threatening, as they cannot realistically respond to the
entitled expectations of these vulnerable individuals and they highlight to the individual
their own vulnerability in a way that is often intolerable.
Diagnostic/Treatment Implications
The present results are consistent with Kohuts (1971) early conceptualization of
grandiose and vulnerable narcissistic characters, indicated by a horizontal versus vertical
split, respectively. According to Kohut, the horizontal split reflects the grandiose
character in the overt display of infantile grandiosity which evolves from archaic,
unfulfilled narcissistic needs that are split off (e.g., repressed) early in childhood. The
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vulnerable character, on the other hand, generally presents with overt low self-esteem and
shame, which is a reaction formation to the underlying narcissistic needs. This is indicated
in a vertical split, where the individual alternates between this usually depleted personality
and infantile grandiosity. In essence, the vulnerable individual shifts from entitled
narcissistic demands to a complete disavowal o f these needs, experiencing shame and a
sense o f fragility. The present study provided support for this conceptualization o f a
broader range of narcissistic personality than the grandiose narcissistic prototype. The
grandiose narcissistic personality reported problems in dominance and vindictiveness, but
high self-esteem and low distress about relationships. It appears that the ability to
maintain an internal enhancement of oneself that is consistent with the grandiose
entitlement allows the individual to avoid the experiences of vulnerability at the heart of
continual disappointment. On the other hand, the vulnerable characters in our sample also
reported entitlement and difficulties with dominance and vindictiveness, but not the ability
to promote oneself. They are thus subject to the chronic disappointment of their entitled
expectations leading to high interpersonal distress and avoidance of relationships.
The validity of two subtypes o f narcissistic pathology has many implications for the
assessment of narcissism, particularly, because the diagnosis of narcissistic pathology can
have a significant impact upon treatment goals and the interpretations of an individuals
experience. The current diagnosis of narcissistic pathology is solely grounded in the
assessment of observable grandiosity in both the diagnostic nomenclature and in the more
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widely-studied measures o f narcissism (American Psychiatric Association, 1994; Wink,
1991). This study provides support for the theoretical contention that narcissistic
pathology is not necessarily grounded in perceptible grandiosity. The main implication is
that narcissistic pathology may be more readily grounded in a cognitive core that is
chronically entitled, but that the methods of dealing with the emotional consequences of
chronic disappointment and self-esteem threat differ between the two subtypes.
Therefore, methods o f assessing pathological narcissism may need to examine the reliable
and valid assessment o f entitlement rather than overt grandiosity.
One likely reason for the grounding of pathological narcissism in the grandiose
narcissistic character is that overt grandiosity is often quite remarkable in its presentation.
Meeting with an individual who is chronically and unrealistically arrogant can initially feel
like a slap to the face. When grandiosity presents overtly, as with the grandiose
narcissistic subtype, the assessment of narcissism is less of a challenge. When discussing
the concept of grandiose narcissism with laypeople, people readily can call to mind a
person they know who may fit the prototype o f this character. Even with the striking
perceptibility of grandiosity, the validity o f NPD in self-report and interview forms is still
questionable (Hilsenroth, et al., 1996). Again, it is argued here that the lack o f a broader
definition of narcissism may contribute to difficulties in validity of this diagnosis.
In contrast, the assessment of vulnerable narcissism would be notably tricky, in
that the grandiosity o f the these individuals is often disavowed and covert, while the overt
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presentation is fearful, cautious, and easily threatened. Kohuts (1977) portrayal o f a
more vulnerable narcissist seemed to underlie his own belief that narcissistic disturbances
are often difficult to readily assess and are best diagnosed within the context of a long
standing relationship with a therapist. Furthermore, there are many other personality
styles in which an individual presents as overtly and chronically vulnerable. Therefore, the
question for the diagnosis of this subtype, is what are the important criteria and how do
