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http://dx.doi.org/10.1037/pap0000159
The Role of Identity Instability in the Relationship Between Narcissism and Emotional
Empathy
Rossella Di Pierro1, Marco Di Sarno1, Emanuele Preti1, Valentina Elisabetta Di Mattei2, Fabio
Madeddu1
1
Department of Psychology, University of Milano-Bicocca, Milan, Italy
2
Vita Salute San-Raffaele University, Milan, Italy
Corresponding author:
Rossella Di Pierro
Department of Psychology, University of Milano-Bicocca
rossella.dipierro@unimib.it
Author notes:
Data, analytic methods, and study materials are available upon request to other researchers by
writing to the corresponding author.
Abstract
Empirical literature has shown that narcissism is often associated with limited empathy, but the
mechanism underlying this association is still unclear. The present study investigated the role of
identity instability as a mediator of the relationship between narcissistic traits and empathic
capabilities. Narcissistic traits, identity instability, and cognitive and emotional empathic
capabilities were assessed among 462 nonclinical participants through self-report measures. Results
showed a positive association between narcissistic traits and cognitive empathy. On the other hand,
a negative association between narcissistic traits and emotional empathy emerged. Furthermore, the
study showed that the association between narcissistic traits and impairments in emotional empathy
was partially explained by identity instability. Results thus demonstrated that narcissistic traits were
associated with higher identity instability, and this, in turn, was associated with decreased abilities
to be emotionally involved in others’ affect states. These findings are discussed in the context of an
Introduction
Narcissism has always been described by both the psychiatric approach and psychodynamic
theories as characterized by empathic dysfunctions. The Diagnostic and Statistical Manual for
Mental Disorders-5 (DSM-5) defines narcissistic personality disorder (NPD) as “a pervasive pattern
of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy” (American
Psychiatric Association [APA], 2013, p. 669). The DSM-5 Alternative Model for Personality
Disorders (DSM–5 AMPD) also refers to the presence of low empathic capabilities when describing
interpersonal functioning in NPD (APA, 2013). In this model, specific difficulties with empathy are
identified, such as “impaired ability to recognize or identify with the feelings and needs of others;
excessively attuned to reactions of others, but only if perceived as relevant to self; over- or
underestimate of own effect on others” (APA, 2013, p.767). Also, the psychodynamic
comprehension of narcissistic pathology has recognized the key role of impairments in empathy.
Although different in etiological explanation, theory, and treatment techniques, psychoanalytic
detachment and coldness toward others (Akhtar, 1989; Kernberg, 1983; Kohut, 1966). Although
psychiatrists and psychoanalysts agree on the key role of empathy in narcissism, empirical studies
on both NPD patients and nonclinical participants have not supported it univocally. Some studies
found that narcissistic traits were associated with empathic impairments (Jonason, Lyons, Bethell,
& Ross, 2013; Porcerelli & Sandler, 1995; Watson & Morris, 1991), whereas others found positive
associations between narcissistic traits and empathic capabilities (Ronningstam & Gunderson, 1990,
1991; Ronningstam, Gunderson, & Lyons, 1995). One of the possible explanations for these
contrasting findings might be due to the fact that most of these studies measured empathy as a one-
Over the last decade the idea that empathic functioning implies both cognitive and emotional
abilities has been established and documented by empirical research (Baskin-Sommers, Krusemark,
& Ronningstam, 2014; Decety & Meyer, 2008; Hepper, Hart, & Sedikides, 2014). Emotional
empathy (EE) refers to the affective involvement and response to others’ emotional state, and it
includes dimensions such as empathic reactivity. Conversely, cognitive empathy (CE) involves
cognitive functions such as perspective taking, that allow people to understand and identify mental
states underlying others’ behaviors and experiences (Baskin-Sommers et al., 2014; de Waal, 2008).
