The association between grandiose narcissism and depressive symptoms in patients with insomnia disorder: Results from a pilot study.

Introduction: Insomnia is one of the most common sleep disorders, affecting approximately one third of the adult population. Although multiple studies have supported the bidirectional relationship between insomnia and depressive symptoms, a growing body of research suggests that insomnia may itself be a risk factor for depression. In insomniacs, depression – beyond being related with insomnia severity and sleep quality – is also associated with stress caused by dysfunctions of daily activities, with childhood interpersonal traumas, and with difficulty controlling negative emotions. Of note, there is also clear evidence that certain personality traits (particularly neuroticism) may act as predisposing/perpetuating factors for insomnia and related emotional-adaptive problems, including depression. Nevertheless, no study has ever considered the role of grandiose narcissism on predicting depression in patients with insomnia disorder (PsWID). Methods: Twenty-two PsWID were administered the Beck Depression Inventory (BDI-II), the Narcissistic Admiration and Rivalry Questionnaire (NARQ), the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), the Perceived Stress Scale (PSS), the Traumatic Experiences Checklist (TEC), and the Difficulties in Emotion Regulation Scale (DERS). A hierarchical multiple linear regression was performed to determine the role of the factors that were significant in Pearson correlations in predicting depressive symptoms. Results: Depressive symptoms were negatively associated with ‘charmingness’ facet of narcissistic admiration dimension, and positively associated with insomnia severity, sleep-induced daytime dysfunction, perceived stress, early interpersonal traumas, and – as regards emotion dysregulation – nonacceptance of negative emotions and difficulties controlling behaviors. Moreover, charmingness emerged as the strongest predictor of depression, followed by early interpersonal traumas and insomnia severity. Discussion: Narcissistic admiration (of which charmingness is the behavioral expression) is an agentic form of grandiose narcissism, which is supposed to act as a protective factor against depression. The results of this study, albeit preliminary, may shed further light on the research investigating the relationship between personality traits, early interpersonal traumas, and depression in PwID.