CHAPTER 9

NARCISSISTIC PERSONALITY DISORdER ANd THE FIVE-FACTOR MOdEL: DELINEATING NARCISSISTIC PERSONALITy DISORdER, GRANdIOSE NARCISSISm, ANd VULNERABLE NARCISSISm
W. Keith Campbell and Joshua D. Miller
Narcissistic personality disorder (NPD), as dened by the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision; DSMIVTR; American Psychiatric Association, 2000) entails a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy (p. 717). NPD is associated with functional impairment of a variety of forms but especially that of an interpersonal nature (Miller, Campbell, & Pilkonis, 2007). Although NPD has typically been found to be relatively rare in epidemiological studies, a recent study found lifetime prevalence rates of NPD to be quite high (i.e., 6.2%), particularly in certain demographic groups (e.g., younger individuals; Stinson et al., 2008). The study of NPD and narcissism is at an interesting crossroads. As we have documented elsewhere (Miller & Campbell, 2010), research on trait narcissism, in which narcissism is viewed as a continuous trait on which all individuals can be placed, is thriving. Alternatively, there is a relative dearth of research on NPD as a categorical psychiatric diagnosis, especially compared with other Cluster B DSMIVTR personality disorders (PDs) such as
Authorship is equal. DOI: 10.1037/13939-009 Personality Disorders and the Five-Factor Model of Personality, Third Edition, T. A. Widiger and P. T. Costa Jr. (Editors) Copyright 2013 by the American Psychological Association. All rights reserved.

antisocial and borderline. Although we believe that the substantial body of research on trait narcissism is largely germane to the study of NPD, others may disagree. In fact, at one point NPD was no longer going to be an ofcial PD diagnosis in the fth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM5)a decision with which we disagreed (see Miller, Widiger, & Campbell, 2010)in part because of the scant research literature on NPD (Skodol, 2010). This was unfortunate because we believe that NPD deserves a place at the table if the DSM5 is going to retain these types of diagnoses (i.e., the DSM5 proposal suggested that ve of the 10 DSMIVTR PD diagnoses be retained in the DSM5). Regardless of the fate of NPD in the DSM5, the constructs of narcissism and NPD are likely to be relevant for the foreseeable future. In the current chapter, we focus on what we perceive to be one of the most signicant problems in the conceptualization, assessment, and study of NPD, which may have contributed to the scarcity of research on this construct: heterogeneity. That is, we review the growing empirical evidence that suggests that there are at least two dimensions of narcissismgrandiose

