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Objective: Evidence suggests that pathological narcissism impacts psychotherapy process and outcome. This study investigates whether traits of pathological narcissism account for distinctiveness (construal) of patients' interpersonal perceptions in treatment settings. Methods: Patients enrolled in psychological/psychotherapeutic treatment (N = 150) described a segment of a session in a written format and subsequently assessed both self- and clinician's behavior on the dimensions of dominance and hostility (patient-reported ratings), along with their pathological narcissistic traits. Three independent raters also assessed interpersonal behaviors (observer-reported ratings) based on the written session descriptions. Indices of construal were defined by the residuals of self-reported (net of observer-reported) ratings and were regressed onto pathological narcissistic traits. Results: No association emerged between pathological narcissism and construal in patients' perceptions of their clinicians. However, grandiose traits of pathological narcissism were related to distinctively perceiving oneself as more dominant, while vulnerable traits were related to distinctively perceiving oneself as more hostile. The former association (but not the latter) also held after incorporating additional observer ratings to investigate the robustness of the results. Conclusion: Findings are discussed in light of treatment-related self-enhancement and self-concealment processes.

La presente ricerca si configura come uno studio pilota all'interno di 5 strutture psichiatriche: due CPA (comunità protetta ad alta intensità assistenziale e media intensità riabilitativa), due CRA (comunità protetta ad alta intensità riabilitativa e ad alta intensità assistenziale) e un Centro Diurno (CD), di natura esplorativa, che ha l'obiettivo di individuare le possibili differenze tra pazienti psichiatrici autori di reato e pazienti psichiatrici non autori di reato sulla base di diversi indici psicopatologici. Sono stati raccolti dati anamnestici, sociodemografici (anno di nascita, genere, stato civile, nazionalità, livello di istruzione), clinici (diagnosi psichiatrica, anno della presa in carico nei servizi pubblici, struttura di residenza e di provenienza, condizione familiare e della rete parentale/sociale), criminologici (esito perizia psichiatrica e medico legale, numero di reati commessi, tipo di reato, pericolosità sociale, misura di sicurezza, misura di protezione giuridica) e psicopatologici in un gruppo di pazienti psichiatrici residenziali. Lo studio ha coinvolto 29 pazienti residenziali adulti (Metà= 44,86). Le informazioni cliniche e sociodemografiche di base sono state recuperate dalle cartelle cliniche e dal sistema di archivio informatizzato. Inoltre, i partecipanti hanno risposto a una batteria di questionari auto-somministrati (SCID-5-PD-SPQ, SD-3, SCL-90-R, AUDIT, CAST e DAST, TAS-20, BIS-11, WHOQL-Breef) e ad una intervista strutturata (C-SSRS, versione breve). La diagnosi più riscontrata nel campione totale è disturbo dello spettro schizofrenico (65,5%), mentre tra i pazienti autori di reato (N=16), che hanno commesso mediamente 2,44 reati a testa, i reati di furto o rapina sono i più comuni (24,1%). I risultati evidenziano delle differenze tra i due sottogruppi del campione: in merito alle variabili sociodemografiche, un basso livello di istruzione correla con l'aver commesso un reato. Per quanto riguarda le variabili cliniche, un pregresso abuso di sostanze in anamnesi e alti livelli di psicopatia sono associati all'aver commesso un crimine, mentre tratti di personalità e/o sintomi internalizzanti sono più marcati nel gruppo dei non autori di reato, suggerendo che potrebbero fungere da fattore di protezione per il comportamento criminale.

Introduction: Both variable- and person-centered approaches identify grandiose and vulnerable themes in pathological narcissism (PN). However, person-centered results rely on cross-sectional data, preventing identification of subtypes of individuals through transitory self-states. Methods: We perform a cluster analysis on the joint trajectory of daily ratings of grandiose (GN) and vulnerable narcissism (GN), collected during a 28-day experience sampling (N = 196 participants). Results: The best partition – identified by multiple criteria – includes three clusters: a “low PN” cluster displays below-average levels of both daily GN and VN; a “high VN” cluster displays average daily GN and above-average levels of daily VN; a “high GN” cluster shows above-average levels of daily GN and below-average levels of daily VN. Significant inter-cluster differences emerge on both daily and trait measures of narcissism, and on trait measures of self-esteem and shame, but less sharply on impairment in personality structure. There is no inter-cluster difference on the variability and instability of daily narcissism. Discussion: We conclude that the constructs of daily GN and VN define corresponding groups of individuals with either high GN or VN, the latter group being more distressed. Yet, this group is also less “pure” in its narcissistic characterization, showing at least some levels of trait and state GN.

