Symptom severity and mindreading in narcissistic personality disorder.
Open accessAbstract
BACKGROUND: Grandiose narcissism has been associated with poor ability to understand one's own mental states and the mental states of others. In particular, two manifestations of Narcissistic Personality Disorder (NPD) can be explained by poor mindreading abilities: absence of symptomatic subjective distress and lack of empathy. METHODS: We conducted two studies to investigate the relationships between mindreading capacity, symptomatic subjective distress and narcissistic personality. In the first study (N = 246), we compared mindreading capacities and symptomatic distress in three outpatient samples: narcissistic patients (NPD); patients with other Personality Disorders (PD); patients without PD. In the second study (N = 1357), we explored the relationships between symptomatic distress, mindreading and specific NPD criteria. RESULTS: In the first study, the NPD patients showed poorer mindreading than the patients without PD and comparable to patients with other PDs. Symptomatic subjective distress in the narcissistic group was less severe than in the other PDs group and comparable to the group without PDs. However, no relationship emerged between mindreading and symptomatic subjective distress. In the second study, taking the clinical sample as a whole, symptomatic distress appeared negatively linked to grandiosity traits, while mindreading scores were negatively linked to empathy. CONCLUSIONS: NPD showed specific mindreading impairments. However, mindreading capacity did not appear to be directly connected with subjective distress, but did appear to be connected with specific aspects of narcissistic pathology.
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Written from the paper’s full text.
TL;DR
In two Italian outpatient studies, grandiose narcissistic personality disorder (NPD) was associated with poorer interview-based mindreading than no personality disorder but similar to other personality disorders, while subjective distress was lower than in other PDs and comparable to no PD. Mindreading impairment was not linked to low subjective distress, but in a larger sample it was linked to specific narcissistic criteria, especially lack of empathy.
Key findings
- Study 1 (N = 246: NPD n = 32, Other PD n = 157, No PD n = 57): NPD patients showed poorer mindreading on the MAI than No PD patients and comparable mindreading to Other PD patients; NPD had the lowest Differentiation and Decentration scores.
- Study 1: NPD patients reported lower symptomatic distress (GSI) than Other PD patients and were comparable to No PD patients; no significant correlation emerged in the NPD group between symptomatic distress and alexithymia (r = .23, p = .201), symptomatic distress and metacognition (r = .16, p = .422), or alexithymia and metacognition (r = -.20, p = .316).
- Study 2 (N = 1357): grandiosity was negatively associated with symptoms severity and alexithymia; lack of empathy was negatively associated with global MAI (β = -.18, p < .001) and positively associated with alexithymia and GSI.
- Study 2: sense of entitlement, lack of empathy, and envy were negatively associated with global MAI; lack of empathy was negatively associated with each MAI dimension (Monitoring, Differentiation, Integration, Decentration).
Methods
- Study 1 compared three outpatient groups selected from a larger treatment-seeking sample (N = 1346) at an Italian clinic between 2011 and 2016: NPD without other PD diagnoses, one other PD diagnosis without NPD criteria, and no PD. Measures included SCID-I/II, SCL-90-R Global Severity Index, TAS-20, and the Metacognition Assessment Interview (MAI).
- Study 1 used MANOVA followed by univariate ANOVAs with LSD post-hoc tests and bivariate correlations.
- Study 2 used the whole sample (N = 1357; 545 no PD, 812 at least one PD) and conducted three linear regressions with NPD criteria entered simultaneously as predictors of TAS-20, GSI, and MAI, plus regressions on the four MAI dimensions.
Limitations
- Stated: Study 1 selected NPD patients without comorbid diagnoses, producing a smaller and less severe group than typically seen in clinical practice; findings may not transfer to the vulnerable narcissism phenotype; Study 2 was exploratory and could not clarify causal relationships between low empathy and low mindreading; analyses used categorical DSM criteria rather than dimensional measures.
- Evident: the paper repeatedly notes small effect sizes in Study 2, and the cross-sectional design cannot establish temporal or causal direction.
Model-written summary. Check it against the paper before relying on it.
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Cites
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Claims the paper makes
0 of 37 cited sources checked · 0 supported · 0 flagged
- Findingown data
The multivariate effect of group on the dependent variables was significant (Wilk's λ = .58; F(34,400) = 3.67; p < .001).
“The Multivariate effect turned out to be significant (Wilk's λ = .58; F (34,400) = 3.67; p < .001).”
Quote in the paperSubstantial claim - Findingown data
In the Other PD group, the correlation between symptomatic distress and metacognition was not significant (r = -.07; p = .427).
“In the same group, the correlation between symptomatic distress and metacognition was not significant (r = -.07; p = .427), as well as the correlation between alexithymia and metacognition (r = -.02; p = .798).”
Quote in the paperNot a substantial claim - Findingown data
NPD showed lower scores of mindreading compared to No PD.
“Concerning our second hypothesis, NPD showed lower scores of mindreading compared to No PD, as hypothesized.”
Quote in the paperSubstantial claim - Findingown data
In the NPD group, no significant correlation emerged between subjective symptomatic distress and alexithymia (r = .23; p = .201).
“No significant correlation emerged between subjective symptomatic distress and alexithymia (r = .23; p = .201), symptomatic distress and metacognition (r = .16; p = .422), and alexithymia and metacognition (r = -.20; p = .316) in the NPD group.”
Quote in the paperSubstantial claim - Findingown data
The differences among the three groups were not significant for the TAS subscale Externally oriented thinking.
“The differences among the three groups were not significant for the TAS subscale Externally oriented thinking.”
Quote in the paperNot a substantial claim
- Findingown data
NPD did not differ from the Other PD group on global MAI mindreading scores.