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and vulnerable that (a) may be intermingled as part of the conceptualization of NPD and (b) have substantially different etiologies, underlying traits, and outcomes relevant to clinical psychology. We focus here on how the ve-factor model (FFM) can help delineate areas in which these narcissism dimensions converge and diverge and how they may both be repre sented in the DSMIVTR conceptualization of NPD. Finally, we discuss how the existing data might be used by the DSM5 Personality and Personality Disorders Work Group to ensure that their new dimensional trait model has adequate content validity, particularly with regard to the assessment of narcissism. HEtEROGENEItY WItHIN NARCISSISm AND NARCISSIStIC PERSONALItY DISORDER As noted previously, there is substantial empirical support for the idea that there are at least two different dimensions of narcissism (i.e., grandiose vs. vulnerable; e.g., Dickinson & Pincus, 2003; Fossati et al., 2005; Miller & Campbell, 2008; Russ, Shedler, Bradley, & Westen, 2008; Wink, 1991). Cain, Pincus, & Ansell (2008) provided a detailed list of many of the terms that have been proffered for grandiose narcissism (e.g., malignant, overt, manipulative, phallic, egotistical, oblivious, exhibitionistic, psychopathic) and vulnerable narcissism (e.g., covert, hypervigilant, shy, craving, contact shunning, thinskinned). In general, grandiose narcissism is associated with traits such as immodesty, interpersonal dominance, self-absorption, and callous manipulativeness; grandiose narcissism also tends to be positively related to self-esteem and negatively related to psychological distress. Alternatively, vulnerable narcissism is associated with increased rates of psychological distress and negative emotions (e.g., depression, anxiety, shame) and low self-esteem; despite these traits, these individuals interact with others in an egocentric, hostile manner. We have argued elsewhere that any immodesty or grandiosity put forth by individuals high on vulnerable narcissism is likely to be a brittle faade that might be easily pierced (Miller & Campbell, 2008; Miller, Dir, et al., 2010). The extent to which these two dimensions can be found in the DSMIVTR conceptualization of
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NPD is debatable. Factor analyses of the NPD symptoms indicate that the DSMIVTR NPD criteria set is either entirely (Miller, Hoffman, Campbell & Pilkonis, 2008) or primarily (Fossati et al., 2005) consistent with the grandiose dimension of narcissism. The DSMIVTR text associated with the NPD diagnostic criteria, however, certainly discussed NPD in a manner suggestive of vulnerability and fragility (e.g., vulnerability in self-esteem makes individuals with Narcissistic Personality Disorder very sensitive to injury from criticism or defeat. Although they may not show it outwardly, criticism may haunt these individuals and may leave them feeling humiliated, degraded, hollow, and empty; American Psychiatric Association, 2000, p. 715). In addition, many self-report measures of NPD include questions that reference vulnerability and fragility when assessing NPD (see, e.g., Miller, Campbell, Pilkonis, & Morse, 2008). Ultimately, DSMIVTR NPD may be a blend of both grandiosity and vulnerability; Miller, Hoffman, et al. (2011) found that both grandiose and vulnerable narcissisms factors, derived from a factor analysis of three popular self-report measures of narcissism, manifested substantial correlations with a measure of DSMIVTR NPD (rs = .48 and .43, respectively). In the sections that follow, we examine the FFM trait correlates, theoretical and empirical, of DSMIVTR NPD and compare them with the correlates manifested by grandiose and vulnerable narcissism. THE FIVE-FACtOR MODEL AND NARCISSIStIC PERSONALItY DISORDER: PROtOtYpICALItY RAtINGS Of NARCISSIStIC PERSONALItY DISORDER Two sets of expert ratings have been developed in which researchers who had published on NPD (Lynam & Widiger, 2001) and clinicians (Samuel & Widiger, 2004) have been asked to rate the prototypical individual with NPD on the 30 facets of the FFM (see Table 9.1). In both studies, expert raters were asked to do the following: describe the prototypic case for one personality disorder on a 1 to 5 point scale, where 1 indicates that the prototypic

Narcissistic Personality Disorder and the Five-Factor Model

TABLE 9.1 Narcissistic Personality Disorder (NPD) and the Five-Factor Model (FFM)
FFM/Big Five Personality Domains and Traits Neuroticism Anxiety Angry hostility Depression Self-consciousness Impulsiveness Vulnerability Extraversion Warmth Gregariousness Assertiveness Activity Excitement Seeking Positive Emotions Openness Fantasy Aesthetics Feelings Actions Ideas Values Agreeableness Trust Straightforwardness Altruism Compliance Modesty Tender-mindedness Conscientiousness Competence Order Dutifulness Achievement striving Self-discipline Deliberation FFM NPD clinician FFM NPD meta-analysis Expert Ratingsa 2.74 2.33 4.08 2.42 1.50 3.17 2.92 3.51 1.42 3.83 4.67 3.67 4.17 3.33 3.18 3.75 3.25 1.92 4.08 2.92 2.67 1.40 1.42 1.83 1.00 1.58 1.08 1.50 2.81 3.25 2.92 2.42 3.92 2.08 2.25 .95* .81* Clinician Ratingsb 2.89 2.71 3.90 2.75 1.67 3.57 2.76 3.63 2.05 3.95 4.00 4.14 4.10 3.52 3.16 3.82 3.32 2.68 3.36 3.09 2.68 1.71 1.86 1.91 1.73 1.77 1.23 1.77 2.73 3.00 3.00 2.50 3.18 2.23 2.45 .87* NPD (MA)c .11 .02 .23 .03 .03 .14 .01 .09 .07 .04 .19 .09 .16 .02 .07 .11 .04 .05 .04 .07 .01 .37 .20 .31 .20 .26 .37 .17 .10 .01 .03 .10 .02 .09 .13

Note. FFM domain names are shown in boldface. Underlined data represent FFM facets thought to be low in the prototypical individual with NPD. Italicized data represent FFM facets thought to be high in the prototypical individual with NPD. MA = meta-analyzed effect sizes. Correlations at the bottom of the table represent the correlations among the three columns of data. aCompilation of ndings from Lynam and Widiger (2001). bCompilation of ndings from Samuel and Widiger (2004). cCompilation of ndings from Samuel and Widiger (2008b). *p < .01.