we discriminate the vulnerability of the vulnerable narcissistic personality from other
notably vulnerable personality disorders.
For example, individuals with vulnerable narcissism in the present study were rated
highly on avoidant personality disorder criteria. Although this study did not utilize a
clinical population, the results suggest that there could potentially be a subset of
individuals receiving the diagnosis of avoidant personality disorder who actually have high
scores on pathological narcissism, or entitlement. If a vulnerable narcissistic subtype is
valid, potential treatment problems may arise if an individual who has narcissistic
pathology is diagnosed with avoidant personality disorder without consideration of
possible entitlement. The assessment of entitled or unrealistic expectations for the self and
others is an important variable that would guide how an individual approaches and
experiences relationships, including a therapeutic relationship. Not acknowledging
narcissistic entitlement when it is present could lead to important misinterpretations o f the
clients experience that either reinforces their sense o f entitlement or leads to
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unrecognized self-esteem threat (Gabbard, 1998). If entitled expectations are the core
guiding factor related to the overt vulnerability, the disavowal o f this entitlement by both
the vulnerable client and the therapist could also lead to difficulties and impasses in
therapy that are difficult to understand and work through.
A Clinical Example
A clinical example of a client treated by the author may clarify the therapeutic
implications of the validity of the vulnerable subtype of narcissistic pathology. Ms. D was
a 41-year-old, European-American female of middle socioeconomic status, who lived with
her husband and two young children. She presented with vague complaints of marital
conflict, chronic emptiness with occasional panic attacks, dysthymic and generally
dissatisfied mood, angry outbursts at home and at work, impulsive spending, and alcohol
abuse. Ms. D also reported transient suicidal ideations and a history of hospitalization that
occurred in early adulthood because of a suicidal threat. She reported few close friends
outside of her family and experienced enjoyment mostly in solitary, but active pursuits.
Ms. D was transferred to this therapist by another therapist who was leaving the area and
with whom Ms. D had worked with for 3 months. The DSM-IV diagnosis o f Ms. D at
transfer was Borderline Personality Disorder, and Bipolar Disorder had been ruled out
(American Psychiatric Association, 1994). In discussing Ms. D with this therapist, she
described a woman who reported significant and longstanding interpersonal difficulties and
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personal distress. In therapy, however, Ms. D is often late and spends the session in
observably anxious conversation that is at times aimed at entertaining her therapist, while
being easily wounded and sometimes angered by confrontation. This therapist reported
significant frustration with the therapeutic process, experiencing her and Ms. D as making
little progress.
Interestingly, in her first meeting with the author, Ms. D attended late and
presented as friendly and talkative. However, in reaction to a benign attempt by this
clinician to gain a better understanding of what difficulties she may be experiencing in
attending her sessions regularly and on time, she became remarkably hostile towards this
therapist. In tears and anger, she immediately denounced this clinicians credibility and
age as it related to being able to adequately understand her problems. Following this
period of tearful rage, however, Ms. D reported feeling ashamed about her outburst
explaining that situations like this have caused her difficulties at home and at work.
However, she did not abandon her concern about this clinicians ability to understand her
nor her impression that this clinician had been critical o f her in her efforts to get help
(interesting because an improved understanding was the intention of this therapists
question). She went on to explain that people at work and at home are also not able to
adequately understand her and appreciate the problems that cause her to feel anxious,
depressed, disappointed, and angry.
I ll
Ms. D related that the conflict she experiences with others is associated with their
unrealistic expectations for her with regard to her meeting their needs. She reported that,
in contrast, she consistently feels disappointed in her expectations for others, namely her
husband and her children. She experiences anxiety at work and at home with regard to the
expectations she perceives that others have for her and is chronically hurt by the ways in
