Impulsivity mediates the association between narcissism and substance-related problems beyond the degree of substance use: a longitudinal observational study

Malin K Hildebrandt; Josepha Noack; Raoul Wuellhorst; Tanja Endrass; Emanuel Jauk

doi:10.1186/s12888-024-05718-y

Impulsivity mediates the association between narcissism and substance-related problems beyond the degree of substance use: a longitudinal observational study

BMC Psychiatry. 2024 Apr 15;24(1):280. doi: 10.1186/s12888-024-05718-y.

Authors

Malin K Hildebrandt¹, Josepha Noack², Raoul Wuellhorst², Tanja Endrass², Emanuel Jauk^{3

4}

Affiliations

¹ Institute of Clinical Psychology and Psychotherapy, Chair of Addiction Research, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Str. 46a, 01187, Dresden, Germany. malin.hildebrandt@googlemail.com.
² Institute of Clinical Psychology and Psychotherapy, Chair of Addiction Research, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Str. 46a, 01187, Dresden, Germany.
³ Department of Medical Psychology, Psychosomatics, and Psychotherapy, Medical University of Graz, Auenbruggerplatz 3, 8036, Graz, Austria.
⁴ Institute of Clinical Psychology and Psychotherapy, Chair of Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Str. 46a, 01187, Dresden, Germany.

Abstract

Background: Narcissism has been implied as a putative risk factor for substance use disorders (SUDs). However, previous research did not disentangle the degree of substance use from substance-related problems, the symptoms of SUDs. This preregistered study addressed the open question whether grandiose and vulnerable narcissism and their constituent traits convey specific SUD risk, that is, explain substance-related problems beyond the degree of use. Furthermore, we tested whether impulsivity or substance use motives linked to narcissistic self-regulation mediate this association.

Methods: Narcissism, impulsivity, substance use motives, past-year substance use, and substance-related problems were assessed in 139 (poly-)substance users, 121 of whom completed a one-year follow-up. For significant longitudinal associations between narcissism factors and substance-related problems controlled for the degree of use, we tested impulsivity and substance use motives as mediators.

Results: Grandiose narcissism (r =.24, p =.007) and its constituent factors antagonistic (r =.27, p =.003) and agentic narcissism (r =.18, p =.050), but not vulnerable narcissism, prospectively predicted substance-related problems beyond the degree of substance use. Associations of grandiose narcissism and antagonistic narcissism with substance-related problems were fully mediated by impulsivity, but not substance use motives. Impulsivity explained roughly one third of the association of both grandiose (P̂_M = 0.30) and antagonistic narcissism (P̂_M = 0.26) with substance-related problems.

Discussion: We demonstrate that grandiose narcissism- particularly antagonistic but also agentic narcissism- is specifically linked to substance-related problems beyond the degree of substance use. The mediating effect of impulsivity but not substance use motives suggests that impulsivity may be a more important mechanism than narcissistic self-regulation in promoting SUD in narcissism. However, future studies may use more targeted measures than substance use motives to further probe the role of self-regulation. Similar result patterns for alcohol compared to all substances together indicate that mechanisms may be alike across substances. In conclusion, narcissistic individuals may not use substances more but have a higher SUD risk, informing prevention and treatment.

Keywords: Addiction; Impulsivity; Narcissism; Substance use disorder; Substance use motives.

Publication types

Observational Study

MeSH terms

Delusions
Humans
Impulsive Behavior
Motivation
Narcissism*
Substance-Related Disorders* / complications