Recent empirical studies have thus investigated the relationship between narcissism and empathic
capabilities distinguishing between these two components. Studies on NPD patients and nonclinical
samples, using both self-report and laboratory measures of empathy, showed that narcissism is
empathy. Moreover, such results have been found by both studies using clinical interview measures
of narcissism (Marissen, Deen, & Franken, 2012; Ritter et al., 2011), as the Structured Clinical
Interview for Personality Disorders (First, Gibbon, Spitzer, Williams, & Benjamin, 1997), and self-
report measures of narcissism (Czarna, Wrobel, Dufner, & Zeigler-Hill, 2015; Konrath, Corneille,
Bushman, & Luminet, 2014; Wai & Tiliopoulos, 2012), as the Narcissistic Personality Inventory
(Raskin & Terry, 1988). These findings suggest that inconsistencies in previous findings were
mainly due to measures of empathy rather than measures of narcissism, and they clarify which
consensus is beginning to emerge around the idea that narcissism is mainly linked to impairments in
A psychodynamic model of narcissism based on object relations theory (Caligor, Levy, &
Yeomans, 2015; Kernberg, 1984; Kernberg & Caligor, 2005) might be useful to shed light on this
association. Within this framework, narcissism can be located at various levels of borderline
primitive defensive style, in the context of an almost intact capacity for reality testing. Lack of
chaotic sense of self, unrealistic self-esteem, and unstable perceptions of self and others (identity
rooted in distorted and superficial representations of the self and of other people, because of the
lack of clear boundaries and difficulties in integrating positive and negative aspects of self- and
level, which defends against split-off vulnerable strivings (Diamond, Yeomans, & Levy, 2012).
In line with this theorization, some empirical studies found significant associations between
narcissistic traits and a key element of lack of identity integration, that is, identity instability
(Dimaggio et al., 2007; Pincus et al., 2009; Roche, Pincus, Lukowitsky, Ménard, & Conroy, 2013).
Indeed, narcissism is usually linked to inflated but unstable self-views, and negative feedback
from others might cause relevant changes in the levels of anxiety, anger, and self-esteem among
individuals high in narcissism (Horton & Sedikides, 2009; Rhodewalt & Morf, 1998; Stucke &
Sporer, 2002; Zeigler-Hill, Myers, & Clark, 2010). Such egothreatening situations often activate a
negative feedback and its source (e.g., Morf & Rhodewalt, 1993), or self-aggrandizing attributions
(e.g., Rhodewalt & Morf, 1998), aiming to bolster and defend the narcissistic self. Finally,
representations of others are also unstable in that narcissists may become suddenly detached in
relationships whenever their partners turn out to be less perfect than they seemed, not being able
anymore to provide the sense of importance and popularity that narcissistic individuals long for
Considering results from the above-mentioned empirical research, the present study aimed at
investigating the relationship between narcissism and empathic capabilities. In line with previous
studies (Ritter et al., 2011; Wai & Tiliopoulos, 2012), we hypothesized that narcissistic traits were
but difficulties in emotional reactions to others’ affect states (i.e., emotional empathy). Moreover,
considering both the conceptualization of narcissism within an object relations framework and
empirical findings suggesting a significant association between narcissism and identity instability,
we tested whether the instability of sense of self and others played a role in the association between
narcissism and impairments in emotional empathy. Empirical literature has recently emphasized the
role of identity integration and stability as prerequisites for the development of emotional empathic
capabilities such as empathic concern and emotion reactivity (Bateman, & Fonagy, 2004a, 2004b;
Fonagy, Gergely, Jurist, & Target, 2002; Lewis, 2002; Steele, 2009). Moreover, Johnstone,
Cohen, Bryant, Glass, and Christ (2015) have recently shown that a stronger sense of self is needed
to determine mature emotional empathic responses when observing others in situations evoking
