Narcissism and narcissistic defences in the eating disorders.

OBJECTIVE: This study examined the associations between eating pathology and narcissism in an eating-disordered group. Narcissism was conceptualized in terms of both its core element (entitlement, grandiosity) and the narcissistic defenses that are used to maintain self-esteem.

METHOD: Seventy non-clinical and 84 eating-disordered patients completed a measure of the different elements of narcissism, and a standardized measure of eating pathology.

RESULTS: The eating-disordered group scored higher than the non-clinical women on the measures of core narcissism and of the narcissistically abused style ("poor me" defense). The pattern of dimensional associations between narcissism and eating pathology was highly similar across the clinical and nonclinical groups, with the narcissistic defenses playing the strongest role. The poisonous pedagogy style ("bad you" defense) was positively associated with restrictive attitudes toward eating, while the narcissistically abused style was positively associated with restraint, eating concern, body shape concern, and body weight concern.

CONCLUSION: The narcissistic defenses are particularly relevant in understanding the eating disorders. Implications for future research are outlined, and suggestions are made about the need to assess and respond to these associations in treatment.