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person would be extremely low on the trait (i.e., lower than the average person), 2 indicates that the prototypic person would be low, 3 indicates that the person would be neither high nor low (i.e., does not differ from the average individual), 4 indicates that the prototypic person would be high on the trait, and 5 indicates that the prototypic person would be extremely high on that trait. (Lynam & Widiger, 2001, p. 403) The two sets of NPD ratings were very similar (the two proles were correlated at .95) and indicated that both researchers and clinicians viewed the prototypical individual with NPD as being high on traits of angry hostility, assertiveness, activity, and excitement seeking and low on traits of self-consciousness, warmth, trust, straightforwardness, altruism, compliance, modesty, and tendermindedness.1 For the most part, individuals with NPD might be described as disagreeable extraverts (Paulhus, 2001) because the traits deemed most prototypic stem from the domains of Extraversion and Agreeableness (with the exception of angry hostility [high] and self-consciousness [low], which are facets of Neuroticism). FIVE-FACtOR MODEL CORRELAtES Of NARCISSIStIC PERSONALItY DISORDER: RESULtS fROm SAmUEL AND WIDIGERS (2008B) MEtA-ANALYSIS Following in the footsteps of the domain-level analyses provided by Saulsman and Pages (2004) metaanalysis, Samuel and Widiger (2008b) meta-analyzed the relations between all DSMIVTR PDs and both the domains and facets of the FFM. The mean effect sizes for NPD are reported in Table 9.1. Overall, the prole of correlations manifested by NPD was strongly correlated with both the researcher and clinician FFM NPD proles, rs = .81 and 87, respectively. Samuel and Widiger reported effect sizes of |.20| or higher for the following FFM facets: angry hostil1

ity (positive), trust (negative), straightforwardness (negative), altruism (negative), compliance (negative), and modesty (negative). The primary difference between the empirical correlates derived from the Samuel and Widiger meta-analysis and the expert ratings was the lack of signicant empirical ndings for the facets of self-consciousness, assertiveness, activity, and excitement seeking. In general, the empirical correlates between measures of the FFM and NPD emphasized the antagonistic aspects associated with NPD more strongly than traits indicative of emotional resilience and interpersonal dominance that are central to the expert conceptualizations of the disorder. These meta-analytic data also contained signicant variance between NPD assessments that may explain some of the differences between these results and those from the prototype ratings. This variance might well reect the mixed conceptualization of NPD that is found in the eld (i.e., vulnerable and grandiose forms). GRANDIOSE AND VULNERABLE NARCISSISm We next explore the use of the FFM as a tool for delineating these two forms of narcissism.

Self-Reported Five-Factor Model Data

As noted earlier, NPD may be best conceptualized as a blend of two relatively distinct dimensions of narcissism: grandiose and vulnerable. Unfortunately, the recognition of these two dimensions has only recently gained signicant theoretical traction in the eld and empirical attention from the perspective of the FFM. In Table 9.2, we present the mean effect sizes for grandiose and vulnerable narcissism in relation to measures of the FFM. Measures of NPD were not included in the derivation of either the grandiose or vulnerable factors. Instead, grandiose narcissism was measured most commonly with the Narcissistic Personality Inventory (NPI; Raskin & Terry, 1988), whereas vulnerable narcissism was assessed with either the Hypersensitive Narcissism Scale (HSNS; Hendin & Cheek, 1997) or certain

 hroughout this chapter, we discuss correlations among FFM proles related to NPD, grandiose narcissism, and vulnerable narcissism. These corT relations involved correlating one column of data (e.g., research ratings of 30 facets of the FFM for NPD) with a second column of data (e.g., clinician ratings of 30 facets of the FFM for NPD). In some cases the data are prototypicality ratings made by experts; in other cases the data are correlations between measures of the FFM and some form of narcissism or NPD.