negative emotional states. As suggested by the authors (Johnstone et al., 2015), having a stable
sense of self allows individuals to incorporate the experiences of others into the experience of the
self, retaining self-control. Narcissistic functioning involves inflated but unstable selfviews:
individuals high in narcissism usually search for selfenhancement experiences to emphasize their
positive attributes, showing difficulties in experiencing self-states that do not support positive self-
views. Indeed, some studies (Horvath & Morf, 2009; Pincus et al., 2009; Ronningstam, 2005) found
that individuals high in narcissism often engage in self-regulation strategies such as emotional
avoid feelings of vulnerability, self-worthlessness, and negative affect states. Thus, being
emotionally involved in others’ negative affect states might be an ego-threatening experience for
individuals with high narcissistic traits because of unstable inner representations and the need
to avoid self-states that might impair positive self-images. In this sense, we hypothesized that
identity instability might explain difficulties in emotionally empathizing with others’ negative affect
states in individuals with high narcissistic traits. Thus, high levels of narcissistic traits may be
associated with high levels of instability of self- and other-representations, and the instability of
inner representations in turn may have effects on the ability to be emotionally involved in others’
Method
The study involved 462 Italian nonclinical adult participants (299 females, 163 males) taken from
the general population, with a mean age of 28.94 (SD = 8.12; range = 20–55). The majority
of participants were single (N = 266; 57.6%), 38.5% (N = 178) were married, and 3.9% (N = 18)
were separated or divorced. The majority of participants (N = 275; 59.5%) reported to have a
university degree or higher and the 40.5% (N = 187) of participants reported to have a high-school
level of education or below. Finally, the majority of participants were university students (N = 260;
56.3%), 36.1% of participants (N = 167) were employed, and 7.6% of participants (N = 35) were
unemployed. Participants were invited to participate in this study through announcements on the
university department website. Students then spread the link to participate to the study through
word of mouth and posts on social networks. All participants voluntarily decided to complete self-
report questionnaires after they read and accepted the informed consent form. All materials and
Measures
Narcissistic Personality Inventory– 40. The Narcissistic Personality Inventory–40 (NPI; Raskin &
Terry, 1988) is a 40-item forced choice measure of narcissism. Participants are asked to choose one
of two paired items that best describes themselves. Example items are “I see myself as a good
leader” (narcissistic statement) or “I am not sure if I would make a good leader” (nonnarcissistic
statement), and “I am more capable than other people” (narcissistic statement) or “There is a lot I
can learn from other people” (nonnarcissistic statement). Consistent with previous studies on the
association between narcissism and empathy in community samples (Czarna et al., 2015; Wai &
Tiliopoulos, 2012), we considered the NPI total score as measure of narcissistic traits (α = .85).
The Inventory of Personality Organization (IPO; Lenzenweger, Clarkin, Kernberg, & Foelsch,
2001; Preti et al., 2015) is a 57-item self-report measure of Kernberg’s model of personality
organization. Items are rated on a 5-point scale ranging from 1 (never true) to 5 (always true). The
IPO measures four personality dimensions: instability of sense of self/others, instability of goals,
instability of behaviors, and psychosis. For the purpose of our study, we considered only the
instability of self/others dimension, which includes 32 items reflecting an unstable inner experience
of self and others. Example items of instability of self/others dimension are “I feel that my tastes
and opinions are not really my own, but have been borrowed from other people” and “It is hard for
me to trust people because they so often turn against me or betray me.” This dimension showed
good internal consistency in our sample (α = .92), with high scores reflecting high levels of identity
instability.