Dysfunctional eating attitudes and behaviors are very common among women. Recent findings suggest that these attitudes are linked to traits of pathological narcissism. However, mechanisms underlying this association need to be elucidated. We investigated the relationship between traits of pathological narcissism and dysfunctional eating attitudes and behaviors in women, testing whether perfectionistic tendencies mediate this association. The study involved a community-based sample of women (N = 306) who completed measures of grandiose and vulnerable narcissistic traits, attitudes of perfectionistic discrepancy and perfectionistic self-presentation, and dysfunctional eating attitudes and behaviors. Results show that vulnerable narcissistic traits are linked to dysfunctional eating attitudes and behaviors. Moreover, discrepancy between the actual self and the ideal self partially explains why women high in vulnerable narcissism engage in dysfunctional eating attitudes and behaviors. Grandiose narcissism was not uniquely associated with dysfunctional eating. The study suggests that the narcissistic need for being perfect, but not the narcissistic need for presenting oneself as perfect to others, promotes dysfunctional eating attitudes and behaviors in women.

Objective: Personality involves both trait and state components, personal goals serving a crucial regulatory function for the expression of personality states. The present study investigates the dynamic interplay between conscientiousness-related goals, conscientious personality states, and trait conscientiousness. Method: A sample of 244 community participants responded to a baseline survey (T1), a 5-times-a-day Ecological Momentary Assessment (EMA) for 15 days, and a post-EMA survey (T2). Results: Pre-registered multilevel analyses indicated significant contemporaneous positive and negative associations between momentary conscientious and unconscientious goals and state conscientiousness, respectively. Cross-lagged associations also emerged, with goals predicting future states of conscientiousness. A latent growth model was fitted on a subsample of participants (N = 159). Results indicated that change in trait conscientiousness from T1 to T2 was explained by growth in conscientiousness-related goals during the EMA phase, with a mediating effect of growth in state conscientiousness. Conclusions: Overall, the results corroborate the importance of goals for modeling contemporaneous and cross-lagged personality dynamics, both in short and longer timeframes.

The authors investigate whether and how borderline and pathological narcissistic traits differ in their associations with trait and state rejection sensitivity, and with affective reactions to experiences of social rejection occurring in daily life. Community adults (N = 189) completed baseline measures of rejection sensitivity, borderline personality, and pathological narcissism, and daily measures of perceived social rejection and affective states for 7 days. Vulnerable narcissism was the main driver of negative anticipated emotions for social rejection. Borderline personality made people prone to experiencing social rejection in daily life. Moreover, borderline personality traits predicted greater self-directed aggressive impulses when experiencing social rejection. Grandiose narcissism showed only a negative association with anticipatory anxiety for rejection. These findings highlight that sensitivity to social rejection is crucial in both borderline personality and pathological narcissism.

Numerous studies have established the importance of body image self-consciousness in predicting sexual distress and dissatisfaction in women. However, there is a dearth of information analyzing whether the same relation applies to men. Sexual perfectionism is a sexual correlate that has shown diverse links with sexual-related outcomes. The aim of the present study was to determine the degree to which certain sexuality-related factors, such as body image self consciousness and sexual perfectionism, and certain personality traits, namely grandiose and vulnerable narcissistic traits, may be associated with sexual discomfort in men. An online survey including self-report measures of sexual correlates variables and narcissistic personality traits was administered to a sample of 212 men, who provided the data used to investigate these associations. We performed a stepwise regression analysis, including the sexual-specific variables in the first step and vulnerable and grandiose narcissism in the second step. Sexual distress was linked to vulnerable narcissistic features and body image self-consciousness, according to our research. The clinical implications of our findings emphasize the need of evaluating body image concerns and taking personality characteristics into account when addressing sexual difficulties in men.