“The post hoc performed showed NPD had significantly lower mean scores than the No PD group, while NPD did not differ from the Other PD group.”
Quote in the paperSubstantial claim - Findingown data
NPD patients showed the lowest scores in the MAI Differentiation and Decentration dimensions.
“Concerning the subscales of MAI, NPD patients showed the lowest scores in the Differentiation and Decentration dimensions.”
Quote in the paperSubstantial claim - Findingown data
In the Other PD group, the association between symptomatic distress and alexithymia was significant (r = .41, p < .001).
“The association between symptomatic distress and alexithyimia turned out significant (r = .41, p < .001) in the Other PD group.”
Quote in the paperNot a substantial claim - Findingown data
In the NPD group, no significant correlation emerged between symptomatic distress and metacognition (r = .16; p = .422).
“No significant correlation emerged between subjective symptomatic distress and alexithymia (r = .23; p = .201), symptomatic distress and metacognition (r = .16; p = .422), and alexithymia and metacognition (r = -.20; p = .316) in the NPD group.”
Quote in the paperSubstantial claim - Findingown data
In the NPD group, no significant correlation emerged between alexithymia and metacognition (r = -.20; p = .316).
“No significant correlation emerged between subjective symptomatic distress and alexithymia (r = .23; p = .201), symptomatic distress and metacognition (r = .16; p = .422), and alexithymia and metacognition (r = -.20; p = .316) in the NPD group.”
Quote in the paperNot a substantial claim - Findingown data
Sense of entitlement was negatively associated with integration.
“Significant negative associations were evidenced between sense of entitlement and integration, decentration and differentiation.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
Sense of entitlement was negatively associated with decentration.
“Significant negative associations were evidenced between sense of entitlement and integration, decentration and differentiation.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
Arrogant attitude was negatively associated with differentiation.
“Finally, arrogant attitude was negatively associated to the dimension differentiation.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
When measured with the MAI, mindreading performance of NPD patients was similar to that of other PD patients.
“As predicted by the hypothesis, when measured with the MAI, the mindreading performance of NPD patients was significantly worse than that of the no PD patients and similar to that of the other PD patients.”
Quote in the paperSubstantial claim - Findingown data
In the No PD group, no significant correlation emerged between alexithymia and metacognition (r = -.12; p = .430).
“In the No PD group, no significant correlation emerged between subjective symptomatic distress and alexithymia (r = .21; p = .111), symptomatic distress and metacognition (r = -.07; p = .647), and alexithymia and metacognition (r = -.12; p = .430).”
Quote in the paperNot a substantial claim - Findingown data
Comparing the correlation coefficients across pairs of groups failed to yield any significant difference in the magnitude of the associations across groups (all ps > .15).
“Comparing the coefficients across pairs of groups failed to yield any significant difference in the magnitude of the associations across groups (all ps >.15).”
Quote in the paperSubstantial claim - Findingown data
Envy was negatively associated with the global score of MAI.
“Other negative associations resulted between the criteria sense of entitlement, lack of empathy and envy, and the global score of MAI.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
Patients with grandiose NPD had significantly lower levels of symptomatic distress than other PD patients.
“As predicted by the hypothesis, patients with grandiose NPD presented with significantly lower levels of symptomatic distress than the other PD patients.”
Quote in the paperSubstantial claim - Findingown data
Grandiosity was negatively associated with symptoms severity.
“The criterion grandiosity was negatively associated with symptoms severity and alexithymia, as hypothesized.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
Compared with self-assessments of other PD patients, NPD patients rate themselves as less alexithymic.
“The results obtained through the semi-structured interview are not consistent with the results of the self-reports measures: compared with self-assessments of other PD, NPD rate themselves as less alexithymic.”
Quote in the paperSubstantial claim - Findingown data
Grandiosity was the only criterion positively associated with an MAI dimension (integration).
“Interestingly, the only positive link that emerged was the one between the first criterion, grandiosity, and the dimension integration.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
In the second study, taking the clinical sample as a whole, symptomatic distress appeared negatively linked to grandiosity traits.
“In the second study, taking the clinical sample as a whole, symptomatic distress appeared negatively linked to grandiosity traits, while mindreading scores were negatively linked to empathy.”
Quote in the paperNot a substantial claim - Findingown data
In the Other PD group, the correlation between alexithymia and metacognition was not significant (r = -.02; p = .798).
“In the same group, the correlation between symptomatic distress and metacognition was not significant (r = -.07; p = .427), as well as the correlation between alexithymia and metacognition (r = -.02; p = .798).”
Quote in the paperNot a substantial claim - Findingown data
Lack of empathy was negatively associated with the global score of MAI.
“Other negative associations resulted between the criteria sense of entitlement, lack of empathy and envy, and the global score of MAI.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
Lack of empathy was positively associated with perceived symptoms severity (GSI).
“Positive links were observed between the criteria fantasies of unlimited success, lack of empathy, envy and perceived symptoms severity (GSI), and between lack of empathy and alexithymia.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
The semi-structured interview results are not consistent with the self-report measures in this sample.
“The results obtained through the semi-structured interview are not consistent with the results of the self-reports measures: compared with self-assessments of other PD, NPD rate themselves as less alexithymic.”
Quote in the paperSubstantial claim - Findingown data
Lack of empathy is the NPD criterion most tightly linked to low mindreading ability.
“The criterion which appears as most tightly linked to low mindreading ability is lack of empathy.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
In the No PD group, no significant correlation emerged between symptomatic distress and metacognition (r = -.07; p = .647).
“In the No PD group, no significant correlation emerged between subjective symptomatic distress and alexithymia (r = .21; p = .111), symptomatic distress and metacognition (r = -.07; p = .647), and alexithymia and metacognition (r = -.12; p = .430).”
