When Is Narcissism a Disorder?

Narcissistic Personality as Category or Continuum

© Tami Port

When is narcissism a mental illness? New research indicates that it is all a matter of degree.
What’s the distinction between “normal” narcissism and psychological disorder? In a new study appearing in the May issue of Personality and Individual Differences, two American psychologists examined the contrasting perspectives on narcissism held by social psychologists and clinical psychologists.

Social Psychology and Clinical Psychology
Social psychologists are scientists who study people in their relationship to others and to society as a whole; the discipline where mental state meets social situation.

Clinical psychology focuses on diagnosis and treatment of emotional and behavioral disorders. These mental health clinicians usually have a PhD and work in a medical setting with psychiatrists and other physicians.

Different Perspectives on Narcissism
There are many similarities to how clinical and social psychologists view narcissism, but there is one very important difference. Clinical psychologists classify narcissism as a personality disorder. So, according to their diagnostic criteria, you either have Narcissistic Personality Disorder (NPD) or you don’t.

Unlike clinicians, social psychologists generally view narcissism as a spectrum or dimension of personality, not as a category. They do not believe that there is a specific point within the continuum of narcissism where ‘normal’ suddenly becomes ‘narcissism’.

New Research on Narcissism
In their recently published research, Foster and Campbell (2007) measured narcissism using the Narcissistic Personality Inventory (NPI), an assessment tool often employed for evaluating narcissistic traits in social psychological research.

What Is the NPI?

The Narcissistic Personality Inventory is a forced-choice questionnaire that uses paired statements to assess narcissism in nonclinical, adult populations. In other words, the NPI is used for research on the general public, not necessarily mental health patients.

Although designed to measure narcissistic traits in the general population, the NPI was designed based on the clinical definition of narcissism found in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This diagnostic reference is published by the American Psychiatric Association (APA), and is the manual that mental health professionals most commonly use to diagnose narcissism and other mental disorders.

Because the purpose of the DSM is to diagnose mental illness, the various disorders are presented as specific, discrete categories. However, in the creation of the NPI, this clinical definition of narcissism was used with the assumption that people who don’t have the psychological disorder of narcissism can still display narcissistic traits.

What’s the Difference between Narcissism and Normal?

So is narcissism a distinct disorder, or is it a dimension of personality that can range from mild to extreme? Since the DSM outlines the specific criteria necessary to diagnose a person as having the psychological disorder of NPD, one might expect there to be an abrupt shift or jump in NPI narcissism scores as a point of demarcation between what is considered “normal” and what is mental illness. This is essentially what Foster and Campbell set out to explore.

Narcissism Study Method

The researchers examined 3895 participants from the general population using an on-line version of the NPI. Subjects were presented with 40 paired statements and instructed to choose the one that best described them. For each statement pair, one choice reflected a more narcissistic perspective. For example, “I am much like everybody else” versus “I am an extraordinary person.”

Narcissism Research Results

Analysis of the scores revealed no point at which there was a distinct shift from “normal” to “narcissist.” Rather the scores ranged across a continuum, a finding more in agreement with the social psychological view of narcissism.

This suggests that narcissism is structured similarly to other aspects of general personality, as a range or dimension. For example, considering the characteristic of sociability, one might see it as ranging from shy and socially withdrawn to gregarious and socially outgoing. Foster and Campbell’s research suggests that narcissism also shows a continuum of individuals who do not strongly display narcissistic traits of self-absorption to those who are extremely or pathologically narcissistic.

More Information on Narcissism
There are numerous on-line and in print resources with additional information on narcissism and personality disorders in general, including: The Mayo Clinic: Mental Health Center and the article What Is a Personality Disorder?: Overview of the Ten Psychological Disorders of Personality.

This Suite 101 article summarizes one study investigating the nature of narcissism. The content of this article is not meant to be used for diagnosis and is not a substitute for professional help and counseling.

Additional Narcissism Sources
Grey, P. (2006). Psychology, 5th Edition. Worth Publishers.

Raskin, R. N., & Hall, C. S. (1979). A narcissistic personality inventory. Psychological Reports, 45.

Raskin, R. N., & Hall, C. S. (1981). The Narcissistic Personality Inventory: Alternate form reliability and further evidence of its construct validity. Journal of Personality Assessment, 45.

Foster, J. D. and Campbell, W. K. (2007). Are there such things as “Narcissists” in social psychology? A taxometric analysis of the Narcissistic Personality Inventory. Personality and Individual Differences, 43, 6.