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Articles

Childhood emotional neglect and depressive and anxiety symptoms among mental health outpatients: the mediating roles of narcissistic vulnerability and shame

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Pages 24-32 | Received 30 Apr 2020, Accepted 08 Sep 2020, Published online: 21 Oct 2020

References

  • Bachar, E., Canetti, L., Hadar, H., Baruch, J., Dor, Y., & Freedman, S. (2015). The role of narcissistic vulnerability in predicting adult posttraumatic symptoms from childhood sexual abuse. Child Psychiatry & Human Development, 46, 800–809.
  • Besser, A., & Priel, B. (2010). Grandiose narcissism versus vulnerable narcissism in threatening situations: Emotional reactions to achievement failure and interpersonal rejection. Journal of Social and Clinical Psychology, 29(8), 874–902. https://doi.org/10.1521/jscp.2010.29.8.874
  • Bilevicius, E., Neufeld, D. C., Single, A., Foot, M., Ellery, M., Keough, M. T., & Johnson, E. A. (2019). Vulnerable narcissism and addiction: the mediating role of shame. Addictive Behaviors, 92, 115–121. https://doi.org/10.1016/j.addbeh.2018.12.035
  • Brim, O. G., Ryff, C. D., & Kessler, R. C. (2004). The MIDUS national survey: An overview. In O. G. Brim, C. D. Ryff, & R. C. Kessler (Eds.), The John D. and Catherine T. MacArthur foundation series on mental health and development. Studies on successful midlife development. How healthy are we?: A national study of well-being at midlife (p. 1–34). University of Chicago Press.
  • Brown, A. A., & Brunell, A. B. (2017). The “modest mask”? An investigation of vulnerable narcissists’ implicit self-esteem. Personality and Individual Differences, 119, 160–167. https://doi.org/10.1016/j.paid.2017.07.020
  • Brown, A. A., Freis, S. D., Carroll, P. J., & Arkin, R. M. (2016). Perceived agency mediates the link between the narcissistic subtypes and self-esteem. Personality and Individual Differences, 90, 124–129. https://doi.org/10.1016/j.paid.2015.10.055
  • Cacioppo, S., Grippo, A. J., London, S., Goossens, L., & Cacioppo, J. T. (2015). Loneliness: Clinical import and interventions. Perspectives on Psychological Science: A Journal of the Association for Psychological Science, 10(2), 238–249. https://doi.org/10.1177/1745691615570616
  • Cain, N. M., Pincus, A. L., & Ansell, E. B. (2008). Narcissism at the crossroads: Phenotypic description of pathological narcissism across clinical theory, social/personality psychology, and psychiatric diagnosis. Clinical Psychology Review, 28(4), 638–656. https://doi.org/10.1016/j.cpr.2007.09.006
  • Casale, S., Fioravanti, G., Rugai, L., Flett, G. L., & Hewitt, P. L. (2020). What lies beyond the superordinate trait perfectionism factors? The Perfectionistic Self-Presentation and Perfectionism Cognitions Inventory versus the Big Three Perfectionism Scale in predicting depression and social anxiety. Journal of Personality Assessment, 102(3), 370–379. https://doi.org/10.1080/00223891.2019.1573429
  • Crick, N. R., & Dodge, K. A. (1994). A review and reformulation of social information-processing mechanisms in children’s social adjustment. Psychological Bulletin, 115(1), 74–101. https://doi.org/10.1037/0033-2909.115.1.74
  • Dawood, S., & Pincus, A. L. (2018). Pathological narcissism and the severity, variability, and instability of depressive symptoms. Personality Disorders: Theory, Research, and Treatment, 9(2), 144–154. https://doi.org/10.1037/per0000239
