Abstract
Objective
Pathological narcissism (PN) carries implications for mental health and treatment. Research indicates similar personality traits can influence risk factors and psychopathology, but no studies have examined the role of PN in how depressive symptoms impact suicide ideation (SI).
Methods
We examined how PN factors (Grandiosity, Vulnerability) moderate the depression-SI relationship in three samples from increased-risk populations: National Guard personnel, individuals with prior suicidal thoughts and/or behaviors, and firearm owners.
Results
Findings supported PN’s role in the depression-SI relationship, while indicating multifactorial and sample-specific differences. Vulnerability was positively related to SI in all samples; Grandiosity evinced some unexpected positive links. Both factors potentiated the depression symptoms-SI relationship among military personnel and firearm owners, but Grandiosity buffered the relationship in the prior history sample.
Conclusion
These findings emphasize the importance of considering how PN factors confer risk in the presence of depression within unique populations to inform cognitive-focused interventions for suicidal thoughts and behaviors.
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Notes
SI variables were operationalized differently across samples based on available data (e.g., frequency, intensity). We did not anticipate differential relationships across operationalizations.
The total number of participants was 934; however, 428 participants were excluded based on missing data across measures of interest. Excluded participants did not significantly differ from included participants based on age, t(850)=-0.64, p=.523; sex, χ2(1, N=858)=1.65, p=.200; or race/ethnicity, χ2(5, N=817)=2.22, p=.827, as well as mean levels of Grandiosity, t(797)=-0.55, p=.584; Vulnerability, t(800)=1.29, p=.199, depression symptoms, t(538)=1.69, p=.091; or SI, t(470.03)=1.94, p=.053.
The non-transformed variable for BSS total score was used as bootstrapping is a preferable approach to transformation in overcoming non-normality in tests of moderation (Russell & Dean, 2000).
Sex (grandiosity: T(1, 376)=4.76, p<.001) and employment [lifetime ideation: F(2, 373)=3.09, p=.047] were included in the models as covariates due to significant differences across variables of interest. After accounting for covariates, Grandiosity was no longer significant as a predictor (IRR: .92, 95% CI: .81, 1.04), although the interaction between depression symptoms and Grandiosity remained significant (IRR: .98, 95% CI: .98, 1.00). Similarly, Vulnerability became non-significant as a predictor (IRR: 1.07, 95% CI: .95, 1.21) while the interaction with depression symptoms remained significant (IRR: .97, 95% CI: .96, .98).
Identification of sexual orientation as a sexual minority was tested as a covariate in the models due to significant differences across the outcome variable (SITBI lifetime SI: T(1, 23.32)=2.17, p=.041). After accounting for sexual minority status, Grandiosity (IRR: 2.30, 95% CI: .00, 40,848.39) and depression (IRR: 0.31, 95% CI: .00, 25.27) were no longer significant as main effects and the interaction was not significant (IRR: 2.57, 95% CI: .77, 8.61). In the second model with Vulnerability, depression (IRR: 5.11, 95% CI: .19, 139.36), Vulnerability (IRR: .96, 95% CI: .00, 47,395.06), and the interaction (IRR: 1.19, 95% CI: .46, 3.10) all became non-significant.
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This work was in part supported by the Military Suicide Research Consortium (MSRC), an effort supported by the Office of the Assistant Secretary of Defense for Health Affairs under Award No. (W81XWH-10-2-0181). Opinions, interpretations, conclusions and recommendations are those of the author and are not necessarily endorsed by the MSRC or the Department of Defense.
The Award No. (W81XWH-10-2-0181) was received by authors Michael D. Anestis and Bradley A. Green.
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Preston, O.C., Daruwala, S.E., Butterworth, S.E. et al. The grim side of narcissism: Examining pathological traits, depression symptomology, and suicidal ideation in at-risk populations. J Cogn Ther 17, 93–121 (2024). https://doi.org/10.1007/s41811-023-00185-x
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DOI: https://doi.org/10.1007/s41811-023-00185-x