which others disappoint her. In her first few sessions, she impressed as chronically
hypervigilant to this clinicians reactions to her and incessantly filling up space within
session in what this clinician experienced as an effort to avoid focusing upon and
experiencing her constant vulnerability.
With her current family, she was the perpetual caretaker who planned and
controlled all social and household activities, a role which Ms. D reported as familiar but
also one in which she resented and which caused a lot of conflict. As a teenager, she had
been the primary caretaker of responsibilities in her familial household due to the
unavailability of alcoholic parents. Ms. D recalls that her parents were generally very
hostile and critical of Ms. D when they were present. Any positive attention she did
receive was largely within the context o f her continual maintenance of the household
duties. She reported also that as a child she was criticized routinely and cruelly by an
older brother, who was idealized by her parents.
In her relationships, Ms. D appeared to vacillate between directly expressing with
angry insistence her unrealistic expectations for other (e.g., I should not have to tell
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people what I need) to disavowing her need to rely upon anyone for attention or support.
In her disavowal, Ms. D would independently take charge of what she felt needed to be
accomplished and not directly ask for help or support o f individuals at work or at home.
Underlying this disavowal, however, was her need for attention for these accomplishments
along with her wish for support in her often unrealistic needs for order within her
household. She described daily experiences at work o f fellow employees or customers
making benign comments or requests that would feel to Ms. D as personal attacks. Ms. D
reported that she feels hopeless about getting her needs met in therapy, feeling often
misunderstood and that the real problem may be a marital issue.
As therapy progressed, it became clear to this clinician that while this client clearly
had borderline traits, her presentation and experience was more appropriately consistent
with vulnerable narcissistic disorder. Because of the lack of acknowledgment of the
vulnerable subtype in the DSM, it was understandable why this individual may have
received the diagnosis of borderline personality disorder. Without an appreciation for
vulnerable narcissism, Ms. D would likely meet the following DSM-IV criteria for
borderline personality disorder anticipates and overreacts to perceived rejection, mood
lability, chronic anger, unstable relationships, feelings of emptiness, alcohol abuse and
impulsive spending (i.e., impulsive behaviors), and suicidal ideations. She also reported a
chronic sense of helplessness in getting her needs met. However, in individuals with
borderline personality disorder, this helplessness is grounded in fears about assuming adult
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responsibilities. Ms. Ds experience o f helplessness, on the other hand, emerged from her
underlying grandiose expectations for herself and others, which were largely
u n a c k n o w led g ed directly to others until she became rageful. Her mood lability was not
influenced by fears o f losing or being abandoned by an important caretaking relationship,
as it is often in borderline personality disorder (Benjamin, 1996; Masterson, 1981).
Rather, it was influenced by her expectations for criticism and sensitivity to perceived
attacks to her self-esteem, along with her entitled expectations for others to provide
attention and submit to needs that often went unspoken.
The differential diagnosis o f borderline versus narcissistic pathology is vital to the
therapist in developing an appropriate therapeutic stance and treatment plan in most
models o f treating personality pathology, including interpersonal (Benjamin, 1996),
cognitive-behavioral (Beck & Freeman, 1990), and psychodynamic (Kemberg, 1975;
Masterson, 1981) models. Ms. D had been treated for borderline personality disorder by a
therapist utilizing a stance and plan guided by psychodynamic theory. In psychodynamic
theory, specifically, the prescription for the treatment of borderline personality disorder is
the facilitation of the individuals autonomy by confronting their ability to set appropriate
interpersonal boundaries and maintain self-care. Ms. D was able to work independently
and take care o f her physical and financial needs. In her home and at work, she was
hyper-independent and often controlling of others. She was not in search of a caretaker
who would assume the adult responsibilities she had already undertaken. Rather, she was
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in search o f a way to regulate emotions that were related to her very tenuous self-esteem,