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TABLE 9.2 Relations Between Grandiose and Vulnerable Narcissism and the Five-Factor Model (FFM)
FFM domains and traits Neuroticism Anxiety Angry hostility Depression Self-consciousness Impulsiveness Vulnerability Extraversion Warmth Gregariousness Assertiveness Activity Excitement seeking Positive emotions Openness Fantasy Aesthetics Feelings Actions Ideas Values Agreeableness Trust Straightforwardness Altruism Compliance Modesty Tender-mindedness Conscientiousness Competence Order Dutifulness Achievement striving Self-discipline Deliberation FFM NPD research FFM NPD clinician FFM NPD MA Grandiose narcissism .17 .25 .19 .24 .32 .10 .26 .33 .09 .27 .53 .33 .35 .18 .14 .11 .06 .15 .13 .15 .04 .39 .10 .44 .15 .38 .62 .23 .09 .20 .05 .02 .24 .10 .14 .78* .82* .79* Vulnerable narcissism .58 .41 .45 .57 .54 .30 .45 .27 .24 .17 .25 .13 .02 .24 .07 .09 .04 .11 .16 .03 .02 .35 .38 .18 .18 .18 .10 .10 .16 .19 .03 .15 .12 .28 .09 .06 .10 .39

Note. FFM domain names and data are shown in bold. Correlations at the bottom of the table represent the correlations between the grandiose and vulnerable FFM proles presented in this table with the Lynam and Widiger (2001) research NPD ratings, Samuel and Widiger (2004) clinician NPD ratings, and NPD effect sizes from the Samuel and Widiger (2008b) meta-analysis. NPD = narcissistic personality disorder; MA = meta-analyzed effect sizes. Effect sizes for grandiose and vulnerable narcissism are from a meta-analytic review of relevant studies. Expert research proles for DSMIVTR personality disorders from Lynam and Widiger (2001). Clinician proles for DSMIVTR personality disorders from Samuel and Widiger (2004). Meta-analytic proles from Samuel and Widiger (2008b). *p .01.

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subscales from the Pathological Narcissism Inventory (PNI; Pincus et al., 2009), which includes subscales believed to be either grandiose (i.e., three subscales) or vulnerable (i.e., four subscales) in nature. The sets of correlations generated by grandiose and vulnerable narcissism scales and the FFM were unrelated (r = .25). This lack of agreement is easily discerned through an examination of the sets of correlations. Grandiose narcissism was most strongly correlated with Agreeableness (negatively) and Extraversion (positively), followed by small correlations with Neuroticism (negative) and Openness (positive). As in the earlier prototype data, individuals who score high on grandiose narcissism might be described as disagreeable extraverts (Paulhus, 2001). In contrast, vulnerable narcissism was most strongly correlated with Neuroticism (positively), Agreeableness (negatively), Extraversion (negatively), and Conscientiousness (negatively). In line with Paulhus description, individuals high on vulnerable narcissism might be better described as disagreeable neurotics. Indeed, from an FFM perspective, the two narcissism dimensions share only a negative relation with Agreeableness; even here, however, the two manifested differential relations at the facet level. Vulnerable narcissism was most strongly related to trust (r = .38), which was not a substantial correlate of grandiose narcissism (r = .10), whereas grandiose narcissism evinced its largest correlation with the facet of modesty (r = .62), which was not substantially related to vulnerable narcissism (r = .10). Even with regard to their one shared domain, individuals high on either of the two narcissism dimensions appear to behave antagonistically in different ways. We discuss this in greater detail later in the chapter. We next correlated the FFM proles generated by grandiose and vulnerable narcissism with the FFM proles provided in Table 9.1 (i.e., researcher ratings, clinician ratings, meta-analytically derived prole; see Table 9.2). The FFM correlates manifested by grandiose narcissism were signicantly related to both sets of expert ratings and metaanalytically derived correlates of NPD (rs ranged from .78 to .82); this was not the case for the FFM
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correlates of vulnerable narcissism (rs ranged from .06 to .39). The FFM correlates of vulnerable narcissism overlap, but to a smaller degree than grandiose narcissism, only with the meta-analytic FFM NPD prole, but the pattern was unrelated to the two expert-rated NPD proles.

