Can neuroscience help to understand narcissism? A systematic review of an emerging field

Decoding the Narcissistic Brain

There is a substantial knowledge gap in the narcissism literature: Less than 1% of the nearly 12,000 articles on narcissism have addressed its neural basis. To help fill this gap, we asked whether the multifacetedness of narcissism could be decoded from spontaneous neural oscillations. We attempted to do so by applying a machine learning approach (multivariate pattern analysis) to the resting-state EEG data of 162 participants who also completed a comprehensive battery of narcissism scales assessing agentic, admirative, rivalrous, communal, and vulnerable forms. Consistent with the agency-communion model of narcissism, agentic and communal forms of grandiose narcissism were reflected in distinct, non-overlapping patterns of spontaneous neural oscillations. Furthermore, consistent with a narcissistic admiration and rivalry concept model of narcissism, we observed largely non-overlapping patterns of spontaneous neural oscillations for admirative and rivalrous forms of narcissism. Vulnerable narcissism was negatively associated with power across fast and slow wave frequency bands. Taken together, the results suggest that the diverse forms of narcissism can be reliably predicted from spontaneous neural oscillations. The findings contribute to the burgeoning field of personality neuroscience.

Beyond good and evil : The pursuit of philosophical and scientific truth in a time of moral ambiguity

The contributions of philosophy from antiquity to the 20th century and modern neuroscience to understanding human’s capability to commit deeds of great good and great evil.

Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach

Pathological narcissism (PN) is a complex, treatment-resistant disorder characterized by unstable self-esteem that fluctuates between grandiosity and vulnerability, complicating the formation of a stable self-image. With few empirically supported therapies, treatment has traditionally relied on long-term psychoanalytic approaches, but these often face high attrition. Recent research suggests a potential therapeutic synergy between psychedelics and psychoanalytic therapy, offering a novel approach to addressing entrenched personality structures. Studies on MDMA (3,4-methylenedioxymethamphetamine), a compound known for enhancing empathy, trust, and social interactions, demonstrate potential to reopen critical periods for social learning in adults, offering the possibility of therapeutic benefits for conditions with core issues in relatedness, such as PN. MDMA promotes psychological flexibility and openness, allowing for deeper self-exploration and strengthening the observing ego, considered in psychoanalytic therapy to be an essential component for recognizing and modifying maladaptive patterns. By reducing fear-based avoidance in the brain, MDMA facilitates access to unconscious emotions, helping individuals process overwhelming feelings linked to early relational trauma commonly seen in PN. Additionally, MDMA's capacity to enhance compassion and empathy can fortify the therapeutic alliance, increasing its potential to facilitate relational change. This paper presents an MDMA-assisted therapy (MDMA-AT) tailored for narcissistic patients which is currently being conducted as an investigator-initiated trial (IIT). It explores the model's theoretical foundations, mechanisms of change, treatment framework, and clinical challenges. Combining MDMA with an evidence-based depth therapy like psychoanalytic psychotherapy may offer an innovative treatment for conditions associated with attachment and developmental trauma, particularly personality disorders. While the role of psychotherapy in psychedelic treatments remains a topic of debate, with some proposing psychedelics be administered without psychotherapy, we assert that individuals with early relational trauma stand the most to gain from an integrated psychedelic-assisted therapy (PAT) model, where MDMA enhances the therapeutic alliance and emotional openness while psychoanalytic interventions provide the structure for lasting change.

Neural rhythms of narcissism: Facets of narcissism are associated with different neural sources in resting-state EEG