whether this was to be found in another persons attention to her efforts or in their
submission to her entitlements (e.g., which were often not acknowledged). When people
were disappointing, Ms. D utilized alcohol to soothe her fragile self. The confrontation of
helplessness that would theoretically help provide structure and facilitate self-care in an
individual with borderline personality disorder had a negative impact upon Ms. D. First, it
was experienced as criticism because of her hypersensitivity to self-esteem threat in the
context of her dem anding expectations for herself and others (Masterson, 1981, 1993).
But, most importantly, it was a misinterpretation of her experience in that she is not
helpless and unable to take care o f adult responsibilities. Early confrontation in a
relationship with someone with narcissistic pathology can be significantly destructive to
the therapeutic relationship and process. An approach that has been suggested in the
treatment of narcissism is aimed at being a strong, but empathic presence who does not
support the entitled expectations, but rather mirrors these needs in light of past
experiences while providing a gentle eye to reality (Kohut, 1977).
Limitations and Future Directions
One limiting factor in the present study is the use of a nonclinical population and
future work on grandiose and vulnerable narcissism will need to incorporate clinical
samples. While nonclinical, the sample was drawn from a large sample using extreme
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responses to dimensional data as criteria. Thus, it is likely that this sample approximated
the two pathological subtypes with respect to personality traits, but the individuals were
likely to be less severely pathological, in general. As suggested, I feel that some of the
results that were in the favored direction but that did not reach significance would be
borne out with the use of a clinical sample.
A second limitation of this study is its primary use of self-report methods of
assessment. While the results of interview converged with self-report, interviewers made
their ratings based upon a brief interaction with the individual. Future work should
include ratings o f participants by individuals who have interacted with them over time
(Wink, 1991). This is particularly important in the study of narcissism, as theorists have
suggested that because of their tendencies towards entitlement, they may have difficulties
effectively evaluating themselves (Kernberg, 1975).
This study found evidence for the validity of grandiose and vulnerable narcissism in
their current interpersonal functioning and parental representations. Future work aimed at
exploring in more detail the interpersonal experiences related to grandiose and vulnerable
narcissism would be highly relevant. O f interest would be longitudinal research on the
interpersonal and emotional experience of grandiose and vulnerable narcissistic
individuals, as well as their peers, in the context of the ongoing vicissitudes o f developing
relationships with others. From the present study, it was apparent that the grandiose
characters did not report significant interpersonal distress, while they reported
116
interpersonal problems and were rated highly in personality disorder criteria. A better
understanding o f their approach and experience within relationships would be useful in
understanding how they maintain their enhanced self-perceptions despite possible negative
feedback from others. The vulnerable characters, on the other hand, were conscious of
their vulnerability within relationships, reporting high distress, fearfulness, and avoidance.
O f interest, would be a thorough understanding o f the impact of both their entitled
expectations and overt emotional vulnerability upon their relationships.
Further work in investigating developmental experiences in individuals with
grandiose and vulnerable narcissism is also indicated, particularly as it would relate to
differences related to the sex of the individual. Why would mothers respond differently to
male and female grandiosity? The clearest suggestion may be that societal gender norms
may influence parental reactions to the natural grandiosity of male and female children.
Indeed, as cited earlier, there has been evidence to suggest that the criteria related to
grandiose narcissism have been considered by both laypeople and clinicians to be more
masculine (Adler, et al., 1990; Lindsay & Widiger, 1995). Perhaps, mothers are more
tolerant of arrogance and grandiosity in their male children, where in extreme cases the
child is provided with unconditional acceptance and mirroring of the grandiosity to a
degree that the child does not come to appreciate his limits and the limits o f others. In
