Debates on the narcissism conundrum: Trait, domain, dimension, type, or disorder?

Abstract

The clinical implications of the term narcissism are a matter of continuous debate. This article critically examines pertinent literature of the last 12 years using a set of validators and attempting to identify narcissism as a trait, a domain, a dimension, or a personality disorder/type. Narcissistic personality disorder (NPD)-specific literature (particularly in epidemiological, developmental, and laboratory-testing areas) is scarce when compared with other personality disorders. A tendency to ideologically dominated clinical reports is observed with individual cases or small samples of nonclinical populations. Clinical descriptions of the condition vary within a wide range of descriptors, superficial or ambiguous conceptualizations, different subtypes, and inconclusive meta-analytical findings. Comorbidity with many Axes I and II conditions and the presence of narcissistic behavioral and emotional manifestations in other DSM conditions were frequent findings. The reintroduction of NPD in the personality disorders DSM-5 proposal seems to be related to nonclinical or heuristic considerations. It is concluded that NPD as such shows nosological inconsistency and that its consideration as a trait domain with needed further research would be strongly beneficial to the field.