In general, co-occurrence rates of other psychiatric disorders among individuals with NPD were much greater than the co-occurrence rates of NPD among individuals with other psychiatric disorders. Mirroring the distribution of psychiatric disorders in the general population, men with NPD had significantly higher rates of most substance use disorders and antisocial PD, whereas women with NPD generally had higher rates of MDD and most covert narcissism and alcoholism anxiety disorders. These results suggest more vigilance in the assessment of substance use and specific mood, anxiety, and other PDs among individuals with NPD, with due consideration for sex differences in the co-occurrence rates observed in this study. In contrast to distributions observed in the general population, rates of NPD among individuals with most substance, mood and anxiety disorders were greater among men than women.
Our results show that while grandiose-fantasy (i.e., desire for special recognition) was negatively linked to IC, devaluing was positively linked to IC. In addition, men scored higher on exploitativeness (i.e., interpersonally manipulative for personal gain) than women. We conducted mediational analysis with asymmetric confidence intervals and a bias-corrected bootstrap technique. Mediational tests showed that higher levels of grandiose-fantasy were indirectly related to fewer alcohol-related problems through less IC and less heavy-episodic drinking.
Overlapping signs and symptoms
Similarly, using alcohol doesn’t mean a person with NPD has AUD, even if there have been incidents of extreme intoxication. 2Entitlement rage was considered a facet of grandiosity or vulnerability in different studies [see Ref. (29)]. “If all else fails, it might be best to take some time away from the discussion until both parties are able to come back in a more positive frame of mind,” Estevez said. This response can validate their feelings while setting a clear boundary, and it also offers a collaborative solution, Estevez added.
A mental health professional can talk through the symptoms of a narcissistic personality disorder and rule out other behavioral disorders. They may ask the person to fill out a questionnaire about their behaviors. The putative mechanisms mediating substance use in narcissism are seen in self-regulatory functions, particularly the stabilization of self-esteem, which is high but instable in grandiose narcissism (34) and low in vulnerable narcissism (35). Drinking is related to grandiose narcissism and self-esteem contingency (such as need for approval) (23). Grandiose narcissism predicts drinking behavior independently of impulsivity, which indicates that other mechanisms might be relevant (24).
As Someone Living With NPD and AUD
Research supports the link between some narcissistic traits and alcohol use. According to the National Institute of Mental Health, 22.6% of people with a personality disorder also have a substance use disorder (SUD), which can include alcohol use. It is not uncommon for two mental health conditions to co-exist (referred to as a comorbidity).
Interestingly, in those cases when associations remained significant among both men and women, there were no differences in the magnitude of the associations. Taken together, these findings generate more focused hypotheses about factors underlying NPD comorbidity. For example, when sex differences exist for associations between NPD and other psychiatric disorders, is there something about one’s gender that would increase vulnerability to that comorbidity? Taken together, these results underscore the importance of future research to address sex differences in NPD comorbidity.
Diagnosing alcoholism and NPD
Further, the co-occurrence rates of NPD among individuals with other psychiatric disorders were lower than the corresponding rates of other psychiatric disorders among individuals with NPD, but were far from trivial. Taken together, these findings suggest increased vigilance in assessing NPD among individuals with substance use, mood, anxiety, and borderline and histrionic PDs, especially among men, whose rates of these disorders consistently exceeded those of women. In the total sample, prevalences of NPD among respondents with lifetime mood, anxiety, and substance use disorders were 11.9%, 11.5%, and 8.8%, respectively (Table 3). Bipolar I disorder (23.8%), panic disorder with agoraphobia (19.9%), and drug dependence (22.0%) were the most prevalent disorders in their classes.
Some individuals have both Narcissistic Personality Disorder and an active addiction. Coping with someone with a dual diagnosis can be more difficult than if that person suffered from only narcissism or untreated alcoholism. With NPD, for example, there are no drugs specifically used for the treatment of the personality disorder, but antidepressants or anxiolytics may be prescribed if depression or anxiety is present. Summary of the reviewed literature on Dark Triad traits in relation to substance use and addictive behaviors. “A person with a narcissistic personality disorder may act like they think the world is a movie in which they’re the star, and everyone else is an extra,” Wagage told Verywell via an email.
Legal Conditions and Terms
The best thing to do at that point is to seek out individual therapy for yourself and work on setting firmer boundaries. Sian Ferguson is a freelance health and cannabis writer based in Cape Town, South Africa. She’s passionate about empowering readers https://ecosoberhouse.com/ to take care of their mental and physical health through science-based, empathetically delivered information. However, treatments like psychotherapy, group support, and self-care strategies can help people with either condition feel much better.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. “+” indicates evidence for positive association, “++” strong evidence for positive association, “∼” no evidence for association. While you have control over what you say and how you say it, you don’t have control over how it’s received, Wagage said. You can, however, choose to walk away when the other party refuses to listen to you or harm you in any way. Sherry Gaba, LCSW, is a licensed psychotherapist/author specializing in addictions, codependency, and underlying issues such as depression, trauma, and anxiety. If one of our treatment centers is not a good fit, our representatives may refer you to another detox or treatment center, or the Substance Abuse and Mental Health Services Administration (SAMHSA) hotline to find a program that best suits your needs.
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