Subtypes, Dimensions, Levels, and Mental States in Narcissism and Narcissistic Personality Disorder
Abstract
Various conceptualizations of subtypes, levels, and dimensions of narcissism and narcissistic personality disorder (NPD) are considered with a particular focus on overt grandiose presentations and covert vulnerable presentations. Evidence supporting this distinction and clinical vignettes to illustrate it are presented as well as their implications for clinical work with NPD patients. The research and clinical evidence points to the conclusion that these broad categorical subtypes are better conceptualized as dimensions on which individual patients vary on relative levels, thus suggesting that grandiose and vulnerable presentations represent two sides of the same coin. A case example and clinical implications are provided and discussed.
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Grandiose and vulnerable functioning are linked, reflecting a common core of impairment, and perhaps best viewed as reflecting two sides of the same coin.
“In this way, grandiose and vulnerable functioning are linked, reflecting a common core of impairment, and perhaps best viewed as reflecting two sides of the same coin [53].”
From “It’s not you, it’s me”: identity disturbance as the main contributor to interpersonal problems in pathological narcissism (2023) · cites this paper as [53]
These results support the notion that an individual's narcissism presentation may fluctuate over time and that vulnerable and grandiose presentations are inter-related and oscillating.
“As such, these results support the notion that an individual’s narcissism presentation may fluctuate over time [20, 21] and that vulnerable and grandiose presentations are inter-related and oscillating [9, 19].”
From Living with pathological narcissism: a qualitative study (2020) · cites this paper as [9]
Grandiose and vulnerable narcissism may reflect both sides of a narcissistic 'coin' that may be regularly oscillating, inter-related and state dependent.
“While the differences in presentation between grandiose and vulnerable narcissism appear manifest, it has been argued that they reflect both sides of a narcissistic ‘coin’ [9] that may be regularly oscillating, inter-related and state dependent [6, 18–22].”
From Living with pathological narcissism: a qualitative study (2020) · cites this paper as [9]
Vulnerable narcissism includes depressed mood, insecurity, hypersensitivity, shame and identification with victimhood.
“Vulnerable narcissism, in marked contrast to the overt grandiose features listed in DSM-5 criteria, includes instances of depressed mood, insecurity, hypersensitivity, shame and identification with victimhood [8–12].”
From Living with pathological narcissism: a qualitative study (2020) · cites this paper as [9]
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- Authors
- Levy, K. N.
- Affiliations
- Pennsylvania State University (US)
- Corresponding author
- Levy, Kenneth N.
- ORCID
- Levy, Kenneth N.
- Venue
- Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2012-06-27
- Volume
- 68
- Issue
- 8
- Pages
- 886-897
- ISSN
- 0021-9762 (ISSN-L)
- 1097-4679
- OpenAlex
- W1552600949
- Cited by
- 93
- References
- 14
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 8 · 2023: 6 · 2022: 3 · 2021: 10 · 2020: 12 · 2019: 7 · 2018: 7 · 2017: 8 · 2016: 5 · 2015: 4 · 2014: 5 · 2013: 4 · 2012: 1
- FWCI
- 5.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- narcissism, narcissistic personality disorder, grandiose narcissism, vulnerable narcissism, subtypes, dimensions, clinical vignettes, clinical implications
- MeSH terms
- Adult, Female, Humans, Narcissism, Personality Disorders, Psychotherapy, Treatment Outcome, Diagnostic and Statistical Manual of Mental Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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