Quote in the paperNot a substantial claim - Findingown data
Entitlement, envy, and arrogance are significantly linked to poor mindreading ability.
“The other criteria which are significantly linked to poor mindreading ability are entitlement, envy and arrogance.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
Sense of entitlement was negatively associated with the global score of MAI.
“Other negative associations resulted between the criteria sense of entitlement, lack of empathy and envy, and the global score of MAI.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
On the MAI decentering sub-function, NPD patients performed slightly but significantly worse than patients with other PDs.
“It is interesting to note that in the MAI, on the decentering sub-function, which evaluates ability to understand the minds of others, the performance of the narcissistic patients was slightly but significantly worse than that of the patients with other PDs.”
Quote in the paperSubstantial claim - Findingown data
Symptomatic distress levels of patients with grandiose NPD are comparable to those of patients with no PD diagnosis.
“Their levels of symptomatic distress are in fact comparable to those reported by patients with no PD diagnosis.”
Quote in the paperSubstantial claim - Findingown data
Envy was negatively associated with monitoring.
“The criterion envy was negatively associated to monitoring and differentiation.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
Envy was negatively associated with differentiation.
“The criterion envy was negatively associated to monitoring and differentiation.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
Lack of empathy was negatively associated with each dimension of MAI.
“Lack of empathy was negatively associated to each dimension of MAI.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
Envy was positively associated with perceived symptoms severity (GSI).
“Positive links were observed between the criteria fantasies of unlimited success, lack of empathy, envy and perceived symptoms severity (GSI), and between lack of empathy and alexithymia.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
Sense of entitlement was negatively associated with differentiation.
“Significant negative associations were evidenced between sense of entitlement and integration, decentration and differentiation.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
When measured with the MAI, mindreading performance of NPD patients was significantly worse than that of no PD patients.
“As predicted by the hypothesis, when measured with the MAI, the mindreading performance of NPD patients was significantly worse than that of the no PD patients and similar to that of the other PD patients.”
Quote in the paperSubstantial claim - Findingown data
Several NPD criteria were linked to various types of metacognitive impairment.
“A number of NPD criteria emerged in this study as linked to various types of metacognitive impairment, to a greater or lesser degree.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
Lack of empathy was positively associated with alexithymia.
“Positive links were observed between the criteria fantasies of unlimited success, lack of empathy, envy and perceived symptoms severity (GSI), and between lack of empathy and alexithymia.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
In the second study, taking the clinical sample as a whole, mindreading scores were negatively linked to empathy.
“In the second study, taking the clinical sample as a whole, symptomatic distress appeared negatively linked to grandiosity traits, while mindreading scores were negatively linked to empathy.”
Quote in the paperSubstantial claim - Findingown data
In the No PD group, no significant correlation emerged between subjective symptomatic distress and alexithymia (r = .21; p = .111).
“In the No PD group, no significant correlation emerged between subjective symptomatic distress and alexithymia (r = .21; p = .111), symptomatic distress and metacognition (r = -.07; p = .647), and alexithymia and metacognition (r = -.12; p = .430).”
Quote in the paperNot a substantial claim - Findingown data
Grandiosity was negatively associated with alexithymia.
“The criterion grandiosity was negatively associated with symptoms severity and alexithymia, as hypothesized.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Findingown data
Fantasies of unlimited success were positively associated with perceived symptoms severity (GSI).
“Positive links were observed between the criteria fantasies of unlimited success, lack of empathy, envy and perceived symptoms severity (GSI), and between lack of empathy and alexithymia.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
- Premisecitation
Patients with NPD have difficulties with recognition of the emotions of others.
“Marissen and colleagues [40] found that patients with NPD have difficulties with recognition of the emotions of others, an ability which is usually considered indicative of cognitive empathy.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [40] MAE Merissen, 2012, Disturbed emotion recognition in patients in patients with narcissistic personality disorder, J Psychiatr Res source
Not checked in the free run.
- Premisecitation
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.”
- Also stated in: § Introduction · plain
“The absence of subjective distress as well as lack of empathy have been associated with grandiose NPD patients’ impaired understanding of their own mental states and of the mental states of others [12–17].”
Quote in the paperSubstantial claim0 of 6 sources checked- cites [12] SK Huprich, 2014, Malignant self-regard: A self-structure enhancing the understanding of masochistic, depressive, and vulnerably narcissistic personalities, Harv Rev Psychiatr source
Not checked in the free run.
- cites [13] JN Butcher, 1989
Not checked in the free run.
- cites [14] OF Kernberg, 1975
Not checked in the free run.
- cites [15] JD Miller, 2007, Narcissistic personality disorder: Relations with distress and functional impairment, Compr Psychiatr source
Not checked in the free run.
- cites [16] H Kohut, 1972, Thoughts on narcissism and narcissistic rage, Psychoanal Stud Child source
Not checked in the free run.
- cites [17] Z Given-Wilson, 2011, Metacognitive and interpersonal difficulties in overt and covert narcissism, Pers Indiv Differ source
Not checked in the free run.
- Also stated in: § Introduction · plain
- Interpretationreasoning
Two manifestations of NPD-absence of symptomatic subjective distress and lack of empathy-can be explained by poor mindreading abilities.
“In particular, two manifestations of Narcissistic Personality Disorder (NPD) can be explained by poor mindreading abilities: absence of symptomatic subjective distress and lack of empathy.”
Quote in the paperNot a substantial claim - Interpretationown data
Mindreading capacity did not appear to be directly connected with subjective distress.
“However, mindreading capacity did not appear to be directly connected with subjective distress, but did appear to be connected with specific aspects of narcissistic pathology.”
