Narcissism and devaluing others: An exploration of impaired control over drinking as a mediating mechanism of alcohol-related problems

https://doi.org/10.1016/j.paid.2018.10.039Get rights and content

Highlights

  • Devaluing others is positively associated with impaired control over drinking.

  • Grandiose-fantasy is negatively associated with impaired control over drinking.

  • Impaired control and heavy-drinking mediate devaluing others and alcohol problems.

  • Entitlement rage is directly associated with alcohol-problems.

  • Men score higher on exploitativeness than women.

Abstract

Devaluing or diminishing the worth of others is how many individuals destroy their relationships, such as by drinking beyond limits at inappropriate times and letting others down. Impaired control over drinking (IC) reflects consuming alcohol beyond predetermined limits. This investigation sought to determine whether facets of vulnerable narcissism (e.g., entitlement-rage, hiding-the-self, contingent-self-esteem, and devaluing) or narcissistic grandiosity (e.g. grandiose-fantasy, self-sacrificing-for-self-enhancement, and exploitativeness) were directly related to IC and indirectly related to drinking outcomes. We examined a path model of 759 university student drinkers. 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. In contrast, higher levels of devaluing were indirectly related to more alcohol-related problems through more IC and heavy-episodic-drinking. Our results suggest that targeting thought processes in which people with Alcohol Use Disorders (AUDs) are actively devaluing others may be a good target for therapeutic intervention.

Introduction

“We have become a nation of addicts--addicted to ourselves. We need a recovery program for the self-absorbed” – Patti Maguire Armstrong (2014). Historically, narcissism has been deemed excessive selfishness or self-admiration. The complete sonnets and poems of Shakespeare (Shakespeare, 1912) recanted the Greek story of Narcissus, who fell in love with his own reflection, while ignoring a chance for a real relationship. Psychoanalysts as early as Sigmund Freud (1914) described a developmental stage in children in which their egos lack concern for anyone else's needs, which he referred to as primary narcissism. According to Freud, individuals severely traumatized during this developmental period never leave the ego-driven state, even as adults, leaving them incapable of caring for others. Karen Horney (1937) theorized that the narcissist's self-esteem is never strong because it is never based on genuine accomplishments. Heinz Kohut (1971) wrote about individuals whose needs were not met in childhood and escape from bad inner negativity into idealized objects outside of themselves. Otto Kernberg (1975) believed narcissism depends upon the affirmation of others and the acquisition of desirable objects. In sum, narcissists have been characterized as developmentally stunted in their concern for the well-being of other people in their lives.

Narcissism can be characterized by overt and covert expressions of maladaptive vulnerable (i.e., entitlement-rage, hiding-the-self, contingent-self-esteem, and devaluing-the-self/others) as well as adaptive grandiose (i.e., grandiose-fantasy, self-sacrificing-self-enhancement, and exploitativeness) facets (PNI; Pincus et al., 2009). Table 1 contains complete definitions and associated constructs of each facet. Vulnerable Narcissism is reflected in experiences of helplessness, emptiness, low self-esteem, shame, and suicidality resulting from behavioral dysregulation in response to ego-threats and self-enhancement failures (Akhtar, 2000; Dickinson & Pincus, 2003). Pincus (2013) provided an example of a vulnerable narcissistic patient who, after hearing that his trust fund was exhausted, strategically attempted suicide at the exact time his mother would find him. In contrast, Grandiose Narcissism is associated with exhibiting adaptive self-enhancement strategies, as well as arrogant, conceited, and domineering attitudes and behaviors (Buss & Chiodo, 1991) that are maladaptive for positive interpersonal relationships. Pincus (2013) exemplified a grandiose-narcissistic patient who regularly threatened to shoot people who parked in his designated parking space–even though he did not drive a car. Grandiose narcissism has been related to alcohol use (Buelow & Brunell, 2014; MacLaren & Best, 2013), temporal discounting (Buelow & Brunell, 2014), and risk-taking behaviors among both college (Foster, Shenesey, & Goff, 2009), and clinical samples (Martin, Benotsch, Lance, & Green, 2013). Yet, facets of narcissism are under-addressed in the existing literature.

