Understanding Grandiose and Vulnerable Narcissism in Adult Outpatients: A Head-to-Head Comparison Between DSM-5 Section II Personality Disorders and DSM-5 Alternative Model for Personality Disorders

To compare the effectiveness of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), Section II personality disorder (PD) model, and of the Alternative Model for Personality Disorders (AMPD) model in characterizing vulnerable (VN) and grandiose (GN) narcissism, a sample of clinical psychotherapy participants (N = 369) was administered the Schedule for Nonadaptive and Adaptive Personality-2, the Levels of Personality Functioning Scale-Self Report (LPFS-SR), the Personality Inventory for DSM-5, the Five-Factor Narcissism InventoryShort Form (FFNI-SF), and the Pathological Narcissism Inventory (PNI). In multiple regression models, the LPFS-SR scales and the Personality Inventory for DSM-5 (PID-5) domain scales explained 34.6% and 23.7% more variance than the self-reports of the 10 Section II PD symptom counts in the FFNI-SF and PNI GN scores, respectively. Similarly, AMPD measures outperformed self-reported symptom counts of the 10 Section II PDs, accounting for 28.8% and 22.6% more variance in the FFNI-SF and PNI VN scale scores, respectively.