- Also stated in: § Results and discussion · hedged
“On the whole, this investigation on the association between subjective distress and mindreading appears to falsify the hypothesis that the relative”
Quote in the paperSubstantial claim- The authors state this as an assumption: Alexithymia can be used as an indirect measure of self-report mindreading.
- Also stated in: § Results and discussion · hedged
- Premisecitation
More severe narcissism is associated with a greater discrepancy between effective and self-assessed competence in understanding mental states of others.
“Analogously, Ames and Kammrath [43] found that more severe narcissism is associated with a greater discrepancy between effective and self-assessed competence in understanding mental states of others.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [43] DR Ames, 2004, Mind-Reading and Metacognition: Narcissism, not Actual Competence, Predicts Self-Estimated Ability, J Nonverbal behav source
Not checked in the free run.
- Interpretationown data
Defense mechanisms, biased information processing and cognitive avoidance may more cogently account for the low levels of subjective symptomatic distress experienced by narcissists than impairments of mindreading ability.
“Defense mechanisms, biased information processing and cognitive avoidance may more cogently account for the low levels of subjective symptomatic distress experienced by narcissists, rather than impairments of mindreading ability.”
Quote in the paperSubstantial claim - Interpretationown data
NPD showed specific mindreading impairments.
“NPD showed specific mindreading impairments.”
Quote in the paperSubstantial claim - Premisecitation
Higher levels of inflated self-esteem protect narcissists from subjective distress.
“This data is coherent with clinical descriptions which suggest that higher levels of inflated self-esteem protect narcissists from subjective distress [58].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [58] D Watson, 2002, Global self-esteem in relation to structural models of personality and affectivity, J Pers Soc Psychol source
Not checked in the free run.
- Interpretationown data
Mindreading capacity did appear to be connected with specific aspects of narcissistic pathology.
“However, mindreading capacity did not appear to be directly connected with subjective distress, but did appear to be connected with specific aspects of narcissistic pathology.”
Quote in the paperSubstantial claim - Interpretationown data
Poor mindreading ability may be linked to the interpersonal aspects of narcissistic pathology.
“In consequence, our data may suggest that poor mindreading ability is linked to the interpersonal aspects of narcissistic pathology.”
Quote in the paperSubstantial claim - Interpretationown data
Narcissists may be prone to bias when assessing their ability to understand their own emotional states.
“These data support the idea that narcissists may be prone to bias when assessing their ability to understand their own emotional states.”
Quote in the paperSubstantial claim - Study design and conductreasoning
The NPD group studied was smaller than would otherwise have been the case.
“However, one consequence of this strategy was that the group we studied was smaller than would otherwise have been the case.”
Quote in the paperNot a substantial claim - Interpretationreasoning
Mindreading could be one of the mediators between narcissism and social impairment.
“Taking into account that social impairment functions as a mediator between narcissism and psychopathology, our data might suggest that mindreading could be one of the mediators between narcissism and social impairment.”
Quote in the paperSubstantial claim - Interpretationown data
Inability to understand one's own mental states does not adequately explain why narcissistic patients appear unaware of distress arising from rejection and personal failure.
“Inability to understand one’s own mental states does not adequately explain the fact that narcissistic patients appear unaware of distress arising from rejection and personal failure.”
Quote in the paperSubstantial claim - Interpretationown data
In real life, narcissistic patients may have difficulties understanding the minds of others, at least in situations of more sophisticated perspective-taking and when they are personally involved in the relationship.
“This result suggests that in real life the narcissistic patients may have difficulties understanding the minds of others, at least in situations of more sophisticated perspective-taking and when they are personally involved in the relationship.”
Quote in the paperSubstantial claim
- May combine two claims. 23
- Classified as probably not a substantial claim. 26
May combine two claims.
Findingown dataOn the MAI dimensions Monitoring and Integration, NPD showed lower scores than No PD, but equal to the Other PD group.
“On the dimensions Monitoring and Integration, NPD showed lower scores than No PD, but equal to Other PD group.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataFor the TAS subscales Difficulties in identifying feelings and Difficulties describing feelings, there was no significant difference between the No PD group and the NPD group, but both groups showed lower scores than patients with Other PD.
“Concerning the TAS subscales Difficulties in identifying feelings and Difficulties describing feelings, no significant difference between the No PD group and the NPD group was found, but both groups showed lower scores than patients with Other PD.”
Quote in the paperNot a substantial claimMay combine two claims.
FindingcitationOn symptoms severity (GSI-SCL-90-R), NPD showed lower levels of perceived suffering compared to Other PD, and were more similar to No PD.
“Concerning the results on symptoms severity (GSI-SCL-90-R) [53], NPD showed lower levels of perceived suffering, compared to Other PD, and were more similar to No PD.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [53] LR Derogatis, 1975
Not checked in the free run.
May combine two claims.
Findingown dataGrandiosity was positively associated with all MAI measures, with a small but statistically significant association with integration.
“Grandiosity emerges not only as not linked to poor mindreading ability but as positively associated with all measures of MAI, reaching small but statistical significance with integration.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
May combine two claims.
Findingown dataThe effects found were small, albeit significant.
“We are aware that the effects we found were small, albeit significant.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn patients with NPD, low subjective distress is not associated with low mindreading ability; the data did not confirm the hypothesis that the relative absence of subjective distress among NPD patients is associated with low mindreading.
“On the whole, this investigation on the association between subjective distress and mindreading appears to falsify the hypothesis that the relative absence of subjective distress among NPD patients is associated with low mindreading.”
- Also stated in: § Results and discussion · plain
“We expected that low mindreading ability would also be associated with a low subjective distress, but the data did not confirm this hypothesis.”