Historically, Alcoholics Anonymous “recognizes pathological narcissism as a central problem in alcoholism” (Levin, 1987, p. 332; for a clinical sample, see Sawrie, Watson, Sherbak, Greene, & Arredondo, 1997). Narcissism and addiction are not entirely distinct.

Author of Trauma and Addiction, Dayton (2009), describes, “the needs of those around them have to come second to their meeting their own, often overpowering desire for their next ‘fix,’ whether it be a drink, drug, food or sexual encounter. Both the narcissist and the addict are first and foremost self-absorbed.” Indeed, in a National Epidemiologic Civilian Survey regarding Narcissistic Personality Disorder (NPD; measured with a composite score), Stinson et al. (2008), found NPD to be prevalent among those with alcohol use disorder (AUD).

Narcissism is described as an underlying need for validation and affirmation of a positive, inflated self-image, at times at the cost of positive interpersonal relationships (Baumeister & Vohs, 2001). Additionally, narcissists tend to hold self-concepts which are both exaggeratedly grandiose and extremely fragile (Morf & Rhodewalt, 2001), leaving them particularly vulnerable to experiencing ego-threat (i.e. an event that calls into question one's positive self-view; Vandellen, Campbell, Hoyle, & Bradfield, 2011). Based on the ego-threat hypothesis (Baumeister, 1997; Kohut, 1972), the theoretical stance suggests that those with inflated but vulnerable self-concepts have more to lose. Thus, they may be more susceptible to brief but severe drops in self-esteem (Bushman & Baumeister, 1998; Kernis, Cornell, Sun, Berry, & Harlow, 1993), which may cause individuals to turn to externalizing behaviors, such as drinking (Kealy, Ogrodniczuk, Rice, & Oliffe, 2017; nationally representative sample of Canadian men), to temporarily relieve the pain of a weakened self-representation. Baumeister, Smart, and Boden (1996) has also specifically noted, “threatened egotism has been shown to be one clear cause of increased drinking.” Of the two dimensions, vulnerable or grandiose, we expected that vulnerable would be more closely associated to dysregulated drinking behaviors. Of the vulnerable facets, Baumeister's theory would suggest that contingent-self-esteem would be the most highly associated with drinking outcomes. Nevertheless, we had no clear predictions regarding which vulnerable facets would be the most closely associated and consider our study to be exploratory.

Studies assessing the relationship between narcissism and alcohol use found that narcissism, as a composite construct, significantly predicts alcohol use (Kealy et al., 2017; Luhtanen & Crocker, 2005). However, narcissism may contain a mix of adaptive and maladaptive features (See Table 1; Cain, Pincus, & Ansell, 2008; Paulhus, 1998; Wink, 1991). While associations between grandiose narcissism and alcohol use exist (Buelow & Brunell, 2014; MacLaren & Best, 2013), Schoenleber, Saden, & Verona (2011) (they used the NPI-16; Ames, Rose, & Anderson, 2006) found that vulnerable narcissism showed stronger associations with substance use than grandiose narcissism. Moreover, in a substance dependent sample, Karakoula and Triliva (2016) found that those with significant narcissistic disturbances were more likely to exhibit vulnerable rather than grandiose traits with composite measures of these constructs. However, it remains unclear as to which vulnerable facets (i.e. entitlement-rage, hiding-the-self, contingent-self-esteem, & devaluing) are most important in the etiology of AUDs. Thus, there is a need to study differential drinking outcomes associated with the various facets of narcissism (Russ & Shedler, 2013). The current study sought to determine how particular facets of either vulnerable or grandiose narcissism may be related to heavy-episodic drinking and alcohol-related problems through the mediating mechanism of impaired-control-over-drinking.

