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Behavioral Traits in People with Malignant Narcissism

What is Malignant Narcissism?

Malignant narcissism is a less common manifestation of narcissistic personality disorder. Many experts believe this subtype of narcissism to be the most severe subtype of this mental health condition. Malignant narcissism is not recognized as a formal diagnosis since it is not included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). However, there are many mental health experts and psychologists who prefer to use the term malignant narcissism to describe a certain set of behavioral traits.(1, 2, 3, 4, 5)

For example, according to the Campbell’s Psychiatric Dictionary, malignant narcissism is a combination of characteristics from the following mental health conditions:(6)

Behavioral Traits in People with Malignant Narcissism

Malignant narcissism tends to present itself in several ways, and as a result, there is no set list of traits. This makes it very difficult for even mental health professionals to differentiate between severe narcissistic personality disorder and malignant narcissism. At the same time, there is no expert consensus on what is the diagnosis criteria for malignant narcissism. However, many mental health professionals support the existence of malignant narcissism as being a part of the narcissism spectrum. There is also a general agreement on some of the possible presentation of symptoms of malignant narcissism.(7, 8, 9)

However, this type of narcissism may develop with any combination of symptoms from the following disorders:

  1. Narcissistic Personality Disorder

    Similar to other personality disorders, narcissistic personality disorder is known to occur on a spectrum and a person having this condition suffers from a wide range of symptoms. According to the DSM-5, there are nine major traits that help identify and diagnose narcissistic personality disorder, but only five features are only needed for diagnosing the condition. Some of the common symptoms of narcissistic personality disorder include:(10, 11, 12)

    • Lack of or no empathy for other people’s feelings or emotions.
    • A prevalent need for attention, recognition, and admiration.
    • Grandiose fantasies and behavior, including a preoccupation with thoughts of personal power, success, attractiveness, or sex appeal.
    • A sense of entitlement.
    • An inflated sense of self-importance, including a tendency to exaggerate and boast about personal achievements or talents.
    • A tendency to take advantage of others or exploit others for personal gain.
    • A tendency to be jealous of others and believe that others are envious of them.
    • Conceited or arrogant attitude and behavior.
    • A strong belief in self-superiority and specialness.

    People with narcissistic personality disorder usually experience trouble when dealing with change. They are likely to feel humiliated or depressed whenever they feel slighted, reach in an angry manner when others don’t regard them with admiration and have a challenging time dealing with vulnerability and insecurity.

    People with narcissistic personality disorder also have difficulty managing their emotions and their behavioral responses to any stressful situation.

  2. Antisocial Personality Disorder

    The biggest characteristic of this mental health condition is the constant disregard for other people’s feelings. This often includes deceit and manipulation, along with emotional and physical abuse. Another major feature of this disorder is a lack of remorse over any wrongdoing.

    Aggressive or violent behavior can also be a symptom of this disorder, but this is not always the case, and many people living with antisocial personality disorder never exhibit any kind of violent behavior.(13, 14)

    People who have antisocial personality disorder usually exhibit symptoms of conduct disorder in their childhood. This might also include violence towards other people and animals, theft, vandalism, and other such behaviors. They also don’t care or take into consideration the consequences of their actions.

    It is important to note that antisocial personality disorder is only diagnosed in adults. Mental health professionals do not diagnose anyone younger than 18 with this condition, and a diagnosis requires the individual to have at least three of the following symptoms:(15, 16)

    • Pattern of deceit, including manipulation and exploitation of others.
    • Having disdain for social norms and authority. This is typically exhibited by law-breaking or illegal behavior.
    • Impulsive, reckless, or risky behavior that indicates an utter disregard for personal safety or, for that matter, the safety of others.
    • Having a general hostile, irritable, aggressive, or restless attitude
    • Showing little to no remorse for illegal or harmful actions.
    • Having difficulty planning head.
    • A pattern of arrogant, irresponsible, or disrespectful behavior.
  3. Sadism

    The symptoms of sadism can also appear with malignant narcissism. Sadism is a term used to refer to behavior that takes pleasure in humiliating a person or causing them pain. According to DSM-5, sexual sadism disorder is defined as a condition that involves getting sexually aroused from the idea of causing an unwilling person unwanted pain. However, sadism itself is not a mental health disorder or diagnosis, and neither does it always have to be sexual.(17, 18, 19, 20)

    People with sadistic tendencies may experience the following:

    • Enjoy watching others feel pain.
    • Enjoy hurting others.
    • Get sexually excited by seeing others in pain.
    • Want to hurt others when they feel angry or irritated.
    • Spend a lot of time fantasizing about hurting others, even if they don’t actually go ahead with it.
    • Tend to be aggressive in their behavior or actions.
    • Enjoy humiliating and putting others down, especially in public.
    • Behave in dominating or controlling ways.