  • Dickinson, K. A., & Pincus, A. L. (2003). Interpersonal analysis of grandiose and vulnerable narcissism. Journal of Personality Disorders, 17(3), 188–207. https://doi.org/10.1521/pedi.17.3.188.22146
  • Ensink, K., Chretien, S., Normandin, L., Begin, M., Daigle, D., & Fonagy, P. (2018). Pathological narcissism in adolescents: Relationships with childhood maltreatment and internalizing and externalizing difficulties. Adolescent Psychiatry, 7(4), 300–314. https://doi.org/10.2174/2210676608666180119165731
  • Erkoreka, L., & Navarro, B. (2017). Vulnerable narcissism is associated with severity of depressive symptoms in dysthymic patients. Psychiatry Research, 257, 265–269. https://doi.org/10.1016/j.psychres.2017.07.061
  • Fernie, B. A., Fung, A., & Nikčević, A. V. (2016). Different coping strategies amongst individuals with grandiose and vulnerable narcissistic traits. Journal of Affective Disorders, 205, 301–305. https://doi.org/10.1016/j.jad.2016.08.009
  • Fossati, A., Borroni, S., Grazioli, F., Dornetti, L., Marcassoli, I., Maffei, C., & Cheek, J. (2009). Tracking the hypersensitive dimension in narcissism: Reliability and validity of the Hypersensitive Narcissism Scale. Personality and Mental Health, 3(4), 235–247. https://doi.org/10.1002/pmh.92
  • Freis, S. D., Brown, A. A., Carroll, P. J., & Arkin, R. M. (2015). Shame, rage, and unsuccessful motivated reasoning in vulnerable narcissism. Journal of Social and Clinical Psychology, 34(10), 877–895. https://doi.org/10.1521/jscp.2015.34.10.877
  • Fritz, M. S., & MacKinnon, D. P. (2007). Required sample size to detect the mediated effect. Psychological Science, 18(3), 233–239.
  • Gore, W. L., & Widiger, T. A. (2016). Fluctuation between grandiose and vulnerable narcissism. Personality Disorders: Theory, Research, and Treatment, 7(4), 363–371. https://doi.org/10.1037/per0000181
  • Hansen-Brown, A. A., & Freis, S. D. (2019). Assuming the worst: Hostile attribution bias in vulnerable narcissists. Self and Identity. Advance online publication. https://doi.org/10.1080/15298868.2019.1609574
  • Harder, D. W., Rockart, L., & Cutler, L. (1993). Additional validity evidence for the harder personal feelings questionnaire‐2 (PFQ2): A measure of shame and guilt proneness. Journal of Clinical Psychology, 49(3), 345–348. https://doi.org/10.1002/1097-4679(199305)49:3<345::AID-JCLP2270490307>3.0.CO;2-Y
  • Harder, D. H., & Zalma, A. (1990). Two promising shame and guilt scales: A construct validity comparison. Journal of Personality Assessment, 55(3–4), 729–745. https://doi.org/10.1080/00223891.1990.9674108
  • Hayes, A. F. (2018). Introduction to mediation, moderation, and conditional process analysis second edition: A regression-based approach. 2nd ed. Guilford Press.
  • Hendin, H. M., & Cheek, J. M. (1997). Assessing hypersensitive narcissism: A re-examination of Murray’s Narcism Scale. Journal of Research in Personality, 31, 588–599.
  • Huprich, S. K., Nelson, S., Sohnleitner, A., Lengu, K., Shankar, S., & Rexer, K. (2018). Are malignant self‐regard and vulnerable narcissism different constructs. Journal of Clinical Psychology, 74(9), 1556–1569. https://doi.org/10.1002/jclp.22599
  • Huxley, E., & Bizumic, B. (2017). Parental invalidation and the development of narcissism. The Journal of Psychology, 151(2), 130–147. https://doi.org/10.1080/00223980.2016.1248807
  • Jakšić, N., Marčinko, D., Skočić Hanzek, M., Rebernjak, B., & Ogrodniczuk, J. S. (2017). Experience of shame mediates the relationship between pathological narcissism and suicidal ideation in psychiatric outpatients. Journal of Clinical Psychology, 73, 1670–1681.