Trait narcissism is characterized by significant heterogeneity across individuals. Despite advances in the conceptualization of narcissism, including the increasing recognition that narcissism is a multidimensional construct, the sources of this heterogeneity remain poorly understood. Here, we used a neural trait approach to help better understand "how," and shed light on "why," individuals vary in facets of trait narcissism. Participants (N = 58) first completed personality measures, including the Narcissistic Personality Inventory (NPI), and then in a second session sat passively while resting-state electroencephalography (rs-EEG) was recorded. We then regressed source-localized rs-EEG activity on the distinct facets of narcissism: Grandiose Exhibitionism (GE), Entitlement/Exploitativeness (EE), and Leadership/Authority (LA). Results revealed that each facet was associated with different (though sometimes overlapping) neural sources. Specifically, GE was associated with reduced activation in the dorsomedial prefrontal cortex (DMPFC). EE was associated with reduced activation in the DMPFC and right lateral PFC. LA was associated with increased activation in the left anterior temporal cortex. These findings support the idea that trait narcissism is a multidimensional construct undergirded by individual differences in neural regions related to social cognition (the DMPFC), self-regulation (right lateral PFC), and self-referential processing (left anterior temporal cortex).

Narcissus reflected: Grey and white matter features joint contribution to the default mode network in predicting narcissistic personality traits

Despite the clinical significance of narcissistic personality, its neural bases have not been clarified yet, primarily because of methodological limitations of the previous studies, such as the low sample size, the use of univariate techniques and the focus on only one brain modality. In this study, we employed for the first time a combination of unsupervised and supervised machine learning methods, to identify the joint contributions of grey matter (GM) and white matter (WM) to narcissistic personality traits (NPT). After preprocessing, the brain scans of 135 participants were decomposed into eight independent networks of covarying GM and WM via parallel ICA. Subsequently, stepwise regression and Random Forest were used to predict NPT. We hypothesized that a fronto-temporo parietal network, mainly related to the default mode network, may be involved in NPT and associated WM regions. Results demonstrated a distributed network that included GM alterations in fronto-temporal regions, the insula and the cingulate cortex, along with WM alterations in cerebellar and thalamic regions. To assess the specificity of our findings, we also examined whether the brain network predicting narcissism could also predict other personality traits (i.e., histrionic, paranoid and avoidant personalities). Notably, this network did not predict such personality traits. Additionally, a supervised machine learning model (Random Forest) was used to extract a predictive model for generalization to new cases. Results confirmed that the same network could predict new cases. These findings hold promise for advancing our understanding of personality traits and potentially uncovering brain biomarkers associated with narcissism.

The dark side of personality functioning: associations between antisocial cognitions, personality functioning (AMPD), empathy and mentalisation

Introduction

With the introduction of the new psychiatric diagnostic manuals, personality functioning has gained new prominence. Several studies have reported consistent findings that individual showing high levels of antisocial features are associated with alterations in interpersonal functioning domains such as empathy and mentalisation. The focus of the current study (N = 198) is to examine antisocial cognitions, as measured by the Scrambled Sentences Task (SST), and to what extent this approach can help to better understand the relationship between antisocial traits and personality functioning/empathy.

Method

We implemented a hypothesis-driven approach using logistic regression and a data-driven approach using machine learning to examine distinct but related measures of personality functioning as predictors of antisocial cognitions.

Results

Antisocial cognitions were associated with low interpersonal functioning as expected, but only when not adjusting for antisocial traits, which accounted for almost all the association. The data-driven analysis revealed that individual items assessing empathic concern in personality functioning scales (as opposed to the whole scores) explained low antisocial cognitions even when adjusting for antisocial traits.

Discussion

Antisocial cognitions appear to be associated to two distinct traits, the antisocial and a specific type of personality functioning. This finding is discussed in terms of the possible distinction between two motivational forces: to harm others/prioritize one's advantage, and to help suffering others.

Linking grandiose and vulnerable narcissism to managerial work performance, through the lens of core personality traits and social desirability

While grandiose narcissism is well-studied, vulnerable narcissism remains largely unexplored in the workplace context. Our study aimed to compare grandiose and vulnerable narcissism among managers and people from the general population. Within the managerial sample, our objective was to examine how these traits diverge concerning core personality traits and socially desirable responses. Furthermore, we endeavored to explore their associations with individual managerial performance, encompassing task performance, contextual performance, and counterproductive work behavior (CWB). Involving a pool of managerial participants (N = 344), we found that compared to the general population, managers exhibited higher levels of grandiose narcissism and lower levels of vulnerable narcissism. While both narcissistic variants had a minimal correlation (r = .02) with each other, they differentially predicted work performance. Notably, grandiose narcissism did not significantly predict any work performance dimension, whereas vulnerable narcissism, along with neuroticism, predicted higher CWB and lower task performance. Conscientiousness emerged as the strongest predictor of task performance. This study suggests that organizations might not benefit from managers with vulnerable narcissism. Understanding these distinct narcissistic variants offers insights into their impacts on managerial performance in work settings.

