Proximal Processes, Temperament, and Pathological Narcissism: An Empirical Exploration from the Longitudinal Study of Personality Disorders

Abstract

Introduction: It is argued that all personality pathology represents the final emergent product of a complex interaction of underlying neurobehavioral systems, which are reflected in personality factors, in conjunction with environmental inputs. Neurobehavioral systems manifest themselves in dispositional temperament and personality processes. Environmental inputs include, obviously, interpersonal relationships (e.g., parenting, social, and mentoring relations) as well as other factors such as abuse, neglect, and/or environmental insults (e.g., economic hardship, deprivation). Narcissistic personality disorder (NPD) is hypothesized to reflect both dispositional and environmental inputs to its pathogenesis. Temperament and personality-based theorizing regarding NPD proposes high dispositional levels of anger and related temperament features that could shape early development and subsequent NPD. Many classic theorists (e.g., Freud, Kernberg, Kohut, Miller) have also proposed that profound parenting failures are implicated in the emergence of NPD, each suggesting some failure in proper engagement and responsivity with the developing child. Such a failure in parenting can be thought of as reflecting diminished proximal process engagement with the developing child. Method: Using data from the Longitudinal Study of Personality Disorders, the present study examines both proximal process and temperament factors in relation to clinically significant NPD features from a prospective perspective. Results: Results suggest that both proximal process and temperament (notably anger) factors independently predict the level of NPD features over time. Conclusion: Both interpersonal relationships and temperament should be considered in models of etiology of NPD, it is not just one or the other.