  • Kamphuis, J. H., & Finn, S. E. (2019). Therapeutic assessment in personality disorders: Toward the restoration of epistemic trust. Journal of Personality Assessment, 101(6), 662–674. https://doi.org/10.1080/00223891.2018.1476360
  • Kealy, D. (2013). The containing selfobject: Reflections about relational process in clinical practice. Journal of Social Work Practice, 27(3), 319–331. https://doi.org/10.1080/02650533.2013.818946
  • Kealy, D., Goodman, G., Rasmussen, B., Weideman, R., & Ogrodniczuk, J. S. (2017). Therapists’ perspectives on optimal treatment for pathological narcissism. Personality Disorders: Theory, Research, and Treatment, 8(1), 35–45. https://doi.org/10.1037/per0000164
  • Kealy, D., Laverdière, O., & Pincus, A. L. (2019). Pathological narcissism and depression: The mediating role of impaired emotional processing. Journal of Nervous and Mental Disease, 208(2):161–164.
  • Kealy, D., & Ogrodniczuk, J. S. (2014). Pathological narcissism and the obstruction of love. Psychodynamic Psychiatry, 42(1), 101–119. https://doi.org/10.1521/pdps.2014.42.1.101
  • Kealy, D., Rice, S. M., Ogrodniczuk, J. S., & Spidel, A. (2018). Childhood trauma and somatic symptoms among psychiatric outpatients: Investigating the role of shame and guilt. Psychiatry Research, 268, 169–174. https://doi.org/10.1016/j.psychres.2018.06.072
  • Kealy, D., Sierra-Hernandez, C. A., & Ogrodniczuk, J. S. (2016). Childhood emotional support and borderline personality features in a sample of Canadian psychiatric outpatients. International Journal of Social Psychiatry, 62(5), 452–454. https://doi.org/10.1177/0020764016650214
  • Kealy, D., Tsai, M., & Ogrodniczuk, J. S. (2012). Depressive tendencies and pathological narcissism among psychiatric outpatients. Psychiatry Research, 196(1), 157–159. https://doi.org/10.1016/j.psychres.2011.08.023
  • Keene, A. C., & Epps, J. (2016). Childhood physical abuse and aggression: Shame and narcissistic vulnerability. Child Abuse & Neglect, 51, 276–283. https://doi.org/10.1016/j.chiabu.2015.09.012
  • Kernberg, O. F. (1975). Borderline conditions and pathological narcissism. Jason Aronson.
  • Kohut, H. (1971). The analysis of the self. International Universities Press.
  • Kohut, H., & Wolf, E. S. (1978). The disorders of the self and their treatment: An outline. International Journal of Psychoanalysis, 59, 413–425.
  • Kramer, U., Pascual‐Leone, A., Rohde, K. B., & Sachse, R. (2018). The role of shame and self-compassion in psychotherapy for narcissistic personality disorder: An exploratory study. Clinical Psychology & Psychotherapy, 25(2), 272–282. https://doi.org/10.1002/cpp.2160
  • Krizan, Z., & Johar, O. (2012). Envy divides the two faces of narcissism. Journal of Personality, 80(5), 1415–1451. https://doi.org/10.1111/j.1467-6494.2012.00767.x
  • Krizan, Z., & Johar, O. (2015). Narcissistic rage revisited. Journal of Personality and Social Psychology, 108(5), 784–801. https://doi.org/10.1037/pspp0000013
  • Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
  • Lamkin, J., Clifton, A., Campbell, W. K., & Miller, J. D. (2014). An examination of the perceptions of social network characteristics associated with grandiose and vulnerable narcissism. Personality Disorders: Theory, Research, and Treatment, 5(2), 137–145. https://doi.org/10.1037/per0000024
  • Leaviss, J., & Uttley, L. (2015). Psychotherapeutic benefits of compassion-focused therapy: An early systematic review. Psychological Medicine, 45(5), 927–945. https://doi.org/10.1017/S0033291714002141
  • Levis, B., Benedetti, A., & Thombs, B. D. (2019). Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: Individual participant data meta-analysis. BMJ, 365, 1476. https://doi.org/10.1136/bmj.l1476
  • Liu, R. T. (2017). Childhood adversities and depression in adulthood: Current findings and future directions. Clinical Psychology: A Publication of the Division of Clinical Psychology of the American Psychological Association, 24(2), 140–153. https://doi.org/10.1111/cpsp.12190
  • Marčinko, D., Jakšić, N., Ivezić, E., Skočić, M., Surányi, Z., Lončar, M., Franić, T., & Jakovljević, M. (2014). Pathological narcissism and depressive symptoms in psychiatric outpatients: Mediating role of dysfunctional attitudes. Journal of Clinical Psychology, 70(4), 341–352. https://doi.org/10.1002/jclp.22033
  • Masterson, J. F. (1993). The emerging self: A developmental, self, and object relations approach to the treatment of the closet narcissistic disorder of the self. Brunner/Mazel.