Predicting narcissistic personality traits from brain and psychological features: A supervised machine learning approach

Narcissism is a multifaceted construct often linked to pathological conditions whose neural correlates are still poorly understood. Previous studies have reported inconsistent findings related to the neural underpinnings of narcissism, probably due to methodological limitations such as the low number of participants or the use of mass univariate methods. The present study aimed to overcome the previous methodological limitations and to build a predictive model of narcissistic traits based on neural and psychological features. In this respect, two machine learning-based methods (Kernel Ridge Regression and Support Vector Regression) were used to predict narcissistic traits from brain structural organization and from other relevant normal and abnormal personality features. Results showed that a circuit including the lateral and middle frontal gyri, the angular gyrus, Rolandic operculum, and Heschl's gyrus successfully predicted narcissistic personality traits (p < 0.003). Moreover, narcissistic traits were predicted by normal (openness, agreeableness, conscientiousness) and abnormal (borderline, antisocial, insecure, addicted, negativistic, machiavellianism) personality traits. This study is the first to predict narcissistic personality traits via a supervised machine learning approach. As such, these results may expand the possibility of deriving personality traits from neural and psychological features.

The Neural Correlates of Narcissism: Is There a Connection with Desire for Fame and Celebrity Worship?

(1) Objective: Narcissism is characterized by emotional regulation deficits, a lack of empathy for others, and extreme self-focus. Narcissism has also been linked to an increased desire for fame and celebrity worship. Here, the neuroscience underlying narcissism is examined in order to determine what regions and networks of the brain are altered when non-narcissistic individuals are compared to participants with both grandiose and vulnerable narcissism. (2) Methods: The behavioral relationships between grandiose narcissism and desire for fame and vulnerable narcissism and celebrity worship are explored, along with a possible relationship at the neural level between these constructs. In this paper, we review research demonstrating that increased levels of grandiose narcissism are associated with an increase in obsession with fame, while vulnerable narcissism is associated with celebrity worship. (3) Results: Based on current data, the frontal regions underlie narcissism and also likely underlie celebrity worship and desire for fame. This tenuous conclusion is based on a limited number of studies. (4) Conclusions: The brain areas associated with grandiose narcissism may be associated with an intense desire for fame as well, while brain regions associated with vulnerable narcissism may be similar in celebrity worshipers. Future research studies on the brain that are specifically designed to test these relationships at a neurological level are needed.

Narcissism predicts noise perception but not signal decoding in emotion

Grandiose narcissists claim that they have better-than-average emotion recognition abilities, but many objective tests do not support this claim. We sought to clarify the relation between grandiose (both agentic and communal) narcissism and emotion recognition by taking a closer look at the components of emotion recognition. In two studies (N1 = 147, N2 = 520), using culturally distinct samples and different stimulus materials, we investigated the relation between grandiose narcissism and signal decoding (accurate view of the intended emotion displayed in an expression) as well as noise perception (inaccurate deciphering of secondary emotions that are not part of the emotional message). Narcissism was inconsistently related to signal decoding, but consistently and positively related to noise perception. High grandiose (agentic and communal) narcissists are not necessarily better at signal decoding, but are more susceptible to noise perception. We discuss implications for narcissists' social interactions and interpersonal relationships.