Narcissism and Five-Factor Model Data Reports From Alternative Perspectives

The previous research on grandiose and vulnerable narcissism and the FFM was derived from a self-report perspective (i.e., self-report data on the FFM and narcissism). Recently, a few studies have examined these relations using alternative sources for the FFM data (see Table 9.3). Both Miller and Campbell (2008) and Miller, Dir, et al. (2010) reported correlations between grandiose and/or vulnerable narcissism and the FFM domains provided by parental reports. For the most part, the patterns of correlations are similar to those derived entirely from self-reports (e.g., data reported in Table 9.2) such that individuals who reported being high on grandiose narcissism were viewed by their parents as being higher in Extraversion and lower in Agreeableness and Neuroticism. Alternatively, individuals who reported being high on vulnerable narcissism were rated by their parents as being higher in Neuroticism and lower in Extraversion. Interestingly, the parental reports did not emphasize the interpersonal antagonism associated with vulnerable narcissism when using self-reported FFM traits. Miller, Hoffman, et al. (2011) also examined these relations using a thin slices approach (see Oltmanns, Friedman, Fiedler, & Turkheimer, 2004, for a more detailed overview of this approach) in which self-report scores on grandiose and vulnerable narcissism were correlated with strangers ratings of each individual on the FFM domains on the basis of viewing a 60-second video clip in which each participant answered the following question: What do you enjoy doing? As can be seen in Table 9.3, the same general pattern was found such that selfreport grandiose narcissism was primarily associated with stranger ratings of Extraversion (positive) and Neuroticism (negative), whereas self-report vulnerable narcissism was most associated with the reverse

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TABLE 9.3 Relations Between Grandiose and Vulnerable Narcissism and Alternative Perspectives of the Five-Factor Model (FFM)
Grandiose narcissism FFM Neuroticism Extraversion Openness Agreeableness Conscientiousness
aCompilation bCompilation

Vulnerable narcissism
b

Parent reports .15 .16 .06 .22 .06

Thin slices .25 .34 .10 .10 .13

Parent reportsc .32 .23 .07 .01 .00

Thin slicesb .16 .18 .07 .00 .11

of ndings from Miller and Campbell (2008) and Miller, Dir, et al. (2010). of ndings from Miller et al. (2011). cCompilation of ndings from Miller, Dir, et al. (2010).

pattern (negatively related to Extraversion, positively related to Neuroticism). It is noteworthy that neither narcissism dimension was associated with stranger ratings of Agreeableness. Grandiose narcissism, but not vulnerable narcissism, was also related to stranger ratings of likeability, attractiveness, and narcissism, which may have important implications for the social functioning associated with the two forms of narcissism. CONVERGENt AND DISCRImINANt VALIDItY Of NARCISSIStIC PERSONALItY DISORDER, GRANDIOSE NARCISSISm, AND VULNERABLE NARCISSISm IN COmpARISON WItH OtHER PERSONALItY DISORDERS Next, we examined the correlations between the trait proles of NPD (from the Samuel and Widiger, 2008b meta-analysis), grandiose and vulnerable narcissism (from Table 9.2), and expert prototypicality ratings of the remaining DSMIVTR PDs (Lynam & Widiger, 2001) and psychopathy (Miller, Lynam, Widiger, & Leukefeld, 2001). As seen in Table 9.4, the meta-analytically derived FFM NPD prole was signicantly positively correlated with expert ratings for all four Cluster B PDs and psychopathy, with the highest correlation with the expert rating for NPD. The FFM NPD prole was also signicantly negatively correlated with the dependent PD prole. The FFM prole for grandiose narcissism was signicantly positively related

to the expert ratings for psychopathy, NPD, antisocial, and histrionic PDs and signicantly negatively related with dependent, avoidant, and schizoid PDs. Finally, the FFM prole for vulnerable narcissism was signicantly positively correlated with expert ratings for borderline, schizotypal, avoidant, and paranoid PDs; importantly, this prole was uncorrelated with the expert ratings of NPD. Overall, the FFM proles for grandiose and vulnerable narcissism are quite different with regard to the proles generated by PD researchers for other PDs. Grandiose narcissism appears to manifest the strongest discriminant validity because it manifested signicant positive correlations only with near neighbors such as psychopathy and antisocial PD, whereas vulnerable narcissism was uncorrelated with expert ratings of NPD and was most strongly correlated with the prototypical prole associated with borderline PD. This latter nding is consistent with previous work suggesting a substantial link between vulnerable narcissism and borderline PD with regard to etiological events (e.g., abuse, maltreatment), attachment styles, personality traits, and behavioral outcomes (Dickinson & Pincus, 2003; Miller, Dir, et al., 2010). The FFM NPD prole generated a pattern of correlations with other PDs that was more consistent with grandiose narcissism, although one again nds evidence supportive of the idea that NPD blends both grandiose and vulnerable dimensions because the meta-analytically derived FFM NPD prole was strongly related to expert ratings of FFM NPD and psychopathy (consistent with
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TABLE 9.4 Prole Correlations of Narcissism Personality Disorder (NPD), Grandiose and Vulnerable Narcissism, and Five-Factor Model (FFM) Personality Disorders
NPD meta-analytic FFM personality disorders Cluster A Paranoid Schizoid Schizotypal Cluster B Antisocial Borderline Histrionic Narcissistic Cluster C Avoidant Dependent  Obsessive-compulsive personality disorder Non-DSMIVTR personality disorder psychopathy proles .40 .34 .05 .78* .68* .56* .81* .39 .65* .29 .76* Grandiose narcissism .09 .57* .45 .69* .22 .51* .74* .79* .22 .82* Vulnerable narcissism .53* .30 .68* .12 .71* .03 .53* .19 .06 .09

