I have been a registered nurse since 2004. I teach mental health nursing and have worked at an in-patient psychiatric healthcare facility.
If you have studied narcissistic personality disorder, you may have heard the term "malignant narcissism." Malignant narcissism is not an actual psychiatric diagnosis—it is more of a proposed subtype of narcissistic personality disorder.
When studying personality disorders in general, it is important to keep in mind that they range from mild to severe, and sometimes they even border on psychosis. Not every antisocial person is a serial killer, and not every narcissistic person has traits of malignant narcissism.
Narcissistic Personality Disorder
According to the Diagnostic and Statistical Manual of Mental Disorders (4th Ed., 2000) narcissistic personality disorder encompasses the following traits:
- A grandiose sense of self-importance
- Preoccupation with fantasies of unlimited success, power, brilliance, beauty or ideal love
- Belief that he/she is “special” and can only be understood by other high-status people
- Requires excessive admiration
- Has a sense of entitlement
- Exploits others
- Lacks empathy
- Is envious and believes others are envious of him/her
- Is arrogant and haughty
About 1% of the general population meet criteria for this disorder, but cases are steadily rising.
Antisocial Personality Disorder
The traits of antisocial personality disorder include:
- Failure to conform to social norms (e.g. laws)
- Deceitfulness (e.g. lying, conning, manipulating)
- Irritability and aggressiveness (e.g. a pattern of fighting, often physical in nature)
- Reckless disregard for the safety of others (e.g. driving recklessly with children in the car)
- Consistently irresponsible behaviors (e.g. doesn’t pay bills, skips from job to job)
- Lack of remorse (e.g. either demonstrates no remorse or demonstrates fake remorse)
You may notice that people with antisocial personality disorder often come across as charming and charismatic. This is part of the manipulation to draw in others who they may exploit and hurt in the future. About 4% of the population meet criteria for antisocial personality disorder and there is a familial pattern noted (DSM-IV TR, 2000). Most of those diagnosed with antisocial personality disorder are male, though females do suffer from it as well. For more detailed information about antisocial personality disorder, please see my article on this topic here.
Malignant Narcissism: Charles Manson?
It is very likely that you have encountered a person who embodies many of these traits. However, it is far less likely that you have encountered a malignant narcissist. You probably have seen or heard of Charles Manson. Those who believe malignant narcissism is a separate entity from narcissistic personality disorder and antisocial personality disorder may give Charles Manson as an example of a malignant narcissist. Watch the video below and then read on for more information about malignant narcissism. Decide for yourself whether Charles Manson and others like him have traits and symptoms that go far beyond those listed for narcissistic and antisocial personality disorder.
A malignant narcissist is hypothesized to have:
- Symptoms of narcissism
- Lack of a conscience
- Grandiosity built around aggression
- A psychological need for power
- Enjoyment of cruelty
You might see malignant narcissism in any of these scenarios:
- Serial killers
- Serial rapists
- Severe bullies
- Serial adulterers
Note that many of these are “serial” in nature. That is because personality disorders do not exacerbate and remit like many other mental illness (e.g. bipolar disorder). When a person has a personality disorder, it is for life, especially without intensive psychiatric treatment. The behaviors are largely choices, though some would argue that the biological and environmental factors at play leave little choice in the long-term.
Treatment of Malignant Narcissism
Malignant narcissism is extremely difficult to treat, as the malignant narcissist believes him/herself to be far superior to any doctor or therapist. He would not want another person to have the power to help him. If he were to improve his behavior, he would want to take all the credit for it, but since he is not equipped to deal with his own behavioral problems, it is unlikely his condition will improve with time. In fact, it is likely to worsen. Much of the prison population in the United States is thought to suffer from narcissistic personality disorder, antisocial personality disorder, or malignant narcissism, which seems to be a combination of the two aforementioned disorders. Basically, we do not know how to help this population and our only solution thus far is to imprison them away from people they may harm.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2013 Leah Wells-Marshburn
Kumar on May 05, 2017:
Hi, I found myself to have those traits of malignant narcissist. I keep hurting those around me. I want to change myself before I lose everyone I love. I need help. Please...
