Malignant self-regard: A self-structure enhancing the understanding of masochistic, depressive, and vulnerably narcissistic personalities
Abstract
Several personality disorders have been prominent in the clinical literature but have been inadequately recognized in the diagnostic manuals. This group includes masochistic, self-defeating, depressive, and vulnerably narcissistic personality disorders. The theoretical and empirical relationship of these disorders is reviewed. It is proposed that the construct of malignant self-regard may account for the similarities among them. The construct describes these personality types as being fundamentally related through problematic manifestations of self-structure. The article discusses the diagnostic value of such a construct and the implications of a psychodynamically informed framework for classifying personality pathology.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Grandiose narcissism/NPD is associated with poor ability to understand one's own mental states and the mental states of others.
“Grandiose narcissism has been associated with poor ability to understand one’s own mental states and the mental states of others.”
From Symptom severity and mindreading in narcissistic personality disorder. (2018) · cites this paper as [12]
Cites
The dark triad of personality: Narcissism, Machiavellianism, and psychopathy
Paulhus, D. L., & Williams, K. M. (2002) · Journal of Research in Personality · doi:10.1016/s0092-6566(02)00505-6 · Cited by 5,265 · see citing works
Pathological narcissism and narcissistic personality disorder
Pincus, A. L., & Lukowitsky, M. R. (2010) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.121208.131215 · Cited by 1,082 · cited 1× · see citing works
“This hypersensitivity to negative or missing attention has been described by many as a cardinal feature of narcissistic personality.(42,43)”
BackgroundBender, D. S., Morey, L. C., & Skodol, A. E. (2011) · Journal of Personality Assessment · doi:10.1080/00223891.2011.583808 · Cited by 631 · see citing works
Westen, D., & Shedler, J. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.2.273 · Cited by 412 · see citing works
Two primary configurations of psychopathology.
Blatt, S. J. (2009) · American Psychological Association eBooks · doi:10.1037/11749-006 · Cited by 374 · see citing works
Luyten, P., & Blatt, S. J. (2013) · American Psychologist · doi:10.1037/a0032243 · Cited by 343 · see citing works
Westen, D. (1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.7.895 · Cited by 330 · see citing works
Skodol, A. E., Clark, L. A., Bender, D. S., Krueger, R. F., Morey, L. C., Verheul, R., Alarcon, R. D., Bell, C. C., Siever, L. J., & Oldham, J. M. (2011) · Personality Disorders: Theory, Research, and Treatment · doi:10.1037/a0021891 · Cited by 305 · see citing works
Refining the Construct of Narcissistic Personality Disorder: Diagnostic Criteria and Subtypes
Russ, E., Shedler, J., Bradley, R., & Westen, D. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2008.07030376 · Cited by 272 · see citing works
Narcissism and Childhood Recollections: A Quantitative Test of Psychoanalytic Predictions
Otway, L. J., & Vignoles, V. L. (2006) · Personality and Social Psychology Bulletin · doi:10.1177/0146167205279907 · Cited by 226 · see citing works
Luyten, P., & Blatt, S. J. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.09.003 · Cited by 186 · see citing works
Bornstein, R. F. (2011) · Psychological Assessment · doi:10.1037/a0022402 · Cited by 144 · see citing works
Pathological narcissism and the depressive temperament
Tritt, S. M., Ryder, A. G., Ring, A. J., & Pincus, A. L. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.09.006 · Cited by 121 · see citing works
Patterns of personality disorder comorbidity in early-onset versus late- onset major depression
D, M. F. M., Alpert, J. E., Borus, J. S., Nierenberg, A. A., Pava, J. A., & Rosenbaum, J. F. (1996) · American Journal of Psychiatry · doi:10.1176/ajp.153.10.1308 · Cited by 118 · see citing works
Pincus, A. L. (2011) · Personality Disorders Theory Research and Treatment · doi:10.1037/a0021191 · Cited by 117 · see citing works
Avi Besser, A., & Zeigler‐Hill, V. (2010) · Journal of Research in Personality · doi:10.1016/j.jrp.2010.06.006 · Cited by 109 · see citing works
Skodol, A. E., Bender, D. S., Oldham, J. M., Clark, L. A., Morey, L. C., Verheul, R., Krueger, R. F., & Siever, L. J. (2011) · Personality Disorders Theory Research and Treatment · doi:10.1037/a0021892 · Cited by 85 · see citing works
Depressive personality disorder
Huprich, S. K. (1998) · Clinical Psychology Review · doi:10.1016/s0272-7358(97)00104-9 · Cited by 79 · see citing works
Self-citationNarcissism and self-handicapping: Linking self-aggrandizement to behavior
Rhodewalt, F. T., Tragakis, M. W., & Finnerty, J. (2005) · Journal of Research in Personality · doi:10.1016/j.jrp.2005.05.001 · Cited by 79 · see citing works
The construct validity of depressive personality disorder.