The Pathological Narcissism Inventory (PNI) is extensively used in recent empirical literature on pathological narcissism. However, most studies using the PNI are community-based, and no studies have used the PNI to investigate narcissistic presentations in personality disordered patients. This study investigates measurement invariance of the PNI in community participants and patients with personality disorders, and examines differences of narcissistic presentations in these samples through a multimethod approach. Results show that the PNI can be used reliably to measure and compare traits of pathological narcissism in community participants and patients with personality disorders. Personality disordered patients show higher traits reflecting vulnerable narcissism and overt manifestations of grandiose narcissism, compared with controls. Finally, network analysis indicates that traits of grandiose fantasies and entitlement rage have a central role in defining manifestations of PNI pathological narcissism, regardless of the presence of an underlying personality disorder. Research and clinical implications are discussed.

The first Italian lockdown during COVID-19 pandemic constituted an example of strong situation. Under this context, we investigated associations of HEXACO personality with COVID-19 mitigation behaviors (self-reported hygiene, distancing, going out). We tested unique associations through regularized regressions and out-of-sample prediction after establishing the best level of analysis (HEXACO traits, facets, items). Personality always explained out-of-sample variance over and above demographics, COVID-related knowledge, concern, impacts, and goals. Hygiene and distancing were best predicted by HEXACO traits, whereas facets constituted the best level for the prediction of going out. In general, honesty-humility (trait or facets) was the clearest predictor of safer behaviors. Results corroborate the relevance of personality even in strong situations, as well as its importance for COVID-19 mitigation.

Research on pathological narcissistic traits and sexuality are mainly focused on the dysfunctional aspects of sexuality. The present study aims to explore the relationship between narcissistic traits and sexual satisfaction in men, testing whether sexual self-esteem mediates this association. Participants included 212 men who completed measures of grandiose and vulnerable narcissistic traits, sexual self-esteem, and sexual satisfaction. Results highlight how vulnerable narcissistic traits are negatively associated with sexual satisfaction. This association is fully mediated by sexual self-esteem. On the contrary, grandiose narcissistic traits are not directly associated with sexual satisfaction, but with sexual self-esteem only, which explains the indirect effect of grandiose traits on sexual satisfaction. In conclusion, sexual self-esteem in personality configurations with high pathological narcissistic traits accounts for the relationship between narcissistic traits and sexual satisfaction.

Background Individuals with narcissistic traits, specifically vulnerable ones, are more prone to experiencing concerns related to self-worth and physical appearance and to showing heightened sensitivity to appearance evaluation. Negative body image and body image self-consciousness may, in turn, undermine sexual functioning, especially when apprehension is related to body appearance in sexual contexts. Methods We aimed to evaluate the associations between self-reported pathological narcissistic traits, both grandiose and vulnerable, and sexual functioning in a large sample of nonclinical women (N = 656). Furthermore, we tested the mediating role of body image self-consciousness in these associations. Outcomes Sexual functioning was measured through the Female Sexual Function Index. RESULTS The results highlight that vulnerable narcissistic traits are associated with lower sexual functioning, this association being mediated by higher levels of body image self-consciousness. Conversely, grandiose narcissistic traits are linked to lower body image self-consciousness and, consequently, higher levels of sexual functioning. Clinical Implications Considering the link between body image self-consciousness and sexuality is of utmost importance in clinical practice with women, as well as in promoting positive body appreciation. Clinicians working with individuals presenting with pathological personality traits should consider including an assessment of their sexual functioning.

Background Due to the high pressure they sustain, family members of substance users are thought to experience negative consequences in mental and physical health. This scoping review provided a comprehensive overview on the mental and physical health of adult Affected Family Members (AFMs). Method We searched in-journal English articles in PubMed, with no date limit, guided by the concepts of stress, strain, and burden, and including several terms related to substance use. Eligibility criteria included focus on adult AFMs, mental and physical health, and clinical forms of substance use. Results PubMed search identified 3549 articles, with 46 additional papers from other sources. Fifty-six articles were included, quantitative (N = 39), qualitative (N = 15) and both (N = 2). Quantitative findings show that AFMs are subject to increased stress and burden, and impaired mental health. Variable rates of physical problems emerge, with some medical conditions being more common among AFMs of substance users versus controls. Finally, evidence shows increased risk for aggression and reduced quality of life and social adjustment. AFMs report higher stress and strain if they are women, in low socio-economic families, and co-habiting with more severe substance users. Qualitative studies additionally suggest that stigma, self-blame, and social isolation are common. Conclusions AFMs of substance users represent a population at higher risk for negative health-related outcomes and should be systematically regarded as targets for treatment.