contrast, early age-appropriate grandiosity and arrogance in female children may lead to
negative parental reactions that may include withholding necessary mirroring, and in
117
extreme cases, may involve harsh punishment. Cold and harsh maternal reactions to age-
appropriate grandiosity are believed to contribute to the development of a defensive
compensatory grandiose self, as delineated by Kohut (1971) and Kemberg (1975).
Therefore, lowered reports of affiliation in the maternal relationship of grandiose females
may be due to the actual reality of a mother (Kemberg, 1975; Kohut, 1971) who is highly
critical of a daughters natural, age-appropriate expression of grandiosity. Certainly, other
factors besides maternal affiliation must contribute, such as temperament (Kemberg,
1975), but these findings clearly promote further work on investigating early social
perceptions in the development o f grandiose narcissism, specifically as this relates to
potential differences for men and women. While the social presentation o f the grandiose
male and the grandiose female may appear similar, the developmental experiences that
drive the presentation of the grandiose self in the males and females in this sample may
differ. The validity of differing pathways to a similar narcissistic presentation impels
future work, as this would have important consequences for the treatment of grandiose
narcissism that has generally rested on the ability to empathically respond to the
individuals expectations by understanding them within the context of developmental
experiences.
One set o f variables not included in the current study that might influence the
development of grandiose and vulnerable narcissism is the individuals actual abilities,
talents, and personal appearance. It may be that the development of grandiose and
118
vulnerable narcissism may be associated with how clearly the grandiose or entitled
expectations match the actual reality of the individuals own skills and appearance. Kohut
(1971) denoted an individuals natural skills and abilities to be a tension arc that help
facilitate the development o f the bipolar self. A child with an entitled and exploitative
nature who actually has special skills or is especially attractive may actually receive or be
able to cajole more consistently positive feedback from the social environment.
Conversely, if ones expectations for the self are grandiose and this individual does not
have the skills to support this or the physical attractiveness that might help influence
positive reactions, one would expect a greater vulnerability to self-esteem threat. The
issue of the individuals actual abilities is an area of important inquiry in understanding the
development of grandiose versus vulnerable narcissism
Finally, much o f the work on pathological narcissism that has been undertaken has
utilized measures o f grandiose narcissism. Based on the evidence for a broader range of
narcissistic pathology found in this study and related research (Hibbard & Bunce, 1995;
Wink, 1991), the assessment of narcissism exclusively in overt grandiosity significantly
limiting to gaining a thorough understanding of pathological narcissism. Thus, future
research should focus on the discrimination of the core features of narcissistic pathology
as this relates to both grandiose and vulnerable narcissistic orientations.
Conclusions
The results o f this study clearly provide evidence that support the validity of
grandiose and vulnerable subtypes o f pathological narcissism. Both groups share a
cognitive orientation o f pathological entitlement, but appear to differ in the manner by
which they attempt to regulate self-esteem. Grandiose narcissistic subtypes are
unrealistically self-enhancing, wherein they were rated with significant personality
pathology, but appeared to dismiss personal or interpersonal difficulties across the other
measures. In contrast, vulnerable narcissistic individuals report high entitlement like their
grandiose peers, but further reported high scores on measures o f personal and
interpersonal vulnerability. Further work in examining the validity o f the overt
presentation of both subtypes with a clinical sample would be a significant contribution, at
this point. In light of the interaction o f narcissism with sex of participant for parental
representations, future work may be initiated to explore further the possible influence of
societal sex roles and styles of parental reaction to overt grandiosity as this relates to the
development and perpetuation o f pathological narcissism.
120
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Kelly Ann Dickinson
1403 8* Street N.W.
Austin, Minnesota SS912
(507) 437 -1258
kadl48@psu.edu
EDUCATION
Pennsylvania State University
APA-approved PhD. program in
Clinical Psychology
G. P. A.: 3.93/4.00
Ph. D. conferred August 4,2001
University of Saint Thomas