Impaired-control-over-drinking (IC) reflects consuming alcohol beyond predetermined limits (For a clinical sample, see Heather, Tebbutt, Mattick, & Zamir, 1993; For a review, see Leeman, Patock-Peckham, & Potenza, 2012) and is a prospective major tenet of alcohol dependence (Leeman, Toll, Taylor, & Volipicelli, 2009). IC has been characterized by some as a loss of self-control specific to the drinking situation (Patock-Peckham & Morgan-Lopez, 2006) and is related to impulsivity in both men and women (Patock-Peckham, King, Morgan-Lopez, Ulloa, & Filson Moses, 2011; Patock-Peckham & Morgan-Lopez, 2006).

According to Vazire & Funder's meta-analysis (Vazire & Funder, 2006), impulsive acts account for much of a narcissist's maladaptive behavior. In fact, narcissists have been found to score lower on overall self-control (Ludwig et al., 2013; sample of healthy 18–34 year olds) than non-narcissists. In addition, self-control has been found to mediate a composite score for narcissism (using the PNI) and substance use. Due to a tendency to use poor self-regulation strategies, narcissists may be particularly prone to engaging in alcohol use through IC, (Dowgwillo, Dawood, & Pincus, 2016; Vazire & Funder, 2006). Because IC has been characterized as impulsivity specific to the drinking context (Patock-Peckham et al., 2011; Patock-Peckham, Cheong, Balhorn, & Nagoshi, 2001; Patock-Peckham & Morgan-Lopez, 2006), we sought to explore how the distinct facets of narcissism might be linked directly to IC and, in turn, to heavy-episodic drinking and alcohol-related problems.

It has been widely shown that men tend to be more narcissistic than women (Grijalva et al., 2015). This finding may be explained by Social Role Theory (Eagly, Wood, & Diekman, 2000), which suggests that women experience greater social consequences than men for exhibiting egotistic behaviors (Tschanz, Morf, & Turner, 1998. In addition, men consistently drink more and have more alcohol-related problems than women (Geisner, Larimer, & Neighbors, 2004). Due to these known differences, we included gender as a covariate in our model.

This study specifically sought to determine which facets of narcissism were directly related to IC. Moreover, we sought to examine if IC and heavy-episodic-drinking would mediate the indirect links between facets of narcissism and alcohol-related problems. As the vulnerable facets suggest irrational and maladaptive actions, we predicted that they would be positively linked to IC. As grandiose-fantasy is associated with higher self-esteem and greater degrees of adaptive self-presentational behavior, we expected that it may be negatively linked to IC among our college sample.

Section snippets

Participants

Participants included 759 (369 women, 390 men) individuals from a large university, all of whom reported consuming alcoholic beverages. All consented to participate in this study. Participants represented 187 distinct majors university wide (not including undeclared) with 51.7% freshman, 25.4% sophomore, 15.1% junior, 6.9% senior, and 5.5% other. The sample was comprised of 51% men, with a mean age of 19.84 (SD = 2.87). Participants were 60.5% Caucasian, 15.5% Hispanic, 14.1% Asian, 5.3%

Results

The means, standard deviations, and correlations among all variables can be found in Table 2. All hypothesized paths were modeled in Fig. 1 and significant paths were modeled in Fig. 2. The model yielded a χ2 (7df) = 8.403, p = 0.2984; CFI = 0.998; RMSEA = 0.016 90% CI (0.00, 0.049).

Discussion

According to the Ego-Threat-Hypothesis (Baumeister, 1997), those with vulnerable self-concepts have more to lose (Kernis et al., 1993), which may be associated with individuals turning to externalizing behaviors, such as drinking, to temporarily assuage the pain of a weakened self-representation (Kealy et al., 2017). While we did find evidence that vulnerable facets (i.e. entitlement-rage and devaluing) were associated with drinking outcomes, contingent-self-esteem was not. Contingent

Acknowledgements

NIH/NIAAA grant KO1AA024160-01A1 to Julie A. Patock-Peckham; Burton Family Foundation's (FP11815) grant to Social Addictions Impulse Lab (SAIL). Both Esha Naidu and Julie A. Patock-Peckham have agreed to share first authorship. All authors participated in the data collection, analysis, writing, or editing of this manuscript.

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