This study investigated the association between narcissism and shame, considering different measures of narcissism, different levels of analysis, and different situational conditions. Nonclinical participants (N = 196) completed baseline measures, followed by daily questionnaires for 28 days. Multilevel models indicated that trait and daily vulnerable narcissism, as well as trait neuroticism, were positively associated with daily shame. When controlling for vulnerable narcissism, trait grandiose narcissism was unrelated to shame, and daily grandiose narcissism was mostly negatively related to it. As for situations, social stress and workload were related to increased shame, especially in those high in trait neuroticism, or narcissism scales with neurotic content. Results highlight the key role of shame in pathological narcissistic functioning.

Purpose: Although there is growing interest in trans-negative attitudes and behaviors, few studies have investigated the psychological variables associated with them. The present study aims to assess the relationship between psychopathological symptoms, defensive style, personality traits and negative attitudes toward transgender people. Methods: Participants (N = 165) were asked to complete several questionnaires assessing their psychopathological symptoms (SCL-90-R), defensive style (REM-71), maladaptive personality traits (PID-5-BF), antitransgender attitudes (ATTI), and sociodemographic characteristics. A four-step hierarchical multiple linear regression analysis was carried out to investigate the predictive role of such variables on antitransgender attitudes. Results: We found a significant negative effect of mature defenses and a positive effect of antagonistic traits on trans-negative attitudes. Political and religious beliefs predicted trans-negative attitudes, whereas no effect was found for the other predictors. We also found a significant effect of age and an interaction effect between sexual orientation and gender, with heterosexual men showing higher levels of trans-negativity than non-heterosexual men. Conclusions: The study highlights the importance of both personality and social constructs in predisposing to negative attitudes toward transgender people. Future research should therefore take into account both personality and social variables

Empirical literature has shown that narcissism is often associated with limited empathy, but the mechanism underlying this association is still unclear. The present study investigated the role of identity instability as a mediator of the relationship between narcissistic traits and empathic capabilities. Narcissistic traits, identity instability, and cognitive and emotional empathic capabilities were assessed among 462 nonclinical participants through self-report measures. Results showed a positive association between narcissistic traits and cognitive empathy. On the other hand, a negative association between narcissistic traits and emotional empathy emerged. Furthermore, the study showed that the association between narcissistic traits and impairments in emotional empathy was partially explained by identity instability. Results thus demonstrated that narcissistic traits were associated with higher identity instability, and this, in turn, was associated with decreased abilities to be emotionally involved in others' affect states. These findings are discussed in the context of an object relations formulation of narcissistic personality.

BACKGROUND: Medically unexplained physical symptoms (MUPS) are physical symptoms without a medical explanation. The study provided for the collection of data from hospitalized patients presenting MUPS, aiming to draw a clinical and sociodemographic profile of patients with somatic symptoms disorder (SSD), and to estimate economic costs related to hospital management. METHODS: This observational retrospective study consisted in the evaluation of data referring to all hospitalized patients admitted between 2008 and 2018 in the wards of a teaching hospital in Northern Italy. RESULTS : A total of 273 patients presenting with MUPS have been hospitalized. The sample showed a prevalence of female, married, and workers patients. The most frequent ward involved is neurology, followed by internal medicine and Short Stay Unit. The most common symptoms found are headache, pain, syncope and vertigo. No evidence that having a medical disease predict the developing of somatic symptoms disorder emerged. A personality disorder diagnosis in patients with MUPS was associated with increased probability of having a diagnosis of SSD. A marginally significant positive association also emerged with anxiety disorders, but not with depressive disorder. The overall estimated cost of hospitalization for MUPS is € 475,409.73. C ONCLUSIONS : Further investigations are needed to extend the study on other clinical areas and to clarify the correlates.

Medically Unexplained Physical Symptoms (MUPS) are physical symptoms without a medical explanation. This study collected data from hospitalized patients presenting MUPS, aiming to draw a clinical and socio-demographic profile of patients with MUPS, to explore psychopathological correlations of Somatic Symptoms Disorder (SSD) diagnosis, and to estimate economic costs related to hospital management for MUPS. The cross-sectional study consisted in the evaluation of data referring to hospitalized patients admitted between 2008 and 2018 in a teaching hospital in Northern Italy. A total of 273 patients presenting MUPS have been hospitalized. The sample showed a prevalence of female, married and employed patients. The most frequent wards involved are Neurology, Internal Medicine and Short Unit Stay. The most common symptoms found are headache, pain, syncope and vertigo. There is no evidence that a history of medical disease is associated with a diagnosis of SSD. A personality disorder diagnosis in patients with MUPS was associated with increased probability of having a diagnosis of SSD. A marginally significant positive association emerged with anxiety disorders, but not with depressive disorder. The overall estimated cost of hospitalization for patients with MUPS is 475'409.73 &euro, The study provides the investigation of a large number of patients with MUPS and a financial estimate of related hospitalization costs.