Saint Paul, Minnesota
Degree: B. A., Psychology
CLINICAL EXPERIENCE
July, 2000 to Present Northwestern Memorial Hospital/
Northwestern Medical School
Outpatient Treatment Center
APA-Accredited Psychology Internship Program
Chicago, Illinois
August, 1999 to May, 2000 Counseling and Psychological Services

The Pennsylvania State University
University Park, Pennsylvania
June, 1999 to August, 1999 State Correctional Institution at Houtzdale

Houtzdale, Pennsylvania
June, 1995 to July, 1998 The Psychological Clinic

Pennsylvania State University
University Park, PA
RESEARCH EXPERIENCE
August, 1994 to Present
Coordinated research on narcissism, dependency, adult attachment, and parental

representations
Conducted research on personality and alcohol use in college population
Publications
Pincus, A. L., & Newes, S. L., Dickinson, K. A., & Ruiz, M. A. (1998) A comparison of
three indices to assess die dimensions of SASB. Journal o f Personality Assessment. 70 (1). 145 -
170.
Pincus, A. L., Dickinson, K. A., Schut, A., Castonguay, L, & Bedics, J. (in press).
Attachment correlates of SASB. Special Issue: Interpersonal Assessment. European Journal of
Personality Assessment.

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GRANDIOSE AND VULNERABLE NARCISSISM

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This paper examined the validity o f two subtypes of pathological narcissism, a

grandiose and a vulnerable subtype through an analysis of current interpersonal

distress related to their interpersonal problems. Vulnerable narcissistic individuals were

attachment. They reported high interpersonal distress, and greater interpersonal

patterns. An interaction effect occurred for participants ratings of the maternal

for diagnosis and treatment.

LIST OF TABLES...................................................................................................... vii

Narcissism and NPD...................................................................... 3

Chapter 2: METHODS AND PROCEDURES..................................................... 40

Group Selection M ethods............................................................................... 40

M anipulation Check Results......................................................................... 56

Selection/M anipulation Check...................................................................... 86

Figure 1. UP-C Profiles o f Narcissistic Personalities........................................... 76

Figure 2. Attachment Styles and Narcissistic Personalities............................... 78

Figure 3. Interaction Effect for SASB Ratings for Mothers Affiliative

Actions Towards Participants.................................................................. 82

Figure 4. Interaction Effect for SASB Ratings for Mothers Affiliative

Figure 5. Interaction Effect for SASB Ratings for Participants Affiliative

Actions Towards M other.......................................................................... 84

Figure 6. Interaction Effect for SASB Ratings for Participants Affiliative

Table 1. Univariate Analyses for Mean Differences in NPI-ADJ

and NPI-MAL Scores across the Four Sam ples................................. 72

Table 2. Percentages for Group Membership Across Samples and

compared with Hibbard & Dunces (1995) initial sample................ 73

Table 3. M anipulation Check Results for Narcissism and

Table 4. Grandiose and Vulnerable Narcissism and Personality

Disorder Criteria M et............................................................................... 75

Table 5. Grandiose and Vulnerable Narcissism and

Table 6. Grandiose and Vulnerable Narcissism and

Adult Attachment Styles.......................................................................... 79

Table 7. M ultivariate and Univariate Results for

Participants Parental Representations................................................ 80

to all individuals in the Department of Psychology at Pennsylvania State University (PSU)

experience I received on predoctoral internship at Northwestern Memorial Hospital

psychiatry residents at NMH 2000-2001 for their excellent contribution to my training

experience. I am grateful for the opportunity provided by my many clients at the

Association, 1980, 1987, 1994) in its inclusion of Narcissistic Personality Disorder

representation of NPD in the DSM (American Psychiatric Association, 1994), wherein

narcissistic pathology is described as grandiose, arrogant, entitled, exploitative, and

envious. The second subtype is regarded as a vulnerable narcissistic personality, which is

described as overtly self-inhibited and modest but harboring underlying grandiose

within relationships than the grandiose subtype.

absence o f empirical research on vulnerable narcissism may be a factor in the current

muddle the diagnostic conceptualization of the grandiose character. Furthermore, and

is not recognized or misdiagnosed as a different type of character pathology, respectively.

subtypes through an analysis of their current interpersonal Sanctioning and their

representations of their early relationships with caregivers.

Narcissism and NPD

History of Concept o f Narcissism and its Pathology

The concept o f narcissism in clinical personality theory emerged principally from

psychoanalytic theory. Freud (1914/1957) designated primary narcissism as a normal

viewed in psychoanalytic theory as significant to the regulation of self-esteem through its

role in the development and regulation o f a positively-infused self-conception and in the