Empathy Quotient. The Empathy Quotient (EQ; Baron-Cohen & Wheelwright, 2004; Lawrence,
Shaw, Baker, Baron-Cohen, & David, 2004; Preti et al., 2011) is a 60-item multidimensional
self-report measure of empathic capabilities. The EQ assesses three dimensions of empathy:
cognitive empathy, emotional reactivity, and social skills. Items are rated on a 4-point scale
ranging from 1 (strongly disagree) to 4 (strongly agree). For the purpose of our study, we
considered two dimensions: cognitive and emotional empathy. Cognitive empathy includes items
that measure the ability to identify and understand other’s affective states, that is, “I can tell if
someone is masking their true emotion,” and “Other people tell me I am good at understanding how
they are feeling and what they are thinking.” Emotional empathy includes items that measure the
tendency to have an emotional reaction in response to others’ mental states or emotions, that is, “I
tend to get emotionally involved with a friend’s problems,” and “seeing people people cry doesn’t
really upset me” (reversed). Acceptable internal consistency was found in our sample both for the
cognitive empathy subscale (α = .85) and for the emotional empathy subscale (α = .71).
Statistical Analyses
All analyses were performed using Statistical Package for the Social Sciences (SPSS) 21.0 (IBM,
participants. One-way analyses of variance (ANOVAs) were conducted to test gender differences in
empathic capabilities (both cognitive and emotional empathy). Indeed, several studies have shown
that females usually report higher levels of emotional empathy than males (Christov-Moore et al.,
2014; O’Brien, Konrath, Grühn, & Hagen, 2013), while contrasting findings have been shown on
gender differences in cognitive empathy (Berthoz, Wessa, Kedia, Wicker, & Grèzes, 2008;
Christov-Moore et al., 2014). Finally, correlations and multiple linear regression analyses were
conducted to investigate the associations between narcissistic traits and empathy. In particular, we
tested whether the dimension of identity instability mediated the relationship between narcissistic
traits and empathic capabilities. The mediation model was conducted separately for cognitive
empathy and emotional empathy, including gender as covariate when gender differences in
We first explored the correlations between narcissistic traits, identity instability, and empathic
capabilities (see Table 1). Results showed that narcissism was positively associated with instability
of self- and other-representations and cognitive empathy, but negatively associated with emotional
empathy. Moreover, identity instability was significantly associated with emotional empathy,
but it was not correlated with cognitive empathy, r = -.07, p < .11. Finally, females reported higher
levels of emotional empathy (M = 16.57) than males (M = 13.57, F = 53.80, p < .05), while
We then investigated the role of identity instability in mediating the associations between
narcissism and both the cognitive and emotional component of empathy. About the association
between narcissism and cognitive empathy, the regression model, R2 = .02, F(2, 459) = 4.10, p <
.01, showed that narcissistic traits were positively associated with cognitive empathic capabilities (β
= .54, p < .05), and this association was not mediated by instability of self- and other-
Finally, we tested whether narcissistic traits were associated with emotional empathic abilities,
controlling for gender and considering the mediational role of identity instability. This regression
model explained approximately 24% of the variance, R2 = .24, F(3, 458) = 47.25, p = .001. Results
showed that narcissistic traits were negatively associated with emotional empathy, controlling
for the effect of gender, and that instability of self- and other-representations partially mediated this
association (see Figure 1). We tested the significance of this indirect effect using bootstrapping
procedures. Unstandardized indirect effects were computed for each of the 5,000 bootstrapped
samples, and the 95% confidence interval was computed by determining the indirect effects at
the 2.5th and 97.5th percentiles. The bootstrapped unstandardized indirect effect was -.02, and the
95% confidence interval ranged from -0.037 to -0.004. As reported in Figure 1, results showed
that women reported higher levels of emotional empathy than men did. Controlling for this effect,
results showed that the higher narcissistic traits the higher instability of self- and other-
representations, and the higher instability of self- and other-representations the lower levels of
emotional empathy.