- Also stated in: § Results and discussion · plain
“Although the patients with NPD show low levels of symptomatic distress and low levels of mindreading ability, we failed to find a link between these two elements.”
Quote in the paperSubstantial claim- Also stated in: § Results and discussion · plain
Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing). May combine two claims.
PremisecitationNarcissistic patients present generalized failures of symbolization and find it difficult to represent affective and visceral feelings in words.
“Mizen [22] suggested that narcissistic patients present generalized failures of symbolization and find it difficult to represent affective and visceral feelings in words.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [22] CS Mizen, 2014, Narcissistic disorder and the failure of symbolization: a relational affected hypothesis, Med Hypotheses source
Not checked in the free run.
May combine two claims.
PremisecitationGrandiose narcissists typically show an inflated self image and lack of depressive symptoms and subjective distress.
“Although every subtype of narcissism is characterized by emotional dysregulation and unstable self esteem instability [8–11], grandiose narcissists typically show an inflated self image and lack of depressive symptoms and subjective distress.”
Quote in the paperNot a substantial claim0 of 4 sources checked- cites [8] EF Ronningstam, 2014, Beyond the diagnostic trait. A collaborative exploratory diagnostic process for dimension and underpinnings of narcissistic personality disorder, Personal Disord source
Not checked in the free run.
- cites [9] E Calgor, 2015, Narcissistic Personality Disorder: Diagnostic and clinical challenges, Am J Psychiatr source
Not checked in the free run.
- cites [10] G Dimaggio, 2002, Metacognition, states of mind, cognitive biases, and interpersonal cycles: Proposal for an integrated narcissism model, J Psychother Integrat source
Not checked in the free run.
- cites [11] EF Ronningstam, 2013, Narcissistic personality disorder: progress in a recognition and treatment, Focus source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationUnder experimental conditions of social exclusion, narcissistic individuals showed hyperactivity of cerebral areas in a social pain network, but this hyperactivation was not reflected in their subjective experience as referred in self-reports.
“Cascio and colleagues, for instance, found that under experimental conditions of social exclusion the narcissistic individuals showed hyperactivity of cerebral areas anatomically defined as a social pain network, but that this hyperactivation was not reflected in their subjective experience as referred in their self-reports [30].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [30] CN Cascio, 2015, Narcissists’ social pain seen only in the brain, Social Soc Cognit Affect Neurosci source
Not checked in the free run.
Classified as probably not a substantial claim. May combine two claims.
PremisecitationPatients with NPD displayed difficulties in recognizing the thoughts and emotions which make up their mental states, and in making connections between internal states and their external causes.
“In a set of single case studies, Dimaggio and colleagues [26] found that patients with NPD displayed difficulties in recognizing the thoughts and emotions which make up their mental states, and also in making connections between internal states and their external causes.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [26] G Dimaggio, 2007, Carcione A, Clin Psychol Psychother
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationSCID-I and SCID-II had adequate inter-rater reliability for trait scores (ICC 0.84-0.99; mean 0.93) and categorical diagnoses (average κ = 0.90) in previous studies.
“In previous studies we observed that inter-rater reliability was adequate for both trait scores (a two-way mixed absolute agreement model for intra-class correlations coefficients ranged between 0.84 and 0.99; mean, 0.93) and categorical diagnoses (average κ = 0.90) [52].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [52] F Moroni, 2016, Mindreading Dysfunction in Avoidant Personality Disorder Compared With Other Personality Disorders, J Nerv Ment Dis source
Not checked in the free run.
Classified as probably not a substantial claim. May combine two claims.
PremisecitationNPD patients show low levels of emotional empathy but normal levels of cognitive empathy.
“The results obtained show low levels of emotional empathy in narcissists but normal levels of cognitive empathy.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [37] K Ritter, 2011, Lack of empathy in patients with narcissistic personality disorder, Psychiatr Res source
Not checked in the free run.
Classified as probably not a substantial claim. May combine two claims.
PremisecitationIn a non-clinical sample, subjects with the highest levels of narcissism demonstrated hypervigilance for information conveying worthlessness, but were apparently unaware of this information.
“Analogously, Horvath and Morf [31] found that in a non-clinical sample the subjects with the highest levels of narcissism demonstrated hypervigilance for information conveying worthlessness, but were also apparently unaware of this information.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [31] S Horvath, 2009, Narcissistic defensiveness: hypervigilance and avoidance of worthlessness, J Exp Soc Psychol source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductreasoningIn the current study, only subjects who met criteria for a single PD diagnosis were selected in order to minimize the effect of general personality severity.
“For the current study, in order to minimize the effect of general personality severity, we selected only subjects who met criteria for a single PD diagnosis.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Study design and conductreasoningIn order to limit bias in self-assessments of narcissistic subjects, both self-report measures of mindreading and semi-structured interviews were used.
“In order to limit bias in self-assessments of narcissistic subjects, we used both self-report measures of mindreading and semi-structured interviews.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
PremisecitationIn a large sample of patients with personality disorders, mindreading impairment was associated more with general personality severity, measured by numbers of criteria met, than with specific styles or categories.
“For example, in a study of a large sample of patients with personality disorders, it was found that mindreading impairment was associated more with general personality severity, measured on the basis of numbers of criteria met, than with specific styles or categories [49].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [49] A Semerari, 2014, Metacognitive dysfunctions in personality disorders: Correlations with disorder severity and personality styles, J Pers Disord source
Not checked in the free run.
Classified as probably not a substantial claim.
PremisecitationMetacognitive deficits play an important role in shaping and maintaining the pathology and problematic interpersonal relations of patients with NPD.