Note. Correlations between grandiose and vulnerable narcissism with narcissistic proles are reported in Table 9.2. Expert research proles for Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision; DSMIVTR) personality disorders use data from Lynam and Widiger (2001) or from Miller, Lynam, Widiger, and Leukefeld (2001). Meta-analytic proles from Samuel and Widiger (2008b). *p .01.

grandiose narcissism) and FFM borderline PD (consistent with vulnerable narcissism). UNDERStANDING GRANDIOSE AND VULNERABLE NARCISSISm: LESSONS FROm tHE FIVE-FACtOR MODEL As reviewed previously, there is compelling evidence that grandiose and vulnerable narcissism are two distinct dimensions of narcissism that are intermingled to some degree in the DSMIVTR conceptualization of NPD. We believe that this commingling has caused substantial problems for the eld because there is a lack of agreement regarding the basic features of NPD (e.g., Do narcissistic individuals have high or low self-esteem? Are they high or low on Neuroticism?). Ultimately, we believe that grandiose and vulnerable narcissism overlap only to the degree that individuals with high scores on either tend to interact with others in a hostile, disagreeable manner (i.e., low
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Agreeableness). Even here, these forms of narcissism are different. Despite relatively similarly sized and valenced correlations with this FFM domain, the two narcissism dimensions manifest substantially different correlations at the more specic facet level. As noted in Table 9.2, individuals high on vulnerable narcissism may behave antagonistically, but we believe this is driven by the existence of angry, distrustful cognitive schemas that are suggestive of a hostile attribution bias. Hostile attribution biases are associated with environmental events such as parental abuse and neglect (e.g., Dodge, Pettit, Bates, & Valente, 1995) that are known correlates of vulnerable but not grandiose narcissism (Miller, Dir, et al., 2010). Individuals high on vulnerable narcissism also manifest a fearful attachment style indicative of both anxiety and avoidance of intimate relationshipswhich is consistent with their higher scores on neuroticism, introversion, and antagonism (Miller, Dir, et al., 2010; Miller et al., 2011). In

Narcissistic Personality Disorder and the Five-Factor Model

addition, the narcissism associated with vulnerable narcissism may be more reective of neediness and egocentricity than immodesty or grandiosity. These ndings are consistent with the fact that vulnerable narcissism appears to be a very near neighbor of borderline PD; in fact, we have argued elsewhere (Miller, Dir, et al., 2010) that the two are part of a vulnerable dark triad (with the third point being Factor 2 psychopathy). Conversely, grandiose narcissism manifests a limited correlation with distrust and is more strongly correlated with Agreeableness facets such as immodesty, noncompliance, and manipulativeness. Interestingly, two of these facetsnoncompliance and manipulativenessare among the strongest FFM correlates of antisocial behavior (Miller, Lynam, & Leukefeld, 2003), and all three are central components of psychopathy (Lynam & Widiger, 2007). This is consistent with the empirical evidence suggesting that grandiose narcissism is a stronger correlate of externalizing behaviors, whereas vulnerable narcissism is a stronger correlate of internalizing symptoms. This is also consistent with the notion that grandiose narcissism is conceived of as being a core member of the dark triad that also includes psychopathy and Machiavellianism (Paulhus & Williams, 2002). Unlike vulnerable narcissism, there is no evidence supporting a link between traumatic events (e.g., childhood abuse) or problematic parenting (e.g., coldness, intrusiveness) in relation to grandiose narcissism (Horton, Bleau, & Drwecki, 2006; Miller, Dir, et al., 2010; Miller et al., 2011). These individuals do not appear to have problems with trusting or developing quasi-normal attachments toward others, probably because they are more likely to cause psychological distress to signicant others (Miller et al., 2007) than experience it themselves (Campbell, Foster, & Finkel, 2002). We believe that individuals high on either narcissism dimension manifest different forms of antagonistic behavior (e.g., vulnerable: suspiciousness, coldness; grandiose: self-enhancement and bragging, lying and conning, oppositionality) for different reasons (vulnerable: antagonism that is reactive to the environment and driven by negative affect; grandiose: antagonism that is more instrumental in nature in
2

