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Cited by 24Personality Disorders and PsychopathologyPersonality Traits and PsychologyPsychoanalysis and Psychopathology Research

Malignant Narcissism in Relation to Clinical Change in Borderline Personality Disorder: An Exploratory Study

Lenzenweger, Mark F., Clarkin, John F., Caligor, Eve, Cain, Nicole M., Kernberg, Otto F.·2018·Psychopathology
DOI 10.1159/000492228
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Abstract

Background: Normal and pathological narcissism have been the focus of considerable theoretical discussion and empirical research in recent years in personality psychology and psychopathology. Kernberg [1-4] has argued that there is a particularly dysfunctional and impairing variant of narcissistic disturbance known as malignant narcissism. This exploratory study sought to develop, using established assessment methods, a dimensional measure of malignant narcissism that incorporates the key features of grandiose narcissism, paranoid propensities, psychopathic features, and proclivity for a sadistic and aggressive interpersonal style. Method and Sampling: This study examined 57 subjects, diagnosed with borderline personality disorder that were treated using 3 different empirically supported treatments in a previous study [5], for possible deviance on the proposed malignant narcissism index. It also evaluated 2 important clinical domains of change in relation to malignant narcissism. To wit, it was predicted, based on Kernberg’s [3, 4] clinical model, that elevated levels of malignant narcissism would be significantly associated with slower rates of improvement in both general psychosocial/psychological functioning and anxiety among treated individuals. Results: Higher levels of malignant narcissism were associated, as predicted, with slower rates of improvement in both global functioning and anxiety. The proposed malignant narcissism index was a more powerful predictor of slowed improvement in global functioning than simple narcissistic personality disorder features. Conclusions: The heuristic potential of the malignant narcissism construct is discussed and the utility of a dimensional approach to this construct is explored, especially in reference employing personality traits/processes to better understand pathological configurations and personality disturbance.

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  • Paranoid thinking, antisocial traits, and ego-syntonic aggression impede improvement in narcissistic personality disorder.

    “On the other hand, paranoid thinking, antisocial traits, and ego-syntonic aggression impede improvement (86).”

    From Narcissistic Personality Disorder: Progress in Understanding and Treatment (2022) · cites this paper as [86]

  • Paranoid thinking, antisocial traits, and ego-syntonic aggression impede improvement in NPD.

    “On the other hand, paranoid thinking, antisocial traits, and ego-syntonic aggression impede improvement (86).”

    From Narcissistic Personality Disorder: Progress in Understanding and Treatment (2022) · cites this paper as [86]

  • For a small number of participants in this study, antisocial themes were also present, meaning the narcissism was severe or malignant.

    “It was clear that for a small number of participants in this study antisocial themes were also present, meaning the narcissism was severe (or ‘malignant’”

    From Pathological narcissism: An analysis of interpersonal dysfunction within intimate relationships (2022) · cites this paper as Lenzenweger et al., 2018

  • Results suggest potential for meaningful expansion of additional traits within the antagonism domain (e.g., manipulativeness, callousness and hostility) to indicate severity of pathology in interpersonal functioning.

    “However, beyond grandiosity and attention seeking, these results suggest potential for meaningful expansion of additional traits within the antagonism domain to indicate the severity of pathology in interpersonal functioning (e.g., manipulativeness, callousness and hostility)”

    From Pathological narcissism: An analysis of interpersonal dysfunction within intimate relationships (2022) · cites this paper as Lenzenweger et al., 2018

  • Extreme expressions of acting out these "ego-syntonic" revenge fantasies may highlight the presence of an extreme form of pathological narcissism in this sample - malignant narcissism.

    “Extreme expressions of acting out these “ego-syntonic” revenge fantasies may also highlight the presence of an extreme form of pathological narcissism in this sample – malignant narcissism, which involves the presence of a narcissistic personality with prominent paranoia and antisocial features [60].”

    From Living with pathological narcissism: a qualitative study (2020) · cites this paper as [60]

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Authors
Lenzenweger, M. F., Clarkin, J. F., Caligor, E., Cain, N. M., & Kernberg, O. F.
Affiliations
  • Binghamton University (US)
  • Weill Cornell Medicine (US)
  • Columbia University (US)
  • Long Island University (US)
ORCID
Venue
Psychopathology
Publisher
S. Karger AG
Published
2018
Volume
51
Issue
5
Pages
318-325
ISSN
  • 0254-4962 (ISSN-L)
  • 1423-033X
DOI
10.1159/000492228
OpenAlex
W2891484027
Cited by
24
References
27
Citations by year
2025: 3 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 2 · 2020: 4 · 2019: 4
FWCI
2.93
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Psychopathology (publishedVersion)
  • PubMed (publishedVersion)
  • Rutgers University Community Repository (Rutgers University) (submittedVersion)
Funders
Weill Cornell Medical College
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
malignant narcissism, borderline personality disorder, narcissistic personality disorder, grandiose narcissism, treatment outcomes, clinical change, anxiety, global functioning, Kernberg
MeSH terms
Adult, Borderline Personality Disorder, Female, Humans, Male, Personality Disorders, Personality Inventory

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