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Theories of personality essay

Current Findings in Psychology: A Review of the Psychological Assessment of

Narcissistic Personality Disorder

According to the National Institute of Mental Health, about 9% of the population in

North America has a personality disorder, which is described as a maladaptive, rigid pattern of

behavior and interpersonal communication (NIMH 2013; Wood, Wood & Boyd; 2018).

Although there are a variety of personality disorders, Narcissistic Personality Disorder (NPD) –

described as a persistent show of grandiosity, a desire for admiration, and a lack of empathy in

the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) – has

remained a common topic in the media and culture. (DSM-5; American Psychiatric Association,

2013; Vater et. al., 2013; Wood, Wood & Boyd; 2018).

The Narcissistic Personality Inventory (NPI) – a 40-item, forced-choice, self-report scale

– is perhaps one of the most frequently used tests for measuring narcissism in current

personality psychology research (Ackerman et. al., 2010; Miller, Price & Campbell 2011). The

NPI was created in 1979 by Robert Raskin and Calvin Hall and consisted of 220 elements based

on the clinical definition of NPD in the third edition of the DSM (Ackerman et. al., 2010; DSM-

III; American Psychiatric Association, 1980; Raskin & Hall, 1979). While studies indicate that

the NPI reliably measures the construct of narcissism, the scale's ability to differentiate between

the adaptive and maladaptive nature of this trait has been questioned (Miller, Price & Campbell,

2011). The NPI is still a contentious subject in personality study, with critics questioning its

accuracy in measuring all aspects of narcissism, particularly given the construct's juxtaposing

nature (Miller et. al., 2017). However, it is important to understand and focus on the causes of

narcissism, the etiology of the condition, and the past behind the theoretical basis of the

inventory itself when considering the relevance of any psychological construct.

Etiology of Narcissism

From a psychological standpoint, narcissism is a multi-faceted personality disorder that

includes both grandiose and fragile subtypes. Whereas grandiosity is manifested by a visible

sense of dominance and privilege, the insecure subtype is marked by less visible feelings of guilt

and helplessness (Huxley & Bizumic, 2016; Vater et. al., 2013). Most theorists believe that an

individual's narcissistic presentation is the product of childhood experiences in either an

overindulging or excessively restrictive parental system, just as grandiose and insecure

narcissism vary in terms of observation (Huxley & Bizumic, 2016). Further to that, current

research suggests that an invalidating parental climate – and the disturbance of an individual's

ability to self-regulate as a result – is the most likely precursor to the creation of either subset of

narcissism (Huxley & Bizumic, 2016; Watson & Biderman, 1993).

The emergence of narcissism is often embedded in early childhood, where underlying

feelings of "smallness," or inadequacy, emerge after persistent invalidation, or lack of empathetic

mirroring between the infant and their mother. Originally viewed from a psychodynamic

viewpoint, and thoroughly explored by theorist and psychoanalyst Otto F. Kernberg. (Kernberg

1998; Rhodewalt & Morf, 1995). The child’s relationship with his or her mother is often their

first experience in impacting other people in the world, (i.e. typically generating thoughts of

worth and importance) and when an insensitive, or depressed mother repeatedly neglects to

mirror her child – invasive feelings of unimportance, or ineffectiveness result (Huxley &

Bizumic, 2016; Rhodewalt & Morf, 1995). Kernberg then extrapolates the child's ineffectiveness

to manifest itself as a defensive style, especially one of reaction-formation – expressing

outwardly the polar opposite of what one feels inwardly. (Huxley & Bizumic, 2016; Kernberg

1998; Rhodewalt & Morf, 1995; Watson & Biderman, 1993; Vater et. al., 2013).
History & Development of the NPI

Understanding the conceptual foundation of the NPI requires distinguishing between the

fragile existence of the narcissistic self-concept and the corresponding – but opposing – features

of grandiosity and insecurity. While this was embodied in Raskin and Hall's (1979) early

attempts to establish the scale, later recognition revealed their initial construction technique to

be an inadequate measure of narcissism, failing to account for both clinical and theoretical

dimensions of the construct (Raskin & Terry, 1988; Rhodewalt & Morf, 1995). As a result,

discussing the NPI's developmental roots without acknowledging the numerous issues

surrounding the measure's validity would be a misrepresentation of its background.

Raskin and Hall's preliminary scale, as previously stated, consisted of 220 items derived

from the behavioral parameters of the DSM-NPD III's definition; a collection of items deemed to

be an appropriate representation of narcissistic ideology. (Ackerman et. al., 2010; Raskin &

Terry, 1988). The scale was refined to 40 items after a series of follow-up studies; it was deemed

a reliable indicator for evaluating global narcissism because it positively aligned with clinical

interpretations of narcissism and had strong internal consistency (Raskin & Terry, 1988). Later

study, however, raised doubts about the scale's validity.

Later, it became apparent that the NPI could not possibly reflect all relevant criteria of

the dichotomous nature of the narcissistic construct within its total score: for example, Miller,

Price & Campbell’s (2011) research denotes the idea that the NPI may only measure the adaptive

traits associated with narcissism (i.e. extraversion, healthy-self concept) instead of the more

pathological traits associated with the construct (i.e. vulnerability, lack of empathy,

internalization of problems, etc.). Furthermore, evidence suggests that the clinical description of

NPD in the DSM-III is more representative of the grandiose subtype than the vulnerable subtype
(Ackerman et. al., 2010). How can the NPI's total score possibly depict all dimensions of

narcissism and its related criteria if all scale items were constructed from the DSM-NPD III's

definition?