the pursuit of dominance and enhanced status). Again, an examination of the facet-level FFM correlates of these narcissism dimensions provides a more nuanced and informative picture of these two narcissism constructs than is available if one works only at the higher order domain level. THE FIVE-FACtOR MODEL AS A TOOL fOR EXpLICAtING tHE CONtENt Of ASSESSmENt MEASURES RELAtED tO NARCISSISm We believe that measures of the FFM also provide a very useful means of testing the construct validity of assessment instruments related to narcissism. That is, a simple correlation matrix between measures of narcissism and the FFM domains and/or facets can provide important information regarding whether the narcissism scale is yielding a construct that is generally in line with its hypothesized nomological network. For instance, if one believes that grandiose narcissism should be related to traits such as immodesty and dominance, one should nd correlations with Agreeableness (negative) and Extraversion (positive), respectively. Alternatively, if one believes that vulnerable narcissism is related to traits such as distrust, noncompliance, shyness, and negative emotionality, one should nd correlations with Agreeableness (negative), Extraversion (negative), and Neuroticism (positive). In Table 9.5 we present data of this sort in the form of correlations between the domains from the Revised NEO Personality Inventory (Costa & McCrae, 1992) and three popular measures of narcissism (NPI, PNI, HSNS) and two traits believed to be related to the conceptualization of narcissism, self-esteem and psychological entitlement.2 It is clear that three of the ve putative measure of grandiose narcissism manifest a positive relation with Extraversion and a negative correlation with Agreeableness (i.e., NPI Leadership/Authority; NPI Exhibitionism/Entitlement; PNI Exploitativeness), as one would expect. Alternatively, the PNI scales of Grandiose Fantasies and Self-Sacricing Self-Enhancement manifest positive correlations

The data presented in Table 9.5 are from a single data set discussed in Miller et al. (2011).

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TABLE 9.5 The Five-Factor Model as a Tool for Discovering the Content of Narcissism-Related Scales
Domain Scale Grandiose narcissism NPI Leadership/Authority NPI Exhibitionism/Entitlement PNI Exploitativeness PNI Grandiose Fantasies PNI Self-Sacricing Self-Enhancement Vulnerable narcissism PNI Hiding the Self PNI Contingent Self-Esteem PNI Devaluing PNI Entitlement Rage Hypersensitive Narcissism Scale Rosenberg Self-Esteem Scale Psychological Entitlement Scale N .26* .15 .09 .19* .22* E .45* .49* .23* .12 .26* .20* .17* .23* .07 .24* .39* .07 O .01 .17* .22* .29* .26* A .46* .41* .49* .15 .03 .23* .00 .15 .38* .27* .01 .29* C .13 .06 .01 .05 .15 .04 .15 .11 .20* .13 .35* .10

.30* .67* .51* .44* .58* .61* .03

.07 .04 .03 .07 .07 .06 .04

Note. N = Neuroticism; E = Extraversion; O = Openness; A = Agreeableness; C = Conscientiousness; NPI = Narcissistic Personality Inventory; PNI = Pathological Narcissism Inventory. Compilation of data from Miller et al. (2011). *p .01.