  • Mechanic, K. L., & Barry, C. T. (2015). Adolescent grandiose and vulnerable narcissism: Associations with perceived parenting practices. Journal of Child and Family Studies, 24(5), 1510–1518. https://doi.org/10.1007/s10826-014-9956-x
  • Miller, J. D., Gentile, B., & Campbell, W. K. (2013). A test of the construct validity of the Five-factor narcissism inventory. Journal of Personality Assessment, 95(4), 377–387. https://doi.org/10.1080/00223891.2012.742903
  • Miller, J. D., Hoffman, B. J., Gaughan, E. T., Gentile, B., Maples, J., & Campbell, W. K. (2011). Grandiose and vulnerable narcissism: A nomological network analysis. Journal of Personality, 79(5), 1013–1042.
  • Miller, J. D., Lynam, D. R., Hyatt, C. S., & Campbell, W. K. (2017). Controversies in narcissism. Annual Review of Clinical Psychology, 13, 291–315. https://doi.org/10.1146/annurev-clinpsy-032816-045244
  • Miller, J. D., Lynam, D. R., Vize, C., Crowe, M., Sleep, C., Maples‐Keller, J. L., Few, L. R., & Campbell, W. K. (2018). Vulnerable narcissism is (mostly) a disorder of neuroticism. Journal of Personality, 86(2), 186–199. https://doi.org/10.1111/jopy.12303
  • Morf, C. C., Schürch, E., Küfner, A., Siegrist, P., Vater, A., Back, M., Mestel, R., & Schröder-Abé, M. (2017). Expanding the nomological net of the pathological narcissism inventory. German validation and extension in a clinical inpatient sample. Assessment, 24(4), 419–443. https://doi.org/10.1177/1073191115627010
  • Morrison, A. P. (2011). The psychodynamics of shame. In R. L. Dearing & J. P. Tangney (Eds.), Shame in the therapy hour (pp. 23–43). American Psychological Association.
  • Nakash, O., & Nagar, M. (2018). Assessment of diagnostic information and quality of working alliance with clients diagnosed with personality disorders during the mental health intake. Journal of Mental Health, 27(4), 314–321. https://doi.org/10.1080/09638237.2017.1294740
  • Otway, L. J., & Vignoles, V. L. (2006). Narcissism and childhood recollections: A quantitative test of psychoanalytic predictions. Personality & Social Psychology Bulletin, 32(1), 104–116. https://doi.org/10.1177/0146167205279907
  • Pincus, A. L., Cain, N. M., & Wright, A. G. (2014). Narcissistic grandiosity and narcissistic vulnerability in psychotherapy. Personality Disorders: Theory, Research, and Treatment, 5(4), 439–443. https://doi.org/10.1037/per0000031
  • Pincus, A. L., & Lukowitsky, M. R. (2010). Pathological narcissism and narcissistic personality disorder. Annual Review of Clinical Psychology, 6, 421–446.
