Narcissism in the Rorschach revisited: Some reflections on empirical data

This study investigates the extent to which the Rorschach was able to identify accurately pathological expressions of narcissism according to the methodological recommendations offered by T. Nezworski and J. Wood (1995). Ninety-one patients who were found to meet DSM-IV criteria for an Axis II disorder (Cluster A personality disorders = 10; antisocial = 20, borderline = 25, histrionic = 5, narcissistic [NPD] - 15; Cluster C personality disorders = 16) and 50 nonclinical participants were compared on 5 Rorschach variables: reflection, pair, personalization, idealization, and the egocentricity index. The results of this study indicate that selected Rorschach variables can be used effectively to differentiate NPD patients from a nonclinical sample and from Cluster A, Cluster C, and other Cluster B personality disorders. Also, the reflection and idealization variables were found to be empirically related to DSM-IV diagnostic criteria for NPD and a self-report measure of NPD. Finally these two variables could be used for classification purposes in ways that were clinically meaningful in the diagnosis of NPD.