Linn is a twenty-year-old female who grew up silently competitive while feeling inferior, and still excelling academically in the background of bullying and social exclusion. This report proposes that the vulnerability to trauma or to the perception of being traumatized can be related to the individual’s level of narcissism. Trauma-associated narcissistic symptoms (TANS) are a result of experiencing a stressor as an affront to the grandiose self. A traumatic disequilibrium occurs in a narcissistically vulnerable self. In both TANS and posttraumatic stress disorder (PTSD), secondary symptoms of anxiety and depression can significantly color the patient’s clinical presentation. Individuals can develop both TANS and PTSD, displaying a mixed clinical presentation. Psychotherapy with the primary goal to restore narcissistic equilibrium is recommended.
Wounds and Injuries ; Stress Disorders, Post-Traumatic ; Narcissism

OBJECTIVES: This study compared covert narcissistic propensity in adolescents with internet addiction tendency to normal adolescents. Further, we investigated the correlation between such propensities and anonymity in cyberspace, presence feeling and interactivity in internet gaming, and achievement motivation in adolescents with internet addiction tendencies. METHODS: Male middle school students with internet addiction tendencies (Addiction Tendency Group, N=27) and normal students (Control Group, N=29) were recruited. The scale of internet use, Covert Narcissism Scale, scale of achievement motivation, scale of anonymity in cyberspace, scale of presence feeling in internet games, and the scale of interactivity in internet games were administered. A comparison of the average scores and correlation analyses were performed. RESULTS: 1) Compared with Control Group, the Addiction Tendency Group showed significantly higher scores on all subscales of the Covert Narcissism Scale, and both the scale of presence feeling and that of interactivity in internet games. Further, the score on the scale of achievement motivation for the Addiction Tendency Group was significantly lower than that of the Control Group. 2) In the Addiction Tendency Group, the scores on several subscales of the Covert Narcissism Scale were significantly positively correlated with the scores on the scale of presence feeling in internet games, anonymity in cyberspace, and interactivity in internet games. However, in the Control Group, the scores of several subscales on the Covert Narcissism Scale were significantly negatively correlated with the score on the scale of achievement motivation, and was significantly positively correlated with the score on the scale of interactivity in internet games. There were no other significant correlations between the scores on the subscales of the Covert Narcissism Scale and the scores of either presence feeling in internet games or anonymity in cyberspace. CONCLUSION: These results suggested that adolescents with a tendency to be addicted to the internet exhibited higher covert narcissistic propensities than normal adolescents and that the covert narcissistic tendencies were related with presence feeling in cyber games as well as with anonymity in cyberspace.
Achievement ; Adolescent ; Anonyms and Pseudonyms ; Humans ; Internet ; Male ; Motivation ; Narcissism

PURPOSE: From the point of view that medical students are under the pressure of academic achievement and vulnerable to subjective distress, there is need for evaluate their strategies for enhancing self-esteem when they failed academically. This study was to develop the scale for enhancing self-esteem and to confirm the convergent, discriminant and criteria validity. METHODS: Data were collected from 279 students at a medical school in Seoul. The scale of strategies for enhancing self-esteem (SSES) comprised comparison with inferior, doubting academic failure, accepting failure, and attribution to incidental factors. Also, to confirm the validities, participants responded to items measuring self-esteem, narcissism, 5 personality factors, depression and adjustment. RESULTS: By explanatory factor analysis of SSES, composed of three factors-comparison, doubting, and acceptance-and in the confirmatory factor analysis, 3 dimensions were best fit. Notably, comparison and doubting strategies were positively associated with depression and negatively associated with adjustment. In contrast, acceptance strategies were negatively associated with depression and positively associated with adjustment. Additionally, comparison and doubting strategies were positively associated with narcissism. CONCLUSION: The SSES of medical school students after academic failure yields 3 dimensions reliably and consistently. Also, it shows satisfactory convergent and concurrent validities.
Achievement ; Depression ; Humans ; Mental Health ; Narcissism ; Schools, Medical ; Self Concept ; Students, Medical

PURPOSE: This study investigated the mental health status, self-esteem, social comparison, and narcissism among medical school students. In addition, the mediational effect of social comparison between self-esteem and narcissism was also tested with regard to whether the students compared themselves with others to enhance their own self-esteem. METHODS: Data were collected from 427 medical school students at a medical school in Seoul. The questionnaire included the Minnesota Multiphasic Personality Inventory (MMPI) 383 scale, the self-esteem scale, the Iowa-Netherlands Comparison Orientation Measure, and the narcissism scale. Using the MMPI findings, a clinical psychologist screened for possible clinical cases. Then, the frequencies of those with distress were compared between three groups, based on affiliation; premedical, medical, and graduate medical students. Also, the level of self-esteem, social comparison, and narcissism was tested by analysis of (ANCOVA), and the mediational role of social comparison was explored. RESULTS: Irrespective of affiliation, almost 10% of medical school students showed mental illness or distress. Of the clinical scales on the MMPI, the T scores of the Pa (Paranoia), Sc (Schizophrenia), and Ma (Hypomania) scales were higher in premedical and medical school students than in graduate medical school students. In addition, the mediational role of social comparison was confirmed only in medical school students. CONCLUSION: We demonstrated that subjective distress in certain medical school students needs to be addressed. Also, self-esteem was an important factor that correlated with mental health and distress indices. However, comparing oneself with others to enhance self-esteem by derogating or focusing could result in increased narcissism.
Humans ; Mental Health ; MMPI ; Narcissism ; Orientation ; Schools, Medical ; Students, Medical ; Weights and Measures ; Surveys and Questionnaires

PURPOSE: This longitudinal study was designed to examine the change in depression and anxiety and their predictors over 1 year among premedical and medical students. We compared depression and anxiety from 2 waves and determined the predictive power of personality, narcissism, social comparison, and social reward value on them. METHODS: Two hundred twenty-six students at a medical school in Seoul were divided into 4 groups according to academic year and completed a questionnaire at the end of 2010 and 2011. The questionnaire included the Zung Depression Scale; Zung Anxiety Scale; scales for social comparison, narcissism, and social reward value; and Neuroticism-Extraversion-Openness Personality Inventory. RESULTS: Among first- and second-year medical students, depression and anxiety increased significantly over the previous year. However, irrespective of academic year, depression increased significantly after 1 year. Also, social reward value had a moderating effect. Specifically, among students with low social reward value who entered their first year of medical school, the negative impact of the tendency toward depression and anxiety was amplified compared with older students. CONCLUSION: Because the predictors of mental health differ between groups, each group must receive specific, appropriate education. Also, because social reward value is important moderating factor of mental health, education and intervention programs that focus on social reward value are needed.
Anxiety ; Depression ; Humans ; Longitudinal Studies ; Mental Health ; Narcissism ; Reward ; Schools, Medical ; Students, Medical ; Weights and Measures ; Surveys and Questionnaires