McDermut, W., Zimmerman, M., & Chelminski, I. (2003) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.112.1.49 · Cited by 68 · see citing works
Huprich, S. K., & Bornstein, R. F. (2007) · Journal of Personality Assessment · doi:10.1080/00223890701356904 · Cited by 66 · see citing works
Self-citationThe concept of the death drive: A clinical perspective
Kernberg, O. F. (2009) · The International Journal of Psychoanalysis · doi:10.1111/j.1745-8315.2009.00187.x · Cited by 61 · see citing works
Narcissism, shame, masochism, and object relations: An exploratory correlational study.
Hibbard, S. (1992) · Psychoanalytic Psychology · doi:10.1037/h0079392 · Cited by 58 · see citing works
Narcissistic and Borderline Personality Disorders in a Sample of Treatment Refractory Patients
Clemence, A. J., Perry, J. C., & Plakun, E. M. (2009) · Psychiatric Annals · doi:10.3928/00485713-20090401-05 · Cited by 47 · see citing works
Depressive personality and dysthymia: Evaluating symptom and syndrome overlap
Ryder, A. G., Schuller, D. R., & Bagby, R. M. (2006) · Journal of Affective Disorders · doi:10.1016/j.jad.2006.01.008 · Cited by 45 · see citing works
Depressive personality disorder, dysthymia, and their relationship to perfectionism
Huprich, S. K., Porcerelli, J. H., Keaschuk, R. A., Binienda, J., & Engle, B. (2007) · Depression and Anxiety · doi:10.1002/da.20290 · Cited by 44 · see citing works
Self-citationInadequacies of the Masochistic Personality Disorder Diagnosis for Women
Walker, L. E. (1987) · Journal of Personality Disorders · doi:10.1521/pedi.1987.1.2.183 · Cited by 40 · see citing works
Axis I and Axis II disorder comorbidity in unipolar depression with anger attacks
Tedlow, J. R., Leslie, V. M., Keefe, B. R., Alpert, J. E., Nierenberg, A. A., Rosenbaum, J. F., & D, M. F. M. (1999) · Journal of Affective Disorders · doi:10.1016/s0165-0327(98)00074-3 · Cited by 36 · see citing works
Huprich, S. K. (2003) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000050935.15349.44 · Cited by 35 · see citing works
Self-citationEvaluating Facet-Level Predictions and Construct Validity of Depressive Personality Disorder
Huprich, S. K. (2003) · Journal of Personality Disorders · doi:10.1521/pedi.17.3.219.22149 · Cited by 31 · see citing works
Self-citationA Critical Analysis of the Proposed Self-Defeating Personality Disorder
Rosewater, L. B. (1987) · Journal of Personality Disorders · doi:10.1521/pedi.1987.1.2.190 · Cited by 29 · see citing works
Huprich, S. K., & Nelson, S. M. (2013) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2013.09.017 · Cited by 27 · see citing works
Self-citationHuprich, S. K., Luchner, A. F., Roberts, C. R. D., & Pouliot, G. S. (2011) · Personality and Mental Health · doi:10.1002/pmh.176 · Cited by 25 · see citing works
Self-citationNew directions for an old construct: Depressive personality research in the DSM‐5 era
Huprich, S. K. (2012) · Personality and Mental Health · doi:10.1002/pmh.1217 · Cited by 23 · see citing works
Self-citationToward a Multidimensional Model of Personality Disorder Diagnosis: Implications forDSM–5
Bornstein, R. F. (2011) · Journal of Personality Assessment · doi:10.1080/00223891.2011.577474 · Cited by 17 · see citing works
Huprich, S. K., Zimmerman, M., & Chelminski, I. (2006) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2005.09.002 · Cited by 17 · see citing works
Self-citationFrom surface to depth: Diagnosis and assessment in personality pathology.