Objective: Whilst the relationship between narcissism and emotion regulation is a topic of great interest, little is known about the nature of this association. The aim of the present study is to clarify the relationship of both grandiose and vulnerable narcissism with difficulties in emotion regulation, controlling for the effect of borderline personality traits. Method: Narcissistic traits, borderline personality traits and difficulties in emotion regulation were assessed in 293 non clinical participants (72.7% women, M= 26.99, SD= 9.13) Results: Narcissistic vulnerability was associated with difficulties in accessing emotion regulation strategies, and in understanding, accepting and being clear about emotional states. Borderline personality traits were associated with difficulties in inhibiting impulsive emotional responses and in accomplishing goal directed behaviours during negative emotional states. Narcissistic grandiosity was not associated with any difficulties in emotion regulation. Conclusions: These findings clarified the relationship between narcissism and emotion regulation, highlighting the importance of considering both grandiose and vulnerable manifestations of pathological narcissism. Research and clinical implications are discussed.

The debate on how psychopathology can be defined and explained is far from over. With few exceptions, single theories devoted to explaining single/distinct disorders have been developed. Yet, the existence of similar correlations and comorbidity between disorders and symptoms in adult populations challenge scholars to look for a general theory which might explain psychopathology, throughout its different manifestations. Literature (reviews, most cited articles of the last ten years, influential contribution) has been explored to identify points of consensus among scholars which might orient the effort to explain the “what” and “the how” of psychopathology. From different conceptual models and lines of research, some important tenets can be recognized: a) hierarchical models are needed to account the evidence that different disorders are at the same time correlated and distinguishable; b) specific syndromes are linked at a more basic level, such that they can be conceived of as specific instantiations of a coherent underlying domain of human variation (spectrum conceptualization), c) given high correlations at the spectrum level, there may be one underlying factor – the so-called “P” factor – that summarizes individuals’ vulnerability to psychopathology and giving way to distinct patterns of symptoms over time. It remains a controversial topic whether the p factor reflects a substantive construct, how its nature might be conceptualized and how it changes over time. Based on clinical experience and varies theories over time, the present work will deepen the suggestion that the general factor might be conceptualized in terms of rigid perseveration in the way of interpreting the intersubjective field of experience. By this perspective, to explain psychopathology we need of a general theory on how the mind works, on the basic mechanism which leads people to persist on their own way of thinking and acting and on the conditions under which dysfunctionalities emerge.

The debate on how problematic internet use (PIU) can be conceptualized and explained is far from over. Scholars ‘opinions vary considerably regarding many different aspects of PIU, including whether and how psychosocial and cultural dimensions interact with individual vulnerability in increasing the likelihood of PIU. The present study starts by Caplan’s conceptualization of PIU as a preference for online social interaction and a mood regulation strategy, which may result in difficulties in self-regulation and negative outcomes. At the same time, the study explores the role of the socio-cultural context in influencing cognitive and affective factors. Measures of problematic internet use were administered along with measures aimed to detect symbolic universes by which the subjects interpret their micro and macro-social environment, negative affects, social anxiety, loneliness and social support, among 424 students from the 9th and 11th grade (age 13-19 year old) of public high schools in Southern Italy. Correlational Analyses have been performed to test relationships among the variables. Adolescent with PIU show to express higher level of negative affects (r=.37; p=.000), social anxiety (r=.31; p=.000), and loneliness (r=.28; p=.000), and lower level of social support (r=-.11; p=.015). Furthermore, symbolic universes characterized by a negative and anomic view of the social environment show to be related to higher preference for online interactions (r=- .13; p= .007) and negative consequences (r=.10; p=.034) and to higher levels of negative affects, social anxiety, and loneliness (r=-.21; r=-.18; r=-.34; p=.000 respectively) and social malaise (r=.53; p=.000). Findings support the idea that social-cultural factors might play a protective role on the individual vulnerability toward PIU. This points to the need for comprehensive programming of prevention that addresses social and cultural influences in the young preference for online interactions.