  • Plummer, F., Manea, L., Trepel, D., & McMillan, D. (2016). Screening for anxiety disorders with the GAD-7 and GAD-2: A systematic review and diagnostic metaanalysis. General Hospital Psychiatry, 39, 24–31. https://doi.org/10.1016/j.genhosppsych.2015.11.005
  • Rice, S. M., Kealy, D., Oliffe, J. L., & Ogrodniczuk, J. S. (2018). Male-type depression symptoms linked to broader psychopathology. Journal of Affective Disorders, 235, 523–524. https://doi.org/10.1016/j.jad.2018.04.062
  • Rice, S. M., Kealy, D., Oliffe, J. L., Treeby, M. S., & Ogrodniczuk, J. S. (2020). Shame and guilt mediate the effects of alexithymia on distress and suicide-related behaviours among men. Psychology, Health & Medicine, 25(1), 17–24. https://doi.org/10.1080/13548506.2019.1601747
  • Ronningstam, E. (2016). Pathological narcissism and narcissistic personality disorder: Recent research and clinical implications. Current Behavioral Neuroscience Reports, 3(1), 34–42. https://doi.org/10.1007/s40473-016-0060-y
  • Rüsch, N., Corrigan, P. W., Bohus, M., Jacob, G. A., Brueck, R., & Lieb, K. (2007). Measuring shame and guilt by self-report questionnaires: A validation study. Psychiatry Research, 150(3), 313–325. https://doi.org/10.1016/j.psychres.2006.04.018
  • Salokangas, R. K. R., Schultze-Lutter, F., Schmidt, S. J., Pesonen, H., Luutonen, S., Patterson, P., Graf von Reventlow, H., Heinimaa, M., From, T., & Hietala, J. (2020). Childhood physical abuse and emotional neglect are specifically associated with adult mental disorders. Journal of Mental Health, 29(4), 376–384. https://doi.org/10.1080/09638237.2018.1521940
  • Sandage, S. J., Jankowski, P. J., Bissonette, C. D., & Paine, D. R. (2017). Vulnerable narcissism, forgiveness, humility, and depression: Mediator effects for differentiation of self. Psychoanalytic Psychology, 34(3), 300–310. https://doi.org/10.1037/pap0000042
  • Schimmenti, A., & Bifulco, A. (2015). Linking lack of care in childhood to anxiety disorders in emerging adulthood: The role of attachment styles. Child and Adolescent Mental Health, 20(1), 41–48. https://doi.org/10.1111/camh.12051
  • Shaw, B. A., Krause, N., Chatters, L. M., Connell, C. M., & Ingersoll-Dayton, B. (2004). Emotional support from parents early in life, aging, and health. Psychology and Aging, 19(1), 4–12. https://doi.org/10.1037/0882-7974.19.1.4
  • Shilkret, C. J. (2006). Endangered by interpretations: Treatment by attitude of the narcissistically vulnerable patient. Psychoanalytic Psychology, 23(1), 30–42. https://doi.org/10.1037/0736-9735.23.1.30
  • Spinhoven, P., Elzinga, B. M., Van Hemert, A. M., de Rooij, M., & Penninx, B. W. (2016). Childhood maltreatment, maladaptive personality types and level and course of psychological distress: A six-year longitudinal study. Journal of Affective Disorders, 191, 100–108. https://doi.org/10.1016/j.jad.2015.11.036
  • Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092
  • Thomas, K. M., Wright, A. G., Lukowitsky, M. R., Donnellan, M. B., & Hopwood, C. J. (2012). Evidence for the criterion validity and clinical utility of the Pathological Narcissism Inventory. Assessment, 19(2), 135–145. https://doi.org/10.1177/1073191112436664
  • Tritt, S. M., Ryder, A. G., Ring, A. J., & Pincus, A. L. (2010). Pathological narcissism and the depressive temperament. Journal of Affective Disorders, 122(3), 280–284. https://doi.org/10.1016/j.jad.2009.09.006
  • Wolf, E. S. (2002). Treating the self: Elements of clinical self psychology. Guilford Press.
  • Wright, A. G., & Edershile, E. A. (2018). Issues resolved and unresolved in pathological narcissism. Current Opinion in Psychology, 21, 74–79. https://doi.org/10.1016/j.copsyc.2017.10.001
  • Zeigler-Hill, V., Clark, C. B., & Pickard, J. D. (2008). Narcissistic subtypes and contingent self-esteem: Do all narcissists base their self-esteem on the same domains? Journal of Personality, 76(4), 753–774. https://doi.org/10.1111/j.1467-6494.2008.00503.x
  • Zeigler-Hill, V., Green, B. A., Arnau, R. C., Sisemore, T. B., & Myers, E. M. (2011). Trouble ahead, trouble behind: Narcissism and early maladaptive schemas. Journal of Behavior Therapy and Experimental Psychiatry, 42(1), 96–103. https://doi.org/10.1016/j.jbtep.2010.07.004

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