Bornstein, R. F. (2007) · Clinical Psychology Science and Practice · doi:10.1111/j.1468-2850.2007.00067.x · Cited by 17 · see citing works
Feature: The Narcissistic-Masochistic Character
Cooper, A. M. (2009) · Psychiatric Annals · doi:10.3928/00485718-20090924-02 · Cited by 15 · see citing works
Mental Hygiene Counseling as a Part of Teacher Education
Baruch, D. W. (1942) · The Journal of Psychology · doi:10.1080/00223980.1942.9917083 · Cited by 13 · see citing works
Huprich, S. K., & Fine, M. A. (1996) · Journal of Personality Disorders · doi:10.1521/pedi.1996.10.3.229 · Cited by 11 · see citing works
Self-citationCombining Self-Defeating and Depressive Personality Symptoms into One Construct
Huprich, S. K., Schmitt, T. A., Zimmerman, M. A., & Chelminski, I. (2011) · Psychopathology · doi:10.1159/000323608 · Cited by 8 · see citing works
Self-citationSelf-Defeating Personality Disorder
Heisler, L. K., Lyons, M. J., & Goethe, J. W. (1995) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199504000-00005 · Cited by 7 · see citing works
RELATIONSHIPS BETWEEN SELF-ESTEEM, PERFECTIONISM AND NARCISSISTIC PERSONALITY WITH SELF-HANDICAPPING
Basaknezhad, S. (2009) · Cited by 4 · see citing works
Flagged first, then by citations
1 of the 44 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Social Media and Depressive Symptoms in Childhood and Adolescence: A Systematic Review
McCrae, N., Gettings, S., & Purssell, E. (2017) · Adolescent Research Review · doi:10.1007/s40894-017-0053-4 · Cited by 304 · see citing works
Avoidant personality disorder: current insights
Lampe, L. A., & Malhi, G. S. (2018) · Psychology Research and Behavior Management · doi:10.2147/prbm.s121073 · Cited by 100 · see citing works
Rogoza, R., Cieciuch, J., & Strus, W. (2021) · Journal of Research in Personality · doi:10.1016/j.jrp.2021.104167 · Cited by 61 · see citing works
Symptom severity and mindreading in narcissistic personality disorder.