“According to Dimaggio and colleagues [10], metacognitive deficits play an important role in shaping and maintaining the pathology and the problematic interpersonal relations of patients with NPD.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [10] G Dimaggio, 2002, Metacognition, states of mind, cognitive biases, and interpersonal cycles: Proposal for an integrated narcissism model, J Psychother Integrat source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIn samples of patients with Personality Disorders, no connection between narcissism and alexithymia was established.
“while other studies carried out on samples of patients with Personality Disorders (PD) established no such connection between narcissism and alexithymia [28, 29].”
Quote in the paperNot a substantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIn patients with eating disorders, the presence of narcissistic traits was linked to alexithymia.
“In one research study on patients with eating disorders, Lawson and colleagues found that the presence of narcissistic traits was linked to alexithymia [27], while other studies carried out on samples of patients with Personality Disorders (PD) established no such connection between narcissism and alexithymia [28, 29].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [27] R Lawson, 2008, Emotional awareness among eating-disordered patients: The role of narcissistic trait, Eur Eat Disord Rev source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIndividuals with narcissistic traits appear to overestimate their own competence at understanding mental states.
“In another study, however [43], individuals with narcissistic traits appear to overestimate their own competence at understanding mental states.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [43] DR Ames, 2004, Mind-Reading and Metacognition: Narcissism, not Actual Competence, Predicts Self-Estimated Ability, J Nonverbal behav source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationNarcissistic individuals present marked difficulties in identifying and verbalizing emotions, i.e., they are alexithymic.
“Krystal [23] found additionally that narcissistic individuals present marked difficulties in identifying and verbalizing emotions; in other words, they are alexithymic, which is associated by Nemiah and Sifneos [24] with susceptibility to psychosomatic disorders.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [23] H Krystal, 1998, Disorder of narcissism: diagnostic, clinical and empirical implications
Not checked in the free run.
May combine two claims.
PremisecitationResearch indicates a strong overall relationship between narcissism and deficient emotional empathy, and a weak connection with dysfunctional cognitive empathy.
“Results indicate a strong overall relationship between narcissism and deficient emotional empathy, and a weak connection with dysfunctional cognitive empathy [36].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [36] A Baskin-Sommers, 2014, Empathy in narcissistic personality disorder: from clinical and empirical perspectives, J Pers Disord source
Not checked in the free run.
Classified as probably not a substantial claim.
PremisecitationSeveral clinicians have associated NPD with impaired mindreading.
“Several clinicians have associated NPD with impaired mindreading.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [10] G Dimaggio, 2002, Metacognition, states of mind, cognitive biases, and interpersonal cycles: Proposal for an integrated narcissism model, J Psychother Integrat source
Not checked in the free run.
- cites [22] CS Mizen, 2014, Narcissistic disorder and the failure of symbolization: a relational affected hypothesis, Med Hypotheses source
Not checked in the free run.
- cites [23] H Krystal, 1998, Disorder of narcissism: diagnostic, clinical and empirical implications
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationPatients with comorbid narcissistic and borderline personality disorder scored low on mentalizing.
“Diamond and colleagues showed that patients with comorbid narcissistic and borderline personality disorder scored low on mentalizing [25].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [25] D Diamond, 2014, Attachment and mentalization in female patients with comorbid narcissistic and borderline personality disorder, Personal Disord source
Not checked in the free run.
Classified as probably not a substantial claim. May combine two claims.
InterpretationreasoningIf mindreading is linked to social functioning levels of patients with narcissism, patients with better mindreading ability may be capable of devising relational strategies that are overall less counterproductive, leading to fewer interpersonal conflicts, fewer threats to self-esteem and improved social functioning.
“If mindreading is linked to the social functioning levels of patients with narcissism, it follows that patients with better mindreading ability may also be capable of devising relational strategies that are overall less counterproductive, leading to fewer interpersonal conflicts, fewer threats to self-esteem and improved social functioning.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThe level of severity in this sample was less significant than that usually encountered in clinical practice, where patients generally show a number of comorbidities.
“Another consequence is that the level of severity in this sample was less significant than that usually encountered in clinical practice, where patients generally show a number of comorbidities.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
InterpretationreasoningLow levels of mindreading ability could constitute a negative prognostic factor which renders patients more vulnerable to social dysfunction and symptomatic deterioration.
“If this is the case, low levels of mindreading ability could constitute a negative prognostic factor which renders patients more vulnerable to social dysfunction and symptomatic deterioration.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Interpretationown dataThe study observed a sample of narcissistic patients with overt grandiosity, and it is unclear whether and to what extent the findings may be transferable to the vulnerable phenotype.
“Moreover, this study observed a sample of narcissistic patients with overt grandiosity and it is unclear whether and to what extent our findings may be transferable to the vulnerable phenotype.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationNarcissistic bias may produce an overestimation of one's own level of social functioning and an underestimation of the negative effects of one's own behaviors upon others.
“This is coherent with the lines of argumentation of Morf and Rhodewalt [41], who propose that this narcissistic bias may produce an overestimation of their own level of social functioning and an underestimation of the negative effects of their own behaviors upon others.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [41] CC Morf, 2001, Unraveling the paradoxes of narcissism: A dynamic self-regulatory processing model, Psychol Inq source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe exploratory analyses in study 2 produced no insight into the type of causal relationship which may exist between low levels of empathy and low levels of mindreading ability.
“In addition, the exploratory analyses we conducted in the second study produced no insight into the type of causal relationship which may exist between low levels of empathy and low levels of mindreading ability.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataThe results confirmed the study's hypotheses, but the limited effect size prevents definitive conclusions.
“The results have confirmed our hypotheses, although the limited dimension of the effect does not allow us to draw definitive conclusion.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing). May combine two claims.
