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Review
. 2023 Mar 1;76(1):15-25.
doi: 10.1176/appi.psychotherapy.20220020. Epub 2022 Oct 12.

Narcissistic Personality Disorder Studied the Long Way: Predicting Change in Narcissistic Pathology During College

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Review

Narcissistic Personality Disorder Studied the Long Way: Predicting Change in Narcissistic Pathology During College

Mark F Lenzenweger. Am J Psychother. .

Abstract

Objective: Otto F. Kernberg pioneered the description, understanding, and treatment of pathological narcissism. Narcissism has emerged as a clinical construct of considerable interest in clinical psychology, psychiatry, and psychoanalysis and has often been featured in the literature on personality and social psychology. Considerable discussion in recent years has focused on whether levels of narcissism seen among young adults have been increasing. Nearly all of that discussion has been focused on changes in successive cohorts in normative (normal-range) expressions of narcissism. No direct prospective longitudinal study of the same individuals has assessed for pathological narcissism during college, the period that has been the specific focus of such lively debate. This study aimed to fill that gap in the literature.

Methods: This multiwave, longitudinal study explored pathological narcissism during college by enrolling first-year undergraduate students (N=250) from the Longitudinal Study of Personality Disorders and by using individual growth curve (IGC) analysis. Participants were assigned to either a possible personality disorder or no personality disorder group, according to results from the International Personality Disorder Examination.

Results: By the third wave of assessments, 16% of the sample received a probable or definite diagnosis of at least one axis II personality disorder. IGC analysis revealed that pathological narcissism declined across the first 4 years of college. Personality predictors of this pattern of change are also discussed.

Conclusions: This study highlights the need for a fine-grained prospective study of the same participants over time to illuminate patterns of change in narcissism.

Keywords: College Mental Health; Personality Disorders; individual growth curve; narcissism; neurobehavioral systems; pathological narcissism.

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