with Neuroticism and null correlations with Agreeableness; as such, it is less clear whether these scales are capturing traits consistent with notions of grandiose narcissism. Conversely, almost all of the putative measures of vulnerable narcissism manifested expected positive relations with Neuroticism and negative relations with Agreeableness and Extraversion. We also present data related to selfesteem and psychological entitlement because both constructs are theoretically linked with narcissism. In general, the most popular measure of self-esteem (i.e., Rosenberg Self-Esteem Scale; Rosenberg, 1965) typically manifests positive correlations with grandiose narcissism and negative correlations with vulnerable narcissism (Miller & Campbell, 2008; Miller, Dir, et al., 2010; Pincus et al., 2009). This overlap is most likely due to the fact that both grandiose narcissism and self-esteem manifest similar patterns of relations with Neuroticism and Extraversion, although self-esteem is unrelated to Agreeableness. This pattern is the opposite of the pattern typically manifested by vulnerable narcissism scales. Psychological entitlement, which is
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related to both grandiose and vulnerable narcissism (e.g., Miller et al., 2011), seems to be almost a pure measure of interpersonal antagonism (see Pryor, Miller, & Gaughan, 2008), which explains its overlap with both forms of narcissism. USING FIVE-FACtOR MODEL NARCISSISm PERSONALItY DISORDER AND NARCISSISm RESEARCH tO ENSURE CONtENt VALIDItY Of tHE DSM5 DImENSIONAL TRAIt MODEL As discussed at the outset of this chapter, the initial proposal for the DSM5 (http://www.dsm5.org) suggested that NPD no longer be an ofcially recognized PD type, deleted along with four other DSMIVTR PD diagnoses (i.e., paranoid, schizoid, histrionic, and dependent). Many viewed the rationale for such a deletion to be weak (Miller, Widiger, & Campbell, 2010; Ronningstam, 2011; Widiger, 2011) because it appeared to be based on the DSM5 Personality and Personality Disorders Work Groups sense that NPD is either or both less prevalent and less impairing

Narcissistic Personality Disorder and the Five-Factor Model

than the ve PDs set for retention (Skodol, 2010). However, in response to these critiques, NPD was returned to the table (Skodol, in press). The DSM5 NPD even appears to be shifting toward the FFM conceptualization by relying in large part on maladaptive personality traits for its diagnosis (Skodol, in press). The DSM5 is likely to include a dimensional trait model consisting of ve domains (i.e., Negative Emotionality, Detachment, Antagonism, Disinhibition, Peculiarity [or Psychoticism]), which align closely with the FFM, and 25 underlying traits, the latter providing the bulk of the diagnostic criteria for each respective personality type. The DSM5 trait model has much in common with the FFM, although it differs in several important ways, some of which may have an important effect on its content validity for the assessment of narcissism-related constructs. Unlike the FFM, the DSM5 trait dimensions will be unipolar rather than bipolar. That is, the DSM5 model will not be able to assess content related to pathologically high levels of domains such as Extraversion or Agreeableness or pathologically low levels of Neuroticism. This is important because evidence suggests that grandiose narcissism is related to high levels of Extraversion (e.g., dominance, reward seeking, activity) and low levels of Neuroticism (e.g., glib charm). These decisions will have signicant ramications regarding the ability of this new personality model to capture all traits relevant to narcissism and NPD. Given the substantial focus on antagonism and negative emotionality in the DSM5 model, one would suspect that it will be able to capture constructs such as NPD and vulnerable narcissism, albeit even within the domain of antagonism the coverage is likely inadequate (i.e., NPD is currently being diagnosed by just two traits, grandiosity and attention seeking; Skodol, in press). Unfortunately, the DSM5 will likely be missing content that is quite important to the assessment of grandiose narcissism, notably traits indicative of pathologically high Extraversion. This is problematic because the high-Extraversion components of grandiose narcissism are partially responsible for the externalizing behaviors associated with this construct (e.g., Foster & Trimm, 2008; Miller, Campbell, et al., 2009).

CONCLUSION NPD is clearly grounded in basic personality traits that are well described with the FFM. It is also evident that there are two dimensions of narcissism, grandiose and vulnerable, that manifest signicantly divergent personality proles when examined from the perspective of the FFM. Given the growing recognition of the importance of accounting for these different narcissism dimensions (e.g., Cain et al., 2008; Miller & Campbell, 2008; Russ et al., 2008), because of their distinct etiologies, trait proles, and clinically relevant behaviors and outcomes (e.g., Miller, Dir, et al., 2010; Pincus et al., 2009), it is unfortunate that the DSM5 Personality and Personality Disorders Work Group had (seemingly) not availed themselves fully of this empirical literature. It is our belief that the literature reviewed in the current chapter, based on signicant amounts of empirical data grounded in the FFM, could be quite helpful in informing the validity of the soon to be released DSM5 trait model, including its ability to describe a variety of different aspects and conceptualizations of narcissism.

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