PremisecitationGrandiosity appears to perform a protective role with regard both to the development of symptoms and to mental functioning.
“Eminent clinicians have suggested that grandiosity appears to perform a protective role with regard both to the development of symptoms and to mental functioning [14, 16].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [14] OF Kernberg, 1975
Not checked in the free run.
- cites [16] H Kohut, 1972, Thoughts on narcissism and narcissistic rage, Psychoanal Stud Child source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductnone givenThe study used only the criteria of the categorical diagnosis.
“Finally, we used only the criteria of the categorical diagnosis.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataPoor mindreading plays a role in aspects of narcissistic interpersonal functioning, but other factors should also be taken into consideration.
“This suggests that poor mindreading plays a role in aspects of narcissistic interpersonal functioning but that other factors should also be taken into consideration.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationSocial impairment may function as a mediator between narcissism and personal distress.
“Considering that previous research studies have highlighted that social impairment may function as a mediator between narcissism and personal distress [15], envy may prove to be linked to symptomatic distress as an emotional marker of social impairment.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [15] JD Miller, 2007, Narcissistic personality disorder: Relations with distress and functional impairment, Compr Psychiatr source
Not checked in the free run.
May combine two claims.
Interpretationown dataThe ability to be empathetic requires not only understanding the minds of others (decentering) but also reading one's own mind (monitoring and integration) and recognizing what one may have in common with others.
“This may indicate that the ability to be empathetic does not only requires an understanding of the minds of others (i.e., decentering), but also an ability to read our own minds (i.e., monitoring and integration) and a consequent recognition of what we may have in common with others.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataPatients with grandiose narcissism are overconfident when assessing their own mental states and those of others but are impaired in their ability to do so.
“On the whole, these data show that patients with grandiose narcissism are overconfident when assessing their own mental states and those of others but in reality impaired in their ability to do so.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationGrandiosity provides narcissists with the means for maintaining a relatively integrated self-image, functioning as a protective measure against processes of fragmentation.
“This data is partially coherent with Kernberg’s model [14], which asserts that grandiosity provides narcissists with the means for maintaining a relatively integrated self-image, functioning as a protective measure against processes of fragmentation.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [14] OF Kernberg, 1975
Not checked in the free run.
The authors state this as an assumption.
Alexithymia can be used as an indirect measure of self-report mindreading.
“In order to do this, we conceived alexithymia as an indirect measure of self-report mindreading.”
The paper relies on this without support.
DSM-IV Narcissistic Personality Disorder as diagnosed in the selected sample corresponds to grandiose NPD.
“The first group (N = 32; 13% of the sample) included participants who met the DSM-IV criteria for Narcissistic Personality Disorder (NPD, 5 or more criteria) and were below the cut-off values for all the other PDs.”
“In the first part we investigated whether patients with grandiose NPD present with low subjective symptomatic distress and poor mindreading skills and whether there is a connection between these two elements.”
The authors state this as an assumption.
Mindreading can be treated as a single overall ability.
“In this article we will use the all-inclusive term mindreading to refer to the overall ability, and the other terms when we refer to the terminology of the cited works.”
The paper relies on this without support.
In the clinical descriptions of narcissism, grandiosity is viewed as the other face of fragility, functioning as a protection against feelings of inferiority, emptiness and dependency, and insulating against experiences of inconsistency and fragmentation of the self.
“In the clinical descriptions of narcissism, grandiosity is viewed as the other face of fragility, functioning as a protection against feelings of inferiority, emptiness and dependency, and insulating against experiences of inconsistency and fragmentation of the self.”
The authors state this as an assumption.
Narcissistic criteria, if present, even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.
“In other words, we are here assuming that narcissistic criteria, if present, and even if not corresponding to any categorical diagnosis, can be associated with certain specific forms of dysfunction.”
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?
People affected by narcissistic personality disorder describe themselves as superior but depend on and manipulate others to gain visibility and admiration.
“People affected by NPD describe themselves as superior but, at the same time, depend on and manipulate others to gain visibility and admiration (a reality called “narcissist supply”) (27).”
From The dark side of empathy in narcissistic personality disorder (2023) · cites this paper as [27]
The Introduction describes NPD as involving grandiosity and pursuit of admiration, and says grandiose narcissists typically have an inflated self-image. Study 2 lists requests for admiration and interpersonal exploitation among NPD criteria. The paper does not say that people with NPD depend on and manipulate others to gain visibility and admiration, or describe this as “narcissist supply.” (LLM, conf=0.85)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Study 2's stated source sample changes size
MinorStudy 2 says it used the whole sample from which the Study 1 groups were selected, but Study 1 gives that source sample as 1,346 patients and Study 2 gives it as 1,357.
“From a large sample of patients seeking treatment (N = 1346), we selected three groups for a total of 246 patients.”
“In this second study, we used the whole sample from which we had selected the three patient groups participating in the previous study, without differentiating for any specific diagnosis. A total of 1357 patients took part in the study”
Reported MAI correlations are mathematically incompatible
MinorTable 3 reports monitoring-differentiation as −.61, while monitoring-integration is .75 and differentiation-integration is .73. Three variables cannot simultaneously have those correlations: the two strong positive correlations require monitoring-differentiation to be positive.
“| 13. Differentiation | -.11** | -.14** | -.09** | -.11** | -.20** | -.16** | -.24** | -.16** | -.18** | -.22** | -.19** | -.61** | 1”
“| 14. Integration | -.05 | -.09** | -.04 | -.08** | -.14** | -.13** | -.18** | -.10** | -.11** | -.14** | -.18** | .75** | .73** | 1”
Grandiosity's effect on symptom severity has conflicting signs
MinorTable 4 gives a positive unstandardized coefficient (.09) but a negative standardized coefficient (−.11) for the same regression term. The text interprets the relationship as negative, which cannot be reconciled with the positive unstandardized coefficient.
