A study of the contributions of narcissism and psychopathy to addiction severity.

摘要

Pervasive social stigma and entrenched professional bias still contaminate the issue of diagnosis in the addiction treatment field, with empirical research repeatedly emphasizing the sociopathic qualities of addicts. Psychodynamic formulations of addicts' psychopathology have begun to offer more empathic explanations of addicts' problems in living. Diagnosis of addicts' personality traits have sifted to an emphasis on narcissistic vulnerabilities and the self-medication of psychic pain, rather than focusing in postulated superego deficits and aggression. It is possible that the criminal behavior exhibited by many addicts is (a) a function of legal sanctions imposed by a social system, and/or (b) a function of the degenerative "disease process" of addiction itself---rather than reflective of a predisposing and underlying psychopathology. If true, this would have significant implications for social policy and treatment interventions.; This study examined the contributions of narcissism and psychopathy to addiction severity in a sample of 66 male addicts. The DSM IV classification criteria for narcissism and addiction were used, as were Cleckley's and Hare's formulations of psychopathy, and Kernberg's theoretical framework for personality pathology. Participants who had been in treatment at a residential drug program for 4--6 months volunteered to participate. Psychopathy was assessed through a structured clinical interview (PCL-R); narcissism and addiction were assessed via three brief self-report questionnaires. Analysis of the data involved a hierarchical multiple regression that was conducted to clarify the above distinctions in psychopathology. Results contradicted the preponderance of research in finding no significant relationships between the predictor (personality) variables and the outcome (addiction) variables. The demographic variable of race was the only one found to be influential, in that Black addicts reported lower levels of substance abuse than either Whites or Hispanics. A supplemental analysis of the relationship between the two personality variables confirmed previous research in yielding several moderate correlations between various subscales and factors. Implications for treatment and suggestions for further research were discussed.