Bilotta, E., Carcione, A., Fera, T., Moroni, F., Nicolò, G., Pedone, R., Pellecchia, G., Semerari, A., & Colle, L. (2018) · PLOS ONE · doi:10.1371/journal.pone.0201216 · Cited by 29 · see citing works
Interpersonal Problems and Their Relationship to Depression, Self-Esteem, and Malignant Self-Regard
Huprich, S. K., Lengu, K. J., & Evich, C. D. (2015) · Journal of Personality Disorders · doi:10.1521/pedi_2015_29_227 · Cited by 28 · see citing works
Self-citationHuprich, S. K., & Nelson, S. M. (2013) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2013.09.017 · Cited by 27 · see citing works
Self-citationNarcissistic Personality Disorder and the Structure of Common Mental Disorders
Eaton, N. R., Rodriguez-Seijas, C., Krueger, R. F., Campbell, W. K., Grant, B. F., & Hasin, D. S. (2017) · Journal of Personality Disorders · doi:10.1521/pedi_2016_30_260 · Cited by 25 · see citing works
Balata, M., Gbreel, M. I., Elrashedy, A. A., Westenfeld, R., Pfister, R., Zimmer, S., Nickenig, G., Becher, M. U., & Sugiura, A. (2023) · BMC Complementary Medicine and Therapies · doi:10.1186/s12906-023-04117-2 · Cited by 24 · see citing works
Talmon, A., & Ginzburg, K. (2018) · Journal of Interpersonal Violence · doi:10.1177/0886260518799450 · Cited by 24 · see citing works
Ronningstam, E., & Weinberg, I. (2023) · Journal of Personality Disorders · doi:10.1521/pedi.2023.37.3.337 · Cited by 22 · see citing works
Are malignant self‐regard and vulnerable narcissism different constructs?
Huprich, S. K., Nelson, S. M., Sohnleitner, A., Lengu, K. J., Shankar, S., & Rexer, K. (2018) · Journal of Clinical Psychology · doi:10.1002/jclp.22599 · Cited by 21 · see citing works
Self-citationPersonality in PDM-2: Controversial issues.
McWilliams, N., Grenyer, B. F. S., & Shedler, J. (2018) · Psychoanalytic Psychology · doi:10.1037/pap0000198 · Cited by 21 · see citing works
Expanding the utility of the malignant self-regard construct
Lengu, K. J., Evich, C. D., Nelson, S. M., & Huprich, S. K. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.07.087 · Cited by 20 · see citing works
Self-citationDo Competitive Contexts Affect Mindreading Performance?
Colle, L., Dimaggio, G., Carcione, A., Nicolò, G., Semerari, A., & Chiavarino, C. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01284 · Cited by 19 · see citing works
Personality‐driven depression: The case for malignant self‐regard (and depressive personalities)
Huprich, S. K. (2019) · Journal of Clinical Psychology · doi:10.1002/jclp.22760 · Cited by 14 · see citing works
Self-citationLecours, S., Philippe, F. L., Boucher, M., Ahoundova, L., & Allard-Chapais, C. (2016) · Journal of the American Psychoanalytic Association · doi:10.1177/0003065116675876 · Cited by 13 · see citing works
Malignant Self-Regard in clinical outpatient samples
Huprich, S. K., Macaluso, M., Baade, L. E., Zackula, R., Jackson, J., & Kitchens, R. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.03.005 · Cited by 13 · see citing works
Self-citationCain, N. M., Jowers, C. E., Blanchard, M. P., Nelson, S. M., & Huprich, S. K. (2021) · Psychopathology · doi:10.1159/000510475 · Cited by 13 · see citing works
Self-citationPedone, R., Huprich, S. K., Nelson, S. M., Cosenza, M., Carcione, A., Nicolò, G., Semerari, A., & Colle, L. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.10.059 · Cited by 9 · see citing works
Self-citationThe Necessary Rapprochement of Negative Affectivity, Personality Disorder, and Depression
Huprich, S. K., Kuribayashi, S. J., & Voytenko, V. L. (2024) · Current Psychiatry Reports · doi:10.1007/s11920-024-01532-1 · Cited by 8 · see citing works
Self-citationThe Domain of Social Dysfunction in Complex Depressive Disorders
Duggal, D., Fertuck, E. A., & Huprich, S. K. (2021) · Depression and personality · doi:10.1007/978-3-030-70699-9_5 · Cited by 7 · see citing works