Discussion
The present study aimed at clarifying the relationship between narcissistic traits and empathic
capabilities, considering the mediational role of identity instability. Consistent with the literature,
capabilities. In line with previous findings (Czarna et al., 2015; Konrath et al., 2014; Marissen et al.,
2012; Ritter et al., 2011; Wai & Tiliopoulos, 2012), narcissistic traits were associated with
enhanced cognitive empathy, but impaired emotional empathic capabilities. In this sense, our
findings suggest that participants with high narcissistic traits are able to understand and identify
emotional states of others, but they are less willing to experience emotional involvement. The
existence of different patterns of associations between narcissism and the two components of
empathy is also confirmed by neuroanatomical studies. Recent studies (Allen et al., 2017; Shamay-
Tsoory, Aharon-Peretz, & Perry, 2009) found that cognitive and emotional empathy depend on
impairments linked to narcissism were identified both in nonclinical samples (Fan et al., 2011) and
In line with our results, positive associations between narcissism and cognitive empathy have been
found both in studies using self-report measures (Wai & Tiliopoulos, 2012) and laboratory
measures of empathy (Ritter et al., 2011). For example, Ritter et al. (2011), asking participants to
identify others’ affect states from photographs or videos showing people in emotionally charged
situations, found that NPD participants correctly inferred others’ mental state. Importantly, these
findings suggest that individuals high in narcissism have good abilities in recognizing others’ affect
states, and that such good abilities are not simply due to narcissistic overestimation tendencies.
To our knowledge, our study is the first to investigate the process underlying the association
between narcissistic traits and impairments in emotional empathy, considering the role played by
identity instability. Confirming our hypotheses, results showed that individuals with high
narcissistic traits report low empathic reactivity toward others’ affect states partially because of
instability of self- and other-representations. Johnstone et al. (2015) have recently highlighted the
role of the quality of sense of self in increasing emotional empathic capabilities (but not cognitive
ones). The authors have found that an increase in the activity of the right parietal lobe (RPL), which
emotional empathy. As suggested by the authors, a stronger sense of self is needed to determine
mature emotional empathic responses because it allows retaining self-control when observing others
in situations evoking negative emotional states. Indeed, differently from cognitive empathic abilities
through which people can understand and identify others’ affect states, being emotionally involved
with others is grounded in the ability to incorporate the experiences of others into the experience of
the self. In line with Johnstone et al. (2015), our results showed that identity instability has a key
role in emotional empathy but not in cognitive empathy. In particular, the present study highlights
that an unstable inner experience of self and others might explain why individuals high in
narcissism report low levels of emotional engagement with others’ affect states. A possible
explanation for this result might rely on narcissistic needs to maintain positive self-states. As
suggested by Atkins (2013), excessive identification with others who are experiencing emotional
states (especially negative ones) might lead to personal distress and avoidance, rather than empathic
involvement, because of the fear to feel the same affect states. In line with this, Baskin-Sommers et
al. (2014) suggest that the association between narcissism and emotional empathic impairments
might be partly motivation-based. Specifically, the authors stated that narcissists generally
disengage from empathic processing as a defensive response to avoid losing control or feelings of
vulnerability. It is thus plausible to hypothesize that the lack of a stable sense of self might
lead individuals high in narcissism to avoid being emotionally involved with others’ negative
emotions because of the need to maintain an inflated self-view. As stated by some studies (Horvath
& Morf, 2009; Pincus et al., 2009; Ronningstam, 2005), narcissistic functioning often involves self-
worthlessness, and negative affects, which might impair positive self-images. Considering such
findings, low emotional reactivity to others’ negative affect states in individuals with high
narcissistic traits might be an attempt of emotional detachment to protect the self from negative
feelings that might affect their self-experience. Indeed, experiencing emotional involvement with
others’ affect states means being able to contact the subjective experience of such emotions
(Johnstone et al., 2015), and individuals with high narcissistic traits could not easily recognize the
existence of negative feelings in their inner world because such recognition could arise up feelings
The results of the current study can be better understood in the context of the study’s limitations.