    Many experts believe that sadistic behavior can help distinguish between narcissistic personality disorder and malignant narcissism.(21)

    Narcissism often involves the self-centered pursuit of goals and desires, but people with narcissistic personality disorder are more likely to still show some remorse and regret hurting others due to their actions.

  4. Aggression

    Aggression is, again, not a mental health condition but a type of behavior. It is not possible to diagnose a person with aggression, but a mental health professional may note aggressive behavior or acts of aggression as part of the diagnostic profile of a person.(22, 23, 24)

    Aggressive behavior tends to occur as a response to anger or any other intense emotion and usually involves an intent to destroy or harm. There are three main types of aggression seen in people, including:

    • Affective aggression: This form of aggressive behavior is usually directed towards a person or object that triggers an emotion. It might be redirected if it is not possible to target the initial source of anger. For example, punching a wall instead of punching another person is a form of affective aggression, especially when the action is based on a desire to cause harm or damage.
    • Hostile aggression: This type of aggressive behavior is aimed at destroying or injuring something or someone.
    • Instrumental aggression: This form of aggression relates to achieving a specific goal, such as smashing a car window to steal a wallet.

Is Malignant Narcissism the Same as Sociopathy?

Many of us often tend to use the term sociopath in casual conversation to describe a person who does not seem to care about others or who takes advantage of or manipulates other people, especially their loved ones. Sociopathy is a term used to refer to the behavior and characteristics often seen in people with antisocial personality disorder. However, sociopathy is only used as an informal term and not as a special diagnosis.

Malignant narcissism is not the same as sociopathy, as the traits of antisocial personality disorder are just a part of this subtype of narcissism.


There is no special treatment for malignant narcissism, and therapy can help those who are looking for treatment and want to seriously make an effort to improve their behavior, feelings, and emotional reactions. It is possible for people living with malignant narcissism to go to therapy and work sincerely towards changing the behaviors that are having a negative impact on their life or the lives of their loved ones.


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  2. Goldner-Vukov, M. and Moore, L.J., 2010. Malignant narcissism: from fairy tales to harsh reality. Psychiatria Danubina, 22(3), pp.392-405.
  3. Geberth, V.J. and Turco, R.N., 1997. Antisocial personality disorder, sexual sadism, malignant narcissism, and serial murder. Journal of Forensic Science, 42(1), pp.49-60.
  4. Lenzenweger, M.F., Clarkin, J.F., Caligor, E., Cain, N.M. and Kernberg, O.F., 2018. Malignant narcissism in relation to clinical change in borderline personality disorder: an exploratory study. Psychopathology, 51(5), pp.318-325.
  5. Faucher, J., Savard, C., Vachon, D.D., Payant, M. and Gamache, D., 2021. A Scoring Procedure for Malignant Narcissism Based on Personality Inventory for DSM-5 Facets. Journal of Personality Assessment, pp.1-13.
  6. Google Books. 2022. Campbell’s Psychiatric Dictionary. [online] Available at: <https://books.google.com/books?id=76vPu_G2UkgC&printsec=frontcover&dq=isbn:0195341597&hl=en&sa=X&ved=0ahUKEwidsruBvuniAhUhoFsKHcwCBbsQ6AEIKjAA#v=onepage&q&f=false> [Accessed 17 May 2022].
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  8. Richards, B., 2018. Exploring malignancies: Narcissism and paranoia today. Psychoanalysis, Culture & Society, 23(1), pp.15-27.
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  10. SALMAN AKHTAR, M.D. and Thomson Jr, J.A., 1982. Overview: Narcissistic personality disorder. Am J Psychiatry, 139(1).
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  20. Berner, W., Berger, P. and Hill, A., 2003. Sexual sadism. International Journal of Offender Therapy and Comparative Criminology, 47(4), pp.383-395.
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  24. Berkowitz, L., 1962. Aggression: A social psychological analysis.
Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:May 28, 2022

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