Clinicians have long noted overlap in some of the key features of narcissism and bipolar disorder, including excessively high goals and impulsivity. In addition, empirical findings consistently document high levels of comorbidity between the two conditions. To better understand the similarities and differences in psychological qualities associated with mania- and narcissism-related vulnerabilities, we administered to 233 undergraduates a broad range of measures pertaining to goals and affects (both their experience and their dysregulation) and impulsivity. As hypothesized, tendencies toward both narcissism and hypomania related to elevations on measures of affective and goal dysregulation. In addition, hypomania tendencies were related to higher impulsivity, but that association did not appear for narcissistic tendencies. Results highlight key commonalities and differences between those at risk for mania versus narcissism. Future research should examine these relationships in clinically diagnosed samples.
For decades, clinicians have written about overlap in several facets of narcissistic personality disorder (NPD) and bipolar disorder. As Akiskal (1992) noted, Kraepelin’s early description of persons with manic temperament—versatile, intelligent, and charming, while at the same time restless, temperamental, and unreliable—closely resembles clinical descriptions of NPD. Indeed, epidemiological studies have documented high rates of NPD among persons with bipolar disorder. As many as 31% of people diagnosed with bipolar I or II disorder also meet criteria for cluster B personality disorders (Garno et al., 2005 and Mantere et al., 2006). Although rates of NPD in the general population rarely exceed 1% (e.g., Torgersen, Kringlen, & Cramer, 2001), bipolar disorder has been related to an eightfold elevation in rates of NPD in both inpatient (Brieger, Ehrt, & Marneros, 2003) and outpatient samples (Garno et al., 2005), despite some lower estimates in other research (Mantere et al., 2006). Even in samples with less extreme manic tendencies, such as persons diagnosed with bipolar II disorder, rates of NPD as high as 5% have been obtained (Vieta et al., 2000). Although NPD in bipolar disorder is most likely to be diagnosed during periods of mania (Akiskal, 1992 and Stormberg et al., 1998), rates of NPD remain as high as 4.5% even among those in remission from mania (George, Miklowitz, Richards, Simoneau, & Taylor, 2003). In sum, narcissism and bipolar disorder are frequently comorbid, and manic episodes appear to exacerbate narcissism symptoms.
Within bipolar disorder, comorbid personality disorders are related to poorer treatment adherence (Colom et al., 2000), more severe symptoms over time (Bieling et al., 2003, Colom et al., 2004 and Dunayevich et al., 2000), and poorer medication adherence (Colom et al., 2000). More specific analyses suggest that Cluster B personality disorders are related to increased risk for suicidal behavior (Garno et al., 2005). Hence it is important to understand this comorbidity and its basis. In this study, we consider three characteristics—approach-related affect, goal pursuit, and impulsivity—and their relations to risk for both mania and narcissism.
