An examination of the factor structure of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, narcissistic personality disorder criteria: one or two factors?

A growing body of research has suggested that narcissistic personality disorder (NPD) contains 2 factors or types: overt/grandiose and covert/vulnerable. A recent factor analysis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), NPD symptoms supported a similar 2-factor model. The present research tested this proposed 2-factor solution against a 1-factor solution (N = 289; 72% patients) using both confirmatory factor analysis and an examination of associations between the resultant factors and theoretically relevant criteria (other personality disorders; depression, anxiety). The results of the confirmatory factor analysis supported a 1-factor solution. Likewise, the 2 factors each yielded a similar pattern of correlations with relevant criteria. Together, these results argue against a 2-factor structure for the current DSM-IV NPD symptoms. Given the broader research literature suggesting a 2-factor structure of narcissism, strategies for assessing both overt/grandiose and covert/vulnerable forms of narcissism in DSM-V are discussed.