Traits of narcissistic vulnerability in adults with autism spectrum disorders without intellectual disabilities

Autism Res. 2024 Jan;17(1):138-147. doi: 10.1002/aur.3065. Epub 2023 Nov 20.

Abstract

The relationship between Autism Spectrum Disorders (ASD) and Narcissistic Personality Disorder (NPD), considering the dimensions of narcissistic grandiosity and vulnerability, represents an important differential diagnosis and potential ground of comorbidity, since both conditions show high grades of pervasiveness, a life-long course, ego-syntonic traits, and difficulties in building up and sustaining interpersonal relationships Although the co-diagnosis rates, according to the categorical criteria in use, are limited (0%-6.4%), it is common to encounter diagnostic doubts in clinical practice. Here we investigated the dimensions of narcissistic vulnerability and grandiosity in a sample of 87 adults diagnosed with ASD without intellectual disabilities through the administration of the Pathological Narcissism Inventory-52 Items (PNI-52). The mean scores of our sample were compared with the normative distribution available in the literature, and we found that individuals with ASD scored significantly higher than neurotypical controls at the Total Score and at the Vulnerable Narcissism subscale, but not at the Grandiose Narcissism subscales. Demographic features did not influence these results. Vulnerable narcissism was significantly associated with the "Ritvo Autism and Asperger Diagnostic Scale - Revised" subscale Social Relatedness. These findings could potentially be indicative of a greater comorbidity rate between the two disorders with respect to the one reported to date, possibly because DSM-5 criteria are mainly focused on the grandiose dimension. Potential explanatory links between ASD phenomenology and vulnerable narcissism, such as the personality dimension of neuroticism, are discussed, together with the possible role of narcissistic vulnerability in mediating internalizing symptoms (e.g., anxiety, depression) in individuals with ASD.

Keywords: autism spectrum disorders; comorbidity; grandiosity; narcissistic personality disorder; neuroticism; personality; personality disorders; vulnerability.

MeSH terms

  • Adult
  • Autism Spectrum Disorder* / complications
  • Autism Spectrum Disorder* / epidemiology
  • Emotions
  • Humans
  • Intellectual Disability* / complications
  • Intellectual Disability* / epidemiology
  • Narcissism
  • Personality Disorders / complications
  • Personality Disorders / diagnosis
  • Personality Disorders / epidemiology