“1. Grandiosity | -1.49(.52)-.10** | .09(.03)-.11* | .77(.49).06”
“The criterion grandiosity was negatively associated with symptoms severity and alexithymia, as hypothesized.”
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Marcoux, L.-A., Michon, P.-E., Lemelin, S., Voisin, J. A., Vachon-Presseau, E., & Jackson, P. L. (2014) · Psychiatry Research: Neuroimaging · doi:10.1016/j.pscychresns.2014.10.002 · Cited by 31 · see citing works
Hengartner, M. P., Ajdacic‐Gross, V., Rodgers, S., Müller, M., Haker, H., & Wulf Rössler, A. (2013) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-013-0441-0 · Cited by 31 · see citing works
Brain Mapping: An Encyclopedic Reference
Hari, R., Parkkonen, L. T., & Hämäläinen, M. (2015) · Cited by 30 · see citing works
Metacognition assessment interview: Instrument description and factor structure
Pellecchia, G., Moroni, F., Carcione, A., Maggio, G. D., Nicolò, G., Pedone, R., Procacci, M., Semerari, A., & Colle, L. (2015) · Institutional Research Information System University of Turin (University of Turin) · Cited by 29 · see citing works
Self-citationEmotional awareness among eating‐disordered patients: the role of narcissistic traits
Lawson, R., Waller, G., Sines, J., & Meyer, C. (2008) · European Eating Disorders Review · doi:10.1002/erv.838 · Cited by 25 · see citing works
Ronningstam, E. (2014) · Personality Disorders Theory Research and Treatment · doi:10.1037/per0000034 · Cited by 25 · see citing works
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The Neural Correlates of Social Cognition and Social Interaction
Schilbach, L. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-397025-1.00172-x · Cited by 15 · see citing works
Narcissistic disorder and the failure of symbolisation: A Relational Affective Hypothesis
Mizen, C. S. (2014) · Medical Hypotheses · doi:10.1016/j.mehy.2014.05.012 · Cited by 11 · see citing works
Flagged first, then by citations
1 of the 59 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- AM Cooper, 1992, American Psychiatric Press review of psychiatry, 11, 80
- G Dimaggio, 2007, Carcione A, Clin Psychol Psychother, 14, 386
Cited by
Sorted by citations
When is narcissism associated with low empathy? A meta-analytic review
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Can neuroscience help to understand narcissism? A systematic review of an emerging field
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The relationship between narcissism and empathy: A meta-analytic review
Simard, P., Simard, V., Laverdière, O., & Descôteaux, J. (2022) · Journal of Research in Personality · doi:10.1016/j.jrp.2022.104329 · Cited by 38 · see citing works
The dark side of empathy in narcissistic personality disorder
di Giacomo, E., Andreini, E., Lorusso, O., & Clerici, M. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1074558 · Cited by 34 · see citing works
Metacognitively oriented psychotherapy for schizotypal personality disorder: A two‐case series
Cheli, S., Lysaker, P. H., & Dimaggio, G. (2019) · Personality and Mental Health · doi:10.1002/pmh.1447 · Cited by 34 · see citing works
Impaired empathy but no theory of mind deficits in adult attention deficit hyperactivity disorder
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A mentalizing approach for narcissistic personality disorder: Moving from “me-mode” to “we-mode
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Self-serving social strategies: A systematic review of social cognition in narcissism
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Jurist, J., Traynor, J. M., Murray, G. E., Ren, B., Masland, S. R., Mermin, S. A., Meehan, K. B., & Choi-Kain, L. W. (2025) · Psychopathology · doi:10.1159/000543363 · Cited by 6 · see citing works
Pedone, R., Barbarulo, A. M., Colle, L., Semerari, A., & Grimaldi, P. (2021) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001304 · Cited by 6 · see citing works
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Czekóová, K., Shaw, D. J., Pokorná, Z., & Brázdil, M. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00563 · Cited by 4 · see citing works
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The common structure of mentalizing
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Self-citationDifferentiation and Decentration
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Self-citationNarsisme Perempuan Urban melalui Simulakra Perhiasan di Media Sosial sebagai Bentuk Endorsement
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Self-citation
- Authors
- Bilotta, E., Carcione, A., Fera, T., Moroni, F., Nicolò, G., Pedone, R., Pellecchia, G., Semerari, A., & Colle, L.
- Affiliations
- University of Campania "Luigi Vanvitelli" (IT)
- University of Turin (IT)
- Corresponding author
- Bilotta, Elena
- Carcione, Antonino
- Fera, Teresa
- Moroni, Fabio
- Nicolò, Giuseppe
- Pedone, Roberto
- Pellecchia, Giovanni
- Semerari, Antonio
- Colle, Livia
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2018-08-15
- Volume
- 13
- Issue
- 8
- Pages
- e0201216
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC6093639
- OpenAlex
- W2886965470
- Cited by
- 29
- References
- 59
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 7 · 2020: 3 · 2019: 4 · 2018: 1
- FWCI
- 4.40
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- 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
- narcissistic personality disorder, grandiose narcissism, theory of mind, subjective distress, empathy, grandiosity, personality disorders, symptom severity
- MeSH terms
- Metacognition, Adolescent, Adult, Affective Symptoms, Aged, Female, Humans, Interview, Psychological, Male, Middle Aged, Personality Disorders, Psychiatric Status Rating Scales, Self Concept, Severity of Illness Index, Social Perception, Stress, Psychological, Young Adult, Theory of Mind
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.
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