"Labeled, Criticized, Looked Down On": Characterizing the Stigma of Narcissistic Personality Disorder

Narcissistic personality disorder (NPD) is widely thought to be highly stigmatized; however, little empirical research has characterized this stigma. In this investigation, we draw on seminal theories and constructs from the stigma literature to improve the field's understanding of NPD stigma across stigma levels (individual, interpersonal, and structural) and dimensions (concealability, origin, course, disruptiveness, aesthetics, and peril). Participants were mental health clinicians (N = 9) with experience treating NPD. Participants completed semistructured qualitative interviews exploring their observations of NPD stigma. Interview questions were guided by existing stigma frameworks. Responses were then coded thematically using inductive and deductive techniques. Results are reported by theme. Overall, clinicians agreed that NPD was a highly stigmatized disorder in both public and healthcare settings. NPD stigma was consistently reported at the individual, interpersonal, and structural levels and was most salient in the dimensions of course, origin, and peril. Stigma is thought to be a central barrier to diagnosing and treating NPD. More research and clinician education are critical next steps in reducing stigma. This investigation represents an important step forward in the characterization and conceptualization of NPD stigma. Additional work is needed to understand the experience of NPD stigma from the perspective of patients, further quantify potential mental health implications, and identify opportunities for stigma intervention.