Narcissism and the perception of failure - evidence from the error-related negativity and the error positivity

The literature on narcissism suggests two contradictory ways how highly narcissistic individuals deal with their failures: They might avoid consciously recognising their failures to protect their ego or they might vigilantly turn towards their failures to process cues that are important for maintaining their grandiosity. We tried to dissolve these contradictory positions by studying event-related potential components of error processing and their variations with narcissism. With a speeded go/no-go task, we examined how the error-related negativity (Ne; reflecting an early, automatic processing stage) and the error positivity (Pe; associated with conscious error detection) vary with Admiration and Rivalry, two narcissism dimensions, under ego-threatening conditions. Using multilevel models, we showed that participants with high Rivalry displayed higher Ne amplitudes suggesting a heightened trait of defensive reactivity. We did not find variations of either narcissism dimension with the Pe, which would have pointed to weaker error awareness. Thus, our results only supported the second position: a heightened vigilance to errors in narcissism at early, rather automatic processing stages.

"It's not you, it's me": identity disturbance as the main contributor to interpersonal problems in pathological narcissism

BACKGROUND

Core impairments in self and other functioning typify individuals with personality disorder. While interpersonal dysfunction is a known element of narcissistic disorders, empirical research investigating intrapersonal elements is lacking. The aim of this study was to investigate the internal representations of individuals with grandiose and vulnerable features, as manifested through their attachment styles, and the specific role of identity disturbance in explaining the relationship between pathological narcissism and maladaptive interpersonal functioning.

METHODS

A sample of 270 university students completed the Brief Pathological Narcissism Inventory (B-PNI), the Severity Indices of Personality Problems (SIPP), the Relationship Questionnaire (RQ), and the Inventory of Interpersonal Problems (IIP-32).

RESULTS

Both vulnerable and grandiose narcissism were positively associated with both fearful and preoccupied attachment, and negatively associated with secure attachment, whilst grandiose narcissism was also positively associated with dismissive attachment. Furthermore, unstable representations of self, poor self-reflective functioning, and low sense of purpose fully mediated the relationship between interpersonal problems and grandiose narcissism while partially mediating the relationship between interpersonal problems and vulnerable narcissism.

CONCLUSIONS

Overall, our findings suggest that for individuals presenting with narcissistic features, capacity for adaptive interpersonal functioning is grounded by deficits in identity integration. Implications of these findings are discussed.

Cortisol reactivity to psychosocial stress in vulnerable and grandiose narcissists: An exploratory study

Introduction

Narcissistic personality manifests itself in at least two different forms: grandiose and vulnerable. In the present study, we compared cortisol and emotional responses to psychosocial stress between subjects high in vulnerable and grandiose narcissism scores, and examined possible associations between narcissism, other personality traits, and stress responses. We hypothesized that subjects with higher scores of vulnerable narcissism would show stronger emotional and physiological reactivity than those with high scores of grandiose narcissism.

Methods

A final sample of forty-seven participants underwent a Trier Social Stress Test (TSST), provided saliva samples to assess cortisol levels, and completed several personality questionnaires.

Results

Consistent with our hypothesis, subjects with higher scores of vulnerable narcissism had a stronger cortisol and emotional response than those with high scores of grandiose narcissism. Vulnerable narcissism was positively correlated with schizotypal traits, while grandiose narcissism was positively correlated with psychopathic traits. Participants with a mixed-type of narcissism were also discussed.

Discussion

This study provides the first evidence of differential physiological and emotional reactivity to social evaluation threat according to scores of vulnerable and grandiose narcissism. Since this is an exploratory study, the results must be interpreted with caution. However, the results will be informative for future confirmatory research with larger and more heterogeneous samples.

Do highly sensitive persons display hypersensitive narcissism? Similarities and differences in the nomological networks of sensory processing sensitivity and vulnerable narcissism

BACKGROUND

Individuals with high sensory processing sensitivity (SPS) ("highly sensitive persons") are thought to be easily excitable and overwhelmed, highly attentive to aesthetic impressions, and particularly sensitive to sensory stimulation. Public discourse suggests that those who describe themselves as highly sensitive see themselves as fundamentally different from others, and view their personality as a gift and a burden. From a clinical personality perspective, high sensitivity could be considered to have substantial overlaps with hypersensitive narcissism, or generally vulnerable narcissism.