Self-citationZeigler‐Hill, V., & Andrews, D. (2021) · Sexes · doi:10.3390/sexes2020017 · Cited by 6 · see citing works
Huprich, S. K. (2020) · Journal of Personality Disorders · doi:10.1521/pedi.2020.34.supp.207 · Cited by 6 · see citing works
Self-citationHewitt, P. L., Ge, S. Y. J., Smith, M. M., Flett, G. L., Cheli, S., Molnar, D. S., Ko, A., Mikail, S. F., & Lang, T. (2024) · Journal of Personality Assessment · doi:10.1080/00223891.2024.2303429 · Cited by 4 · see citing works
Self-deprecation: Searching for a Measure
Santos, I. L. S., ́Pimentel, C. E., & Mariano, T. E. (2022) · psicogente · doi:10.17081/psico.25.48.4821 · Cited by 4 · see citing works
Sarno, M. D., Frisina, S., Madeddu, F., & Pierro, R. D. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23454 · Cited by 3 · see citing works
Thomson, S. M., & Bornstein, R. F. (2023) · Journal of Personality Assessment · doi:10.1080/00223891.2023.2289468 · Cited by 5 · see citing works
Malone, B. C., & Huprich, S. K. (2023) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001646 · Cited by 3 · see citing works
Self-citationPedone, R., Huprich, S. K., Colle, L., Barbarulo, A. M., & Semerari, A. (2023) · Journal of Personality Disorders · doi:10.1521/pedi.2023.37.3.285 · Cited by 3 · see citing works
Self-citationAdult Personality Growth in Psychotherapy
Horowitz, M. J. (2016) · Cambridge University Press eBooks · doi:10.1017/cbo9781316285633 · Cited by 3 · see citing works
Managing treatment-resistant depression with comorbid personality disorders
Voytenko, V. L., & Huprich, S. K. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-824067-0.00030-x · Cited by 3 · see citing works
Self-citationUnderstanding Malignant Self-Regard and Its Implications for Achievement
Evich, C. D. (2015) · Cited by 1 · see citing works
Huprich, S. K. (2016) · Springer eBooks · doi:10.1007/978-3-319-28099-8_2143-1
Self-citationSelf‐reassurance moderated by identity dysfunction: Associations with distress and impairment
Kealy, D., Ben‐David, S., Spidel, A., Wadsley‐Rose, S., & Kim, D. (2021) · Journal of Counseling & Development · doi:10.1002/jcad.12411
Huprich, S. K. (2020) · Springer eBooks · doi:10.1007/978-3-319-24612-3_2143
Self-citationMalignant Self-Regard and Characterological Depressivity
Huprich, S. K., & Malone, B. C. (2025) · Oxford University Press eBooks · doi:10.1093/9780191964343.003.0010
Self-citationInfluence of childhood maltreatment on malignant self-regard
Barbera, E. R., Ceroni, D. B., Peters, W., & Yalch, M. M. (2025) · Journal of Family Trauma Child Custody & Child Development · doi:10.1080/26904586.2025.2575340
Servant, S. C., Koch, J., & da Costa, B. (2026) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-026-00592-8
- Authors
- Huprich, S. K.
- Affiliations
- Eastern Michigan University (US)
- Corresponding author
- Huprich, Steven K.
- ORCID
- Huprich, Steven K.
- Venue
- Harvard Review of Psychiatry
- Published
- 2014-09
- Volume
- 22
- Issue
- 5
- Pages
- 295-305
- ISSN
- 1067-3229 (ISSN-L)
- OpenAlex
- W2061647902
- Cited by
- 38
- References
- 44
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 5 · 2020: 3 · 2019: 1 · 2018: 7 · 2017: 1 · 2016: 4 · 2015: 3 · 2013: 1
- FWCI
- 0.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Harvard Review of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Holmes Museum Of Anthropology (Wichita State University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- personality disorders, self-defeating personality disorder, depressive personality disorder, self-structure, psychodynamic theory, diagnostic validity
- MeSH terms
- Humans, Personality Disorders, Self Concept
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 ›
Are you an author, or do you see a problem with this page? Request a review