Discussion and Limitations

The creation of a total score by the NPI has a number of limitations. The scale's

combination of natural and pathological narcissistic characteristics simply increases the

likelihood of paradoxical outcomes, where a high score on the scale may not equate to a

diagnosis of NPD, but rather to normal narcissism – which is basically a healthy degree of self-

esteem (Vater et. al., 2013). Clinical narcissists, according to theory, are continually engaged in

self-esteem control, and it is widely accepted that this interpersonal challenge manifests itself

in a higher self-concept yet lower self-representation scores on self-report tests (Ackerman et.

al., 2010; Rhodewalt & Morf, 1995). As a result, if the NPI is focused on psychiatric concepts

of narcissism, NPI-defined narcissists should report accordingly, resulting in low self-esteem

scores.

However, the opposite was accurate, as the NPI's diagnosis of pathological narcissism

was found to be incorrect. In a 2016 study by Vater et al., it was discovered that NPI-defined

narcissists had significantly higher self-esteem reports than NPD diagnosed narcissists, who

scored significantly lower on self-esteem tests. In fact, NPD patients do not score higher on the

NPI compared to nonclinical populations – unless self-esteem is accounted for (Vater et. al.,

2016). This not only supports proof that the NPI is a better indicator of narcissism's adaptive

existence, but also that it fails to capture the very essence of a narcissist – whom experiences

feelings of inadequacy and low self-esteem.

Conclusion, Suggestions & Future Directions

 Although the NPI's construct validity can be credited with reliably assessing trait

narcissism, it is not a predictor of pathological narcissism (specifically the vulnerable subtype),

the construct's maladaptive existence, or indicative of the NPD parameters on which it was

originally conceptualized (Ackerman et. al., 2010; Stanton et. al., 2016; Watson & Biderman,

1993; Vater et. al., 2013). However, this does not mean that the NPI is no longer relevant;

current research requires that the NPI be used and understood in its proper contexts (i.e. where

the scale can determine grandiosity on some pathological level, it fails in measuring the

vulnerable qualities of narcissism). The scale can be useful for testing grandiosity in subclinical

populations in studies focusing on natural versus pathological narcissism (Miller, Price &

Campbell 2011). The NPI is undeniably far from an optimal indicator of pathological or clinical

narcissism, instead focusing on the more adaptive aspects of the construct. Nonetheless, it

remains one of the most thoroughly studied and commonly used tests of narcissism today, since

it continues to be a useful measurement method in psychological and personality studies.

 References

Ackerman, R. A., Witt, E. A., Donnellan, M. B., Trzesniewski, K. H., Robins, R. W., & Kashy, D. A.

(2010). What Does the Narcissistic Personality Inventory Really Measure? Assessment,18(1), 67-87.

doi:10.1177/1073191110382845

Huxley, E., & Bizumic, B. (2016). Parental Invalidation and the Development of Narcissism.

The Journal of Psychology,151(2), 130-147. doi:10.1080/00223980.2016.1248807

Kernberg, O. F. (1998). Pathological narcissism and narcissistic personality disorder: Theoretical

background and diagnostic classification. In E. F. Ronningstam (Ed.), Disorders of narcissism:

Diagnostic, clinical, and empirical implications (pp. 29-51). Northvale, NJ: Jason Aronson.

Miller, J. D., Price, J., & Campbell, W. K. (2011). Is the Narcissistic Personality Inventory

Still Relevant? A Test of Independent Grandiosity and Entitlement Scales in the

Assessment of Narcissism. Assessment,19(1), 8-13. doi:10.1177/1073191111429390

Miller, J. D., Gentile, B., Carter, N. T., Crowe, M., Hoffman, B. J., & Campbell, W. K. (2017). A

Comparison of the Nomological Networks Associated With Forced-Choice and Likert Formats of

the Narcissistic Personality Inventory. Journal of Personality Assessment,100(3), 259-267.

doi:10.1080/00223891.2017.1310731

NIMH. (2013.). Retrieved from https://www.nimh.nih.gov/index.shtml

Raskin, R., & Terry, H. (1988). A principal-components analysis of the Narcissistic Personality

Inventory and further evidence of its construct validity. Journal of Personality and Social

Psychology,54(5), 890-902. doi:10.1037/0022-3514.54.5.890

Rhodewalt, F., & Morf, C. C. (1995). Self and Interpersonal Correlates of the Narcissistic Personality

Inventory: A Review and New Findings. Journal of Research in Personality,29(1), 1-23.

doi:10.1006/jrpe.1995.1001
Stanton, K., Daly, E., Stasik-O’Brien, S. M., Ellickson-Larew, S., Clark, L. A., & Watson, D.

(2016). An Integrative Analysis of the Narcissistic Personality Inventory and the Hypomanic

Personality Scale: Implications for Construct Validity. Assessment,24(6), 695-711.

doi:10.1177/1073191115625801

Vater, A., Schröder-Abé, M., Ritter, K., Renneberg, B., Schulze, L., Bosson, J. K., & Roepke, S.

(2013). The Narcissistic Personality Inventory: A Useful Tool for Assessing Pathological

Narcissism? Evidence From Patients With Narcissistic Personality Disorder. Journal of Personality

Assessment,95(3), 301-308. doi:10.1080/00223891.2012.732636

Watson, P., & Biderman, M. D. (1993). Narcissistic Personality Inventory Factors, Splitting, and Self-

Consciousness. Journal of Personality Assessment,61(1), 41-57. doi:10.1207/s15327752jpa6101_4

Wood, S. E., Wood, E. G., & Boyd, D. (2018). Personality Theory and Assessment. In Mastering

the World of Psychology (Sixth ed.). Upper Saddle River, NJ: Pearson Education.

Wood, S. E., Wood, E. G., & Boyd, D. (2018). Psychological Disorders. In Mastering the
World of Psychology (Sixth ed.). Upper Saddle River, NJ: Pearson Education