METHOD

We investigated the associations and shared nomological networks between high sensitivity and hypersensitive narcissism in two studies using convenience and representative samples (n₁  = 280, n₂  = 310).

RESULTS

There is evidence for replicable associations between SPS and hypersensitive (.53 ≤ r ≤ .54) as well as vulnerable narcissism (.44 ≤ r ≤ .54), associations were not attributable to general neuroticism. Nomological networks were similar and pointed to a neurotic-introverted personality profile with reduced personality functioning. Latent class analyses further pointed to substantial and practically relevant person-level covariance.

CONCLUSION

Sensory processing sensitivity and hypersensitive narcissism are substantially related constructs. For clinicians, this points to the importance of being attentive to narcissistic self-regulatory strategies in individuals presenting as highly sensitive.

The concept of Narcissistic Personality Disorder-Three levels of analysis for interdisciplinary integration

In this paper, I distinguish three different levels for describing, and three corresponding ways for understanding, deficient empathy as the core of NPD (Narcissistic Personality Disorder). On the macro level, deficient empathy can be explained as disturbed interpersonal functioning, and is understood as lack of recognition. On the meso-level, deficient empathy can be described as psychic disintegration, and can be understood specifically in its dissocial aspects. Psychic disintegration in NPD correlates with somatic changes, i.e., dysfunctional affective empathy and mind-reading on the micro level of description, which is the third level. The "core-deficit-model of NPD" that I outline, while not rejecting reductionist approaches outright, argues in favor of integrating (top-down/bottom-up) functionalist descriptions of empathy into a wider conceptual framework of bio-psycho-social functioning. The "core-deficit-model of NPD" is interdisciplinary, can bypass monodisciplinary skepticism, and removes purported barriers between explaining and understanding the "lack" of empathy as the core of pathological narcissism.

The nonlinear association between grandiose and vulnerable narcissism: An individual data meta-analysis

OBJECTIVE

Narcissism can manifest in grandiose and vulnerable patterns of experience and behavior. While largely unrelated in the general population, individuals with clinically relevant narcissism are thought to display both. Our previous studies showed that trait measures of grandiosity and vulnerability were unrelated at low-to-moderate levels of grandiose narcissism, but related at high levels.

METHOD

We replicate and extend these findings in a preregistered individual data meta-analysis ("mega-analysis") using data from the Narcissistic Personality Inventory (NPI)/Hypersensitive Narcissism Scale (HSNS; N = 10,519, k = 28) and the Five-Factor Narcissism Inventory (FFNI; N = 7,738, k = 17).

RESULTS

There was strong evidence for the hypothesis in the FFNI (β_{Grandiose < 1 SD}  = .08, β_{Grandiose > 1 SD}  = .36, β_{Grandiose > 2 SD}  = .53), and weaker evidence in the NPI/HSNS (β_{Grandiose < 1 SD}  = .00, β_{Grandiose > 1 SD}  = .12, β_{Grandiose > 2 SD}  = .32). Nonlinearity increased with age but was invariant across other moderators. Higher vulnerability was predicted by elevated antagonistic and low agentic narcissism at subfactor level.

CONCLUSION

Narcissistic vulnerability increases at high levels of grandiosity. Interpreted along Whole Trait Theory, the effects are thought to reflect state changes echoing in trait measures and can help to link personality and clinical models.

Effects of Self-Esteem on Self-Viewing: An Eye-Tracking Investigation on Mirror Gazing

While some people enjoy looking at their faces in the mirror, others experience emotional distress. Despite these individual differences concerning self-viewing in the mirror, systematic investigations on this topic have not been conducted so far. The present eye-tracking study examined whether personality traits (self-esteem, narcissism propensity, self-disgust) are associated with gaze behavior (gaze duration, fixation count) during free mirror viewing of one's face. Sixty-eight adults (mean age = 23.5 years; 39 females, 29 males) viewed their faces in the mirror and watched a video of an unknown person matched for gender and age (control condition) for 90 s each. The computed regression analysis showed that higher self-esteem was associated with a shorter gaze duration for both self-face and other-face. This effect may reflect a less critical evaluation of the faces.