Considering the nature of the constructs investigated, we hypothesized that empathic difficulties
would have been influenced by narcissistic traits and identity instability. Despite the model where
personality features influence empathic capabilities is more plausible than the opposite pattern,
future longitudinal studies should test causal effects. Furthermore, it would be useful to replicate
this study using both direct and indirect measures of empathy. Studies on the relationship between
narcissism and empathic capabilities assessed emotional empathy using both self-report and
laboratory measures, asking people to explicit rate their emotional involvement with others’ affect
states. Differently from direct measures, indirect measures of empathy such as skin conductance
response to pictures of people in emotionally charged situations (Pfabigan et al., 2015), are fast and
automatic responses which cannot be intentionally manipulated by subjects. Thus, using both direct
and indirect measures of empathy could help to clarify whether narcissism is linked to impairments
in emotional empathy or whether low emotional involvement with others’ affect states is reported
because of the conscious attempt to maintain a positive and inflated sense of self, avoiding a
conscious contact with negative affect states. Again, debates persist about the NPI construct
validity: some authors have argued the NPI measures a “confusing mixture of adaptive and
maladaptive traits” (Cain, Pincus, & Ansell, 2008) mainly because of its relations with high levels
of self-esteem and features of adaptive psychological functioning. Based on such results, new
measures of narcissism have been developed, such as the Pathological Narcissism Inventory
(PNI; Pincus et al., 2009) and the Five Factor Narcissism Inventory (FFNI; Glover, Miller, Lynam,
Crego, & Widiger, 2012). Actually, the relationship between narcissism and self-esteem is complex
(Di Pierro, Mattavelli, & Gallucci, 2016), and empirical findings showing positive associations
between the NPI and self-esteem, as well as lack of distress, might be affected by biased positive
self-perceptions of narcissists, rather than being evidence of the poor construct validity of the NPI
(Miller, Lynam, Hyatt, & Campbell, 2017). Indeed, some studies have supported that the NPI
assesses pathological variants of narcissism, as the NPI total score is strongly related to symptoms
of NPD (Miller, Gaughan, Pryor, Kamen, & Campbell, 2009) and trait profiles that are consistent
with expert ratings of prototypical cases of grandiose narcissism (e.g., Miller et al., 2014).
However, differently from the PNI and the FFNI, the NPI measures only grandiose narcissistic
traits, and this should be considered in interpreting our results as indicative exclusively of the
relationship between grandiose narcissistic traits and empathic capabilities. Multiple measures
of grandiose narcissism should be used by further studies to investigate whether the pattern of
associations showed in the present study might be found regardless of the measurement of
grandiose narcissism. Finally, we found that narcissism was significantly associated with instability
of self- and other-representations. Despite significant, the strength of such association was weak,
probably because the study involved community participants. Indeed, it is plausible that both
narcissistic traits and identity instability are less severe in community participants compared
with clinical ones. In this sense, it could be useful to study the association between narcissistic
traits, instability of self- and other-representations, and empathy in clinical samples (e.g., patients
with NPD). In particular, we expect that studies in clinical samples will find similar patterns of
association between narcissism, identity instability, and empathic abilities, and that such
In conclusion, our study may advance research on the association between narcissism and empathy.
In particular, our findings suggested that identity instability has a key role in explaining
participants, we hypothesized that subjective experience of contact with others’ negative affect
states in individuals high in narcissism might be a challenge for their sense of grandiosity because
such contact might arise up feelings of vulnerability, as suggested by the object relation framework
Finally, results from the present study have also relevant clinical implications. Considering the
characterize patients with narcissistic traits in terms of their personality structure. The role of
identity, in fact, is central in determining the severity of such pathological traits, as recognized also
by the DSM–5 AMPD (APA, 2013). In line with this, the interplay between narcissistic traits,
identity, and emotional empathy is also relevant for treatment. Indeed, the present study suggests
that treatment techniques promoting the integration of self- and other-representations among
individuals with high narcissistic traits could improve their ability to being emotionally involved
with others.
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Table 1. Correlations Between Narcissistic Traits, Instability of Self- and Other-Representations,
Variable 1 2 3
1. NPI _
2. ISO .11* _
3. EE -.40** -.19** _
N = 462.
empathy.