Psychological Medicine

Original Articles

The narcissistic self and its psychological and neural correlates: an exploratory fMRI study

Y. Fana1a2a3, C. Wonnebergera1a2, B. Enzia2, M. de Grecka4, C. Ulricha5, C. Tempelmanna6, B. Bogertsa2, S. Doeringa7a8a9 and G. Northoffa1 c1

a1 Institute of Mental Health Research, University of Ottawa, Canada

a2 Department of Psychiatry, Otto-von-Guericke University Magdeburg, Germany

a3 Cluster of Excellence ‘Language of Emotion’ and Dahlem Institute for Neuroimaging of Emotion, Freie Universität Berlin, Berlin, Germany

a4 Department of Psychology, Peking University, Beijing, China

a5 Department of Psychotherapeutic Medicine, Fachklinikum Uchtspringe, Germany

a6 Department of Neurology, Otto-von-Guericke University Magdeburg, Germany

a7 Psychosomatics in Dentistry, Department of Prosthodontics and Material Sciences, University of Muenster, Germany

a8 Department of Psychosomatics and Psychotherapy, University of Muenster, Germany

a9 Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Austria


Background The concept of narcissism has been much researched in psychoanalysis and especially in self psychology. One of the hallmarks of narcissism is altered emotion, including decreased affective resonance (e.g. empathy) with others, the neural underpinnings of which remain unclear. The aim of our exploratory study was to investigate the psychological and neural correlates of empathy in two groups of healthy subjects with high and low narcissistic personality trait. We hypothesized that high narcissistic subjects would show a differential activity pattern in regions such as the anterior insula that are typically associated with empathy.

Method A sample of 34 non-clinical subjects was divided into high (n=11) and low (n=11) narcissistic groups according to the 66th and 33rd percentiles of their scores on the Narcissism Inventory (NI). Combining the psychological, behavioral and neuronal [i.e. functional magnetic resonance imaging (fMRI)] measurements of empathy, we compared the high and low narcissistic groups of subjects.

Results High narcissistic subjects showed higher scores on the Symptom Checklist-90 – Revised (SCL-90-R) and the 20-item Toronto Alexithymia Scale (TAS-20) when compared to low narcissistic subjects. High narcissistic subjects also showed significantly decreased deactivation during empathy, especially in the right anterior insula.

Conclusions Psychological and neuroimaging data indicate respectively higher degrees of alexithymia and lower deactivation during empathy in the insula in high narcissistic subjects. Taken together, our preliminary findings demonstrate, for the first time, psychological and neuronal correlates of narcissism in non-clinical subjects. This might stipulate both novel psychodynamic conceptualization and future psychological–neuronal investigation of narcissism.

(Received May 04 2010)

(Revised October 20 2010)

(Accepted October 20 2010)

(Online publication December 13 2010)


c1 Address for correspondence: Dr G. Northoff, M.D., Ph.D., F.R.C.P.C., Research Unit Director, Mind, Brain Imaging and Neuroethics, Canada Research Chair, The Michael Smith Chair, ELJB-CIHR, Royal Ottawa Healthcare Group, University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Room 6435, Ottawa, ON K1Z 7K4, Canada. (Email:


† These authors contributed equally to this work.