Brooklyne on May 17, 2015:
My mother is a malignant narcissist, but without the killing, maiming or anything that would get her in trouble. She has a clear fear of the law and I think that keeps her from harming anyone but her children. My sister and I were neglected emotionally, lied to constantly, gaslighted and she refuses to see the issues with how we were raised. My sister committed suicide 15 years ago and it slowly became apparent how deep her narcissism is. Only SHE knows God's heart and anyone who disagrees with her are going to hell, even the devout servants of God. She's paranoid that any interaction with people who do not believe as she does will drag her down to hell with them, so she's curt and rude to her customers at her shop. In the world she's created for herself, she has to be the leader. If someone leads her, it's temporary while she gets in position to take over. If someone else has a stronger personality (my curse as her daughter), they are squashed and made to feel inadequate and petty. I cannot even fathom how I was treated as a baby. Babies have needs. Needs she could never provide. I see her playing the role as grandmother well in front of people, but the few times I've caught her talking to my daughters (one was 2 and the other was 1) leaves me little guilt from removing them from her life. I think that if she had an enjoyment for cruelty, she'd keep it hidden, though she does inflict psychological cruelty on people. One day she told me all homosexuals are pedophiles. She has known that I'm gay for at least 12 years now. Anyhow, the manner in which it was done was clearly to mess with my head. A month later I brought it up as an example of how she says things without thinking about the consequences and she insisted that she never ever would say that and I was clearly making it up. I don't make things up. I have aspergers. Reality is hard enough to manage without keeping track of lies and stories. I have a hard time not being too honest with people. Anyhow, that's how a malignant narcissist can be incognito and not necessarily a gross sociopath.
Kenneth Avery from Hamilton, Alabama on May 02, 2014:
This was a fantastic hub. I loved every word. Voted up and all the choices. I know that you are a very talented writer with big things in your future. I wish you my best.
I am going to leave you some fan mail and be one of your followers.
I invite you to check out one of my hubs and follow me back. I would love that.
Have a safe weekend.
Kenneth/ from northwest Alabama
starme77 on November 20, 2013:
Nice Hub :) shared on Facebook, Pinned and linked to also :)
Leah Wells-Marshburn (author) from West Virginia on August 07, 2013:
Thank you so much for taking the time to read, comment, and link to this article! There is much confusion about the term and it still is not an actual diagnosis, but more of a hypothesis. You are right about Wikipedia; the information there is entered by users rather than authorities on subjects or from research-based, factual information. That causes some problems from time to time.
I will be sure to check out your hubs soon. It sounds like you have a unique perspective as an adult child of a narcissistic parent.
Gail Meyers from Johnson County, Kansas on August 05, 2013:
I inserted a link to this hub in my hub on The Death of a Narcissistic Personality Disordered Mother as a reference for an informed discussion of malignant narcissism.
Gail Meyers from Johnson County, Kansas on August 05, 2013:
Weclome to HubPages! I also write on narcissistic personality disorder from the perspective of an adult child of a narcissistic personality disordered mother. This is a good hub with needed professional input on the topic of malignant narcissism.
Only a few months ago there was a dispute on Wikipedia over the definition of the term "malignant narcissism" and "malignant narcissist." Even though many consider that to carry the same authority as an encyclopedia, to the best of my knowledge the information is entered on the site by individuals who care to voluntarily enter it.
I know Scott Peck used the term "malignant narcissist" in his book People of the Lie 30 years ago. He clearly describes these people as "malignant narcissists," which some have interpreted as today's definition of antisocial personality disorder with narcissistic traits. Others interpret it as malignant narcissism being the most severe case of NPD. So I think that in itself causes confusion. I have understood malignant narcissism to also mean narcissism that reaches the level of being malignant.
Then personality disorders in general have been under review by the profession, but I think quite a bit of that has been cleared up with the recent release of the DSM-5. The American Psychiatric Association Board apparently decided to keep the 10 classifications of personality disorders in the recently released DSM-5, as they stood in the DSM-IV.
It is my opinion that the ones who would be deemed the "sickest" among us often do not end up in prison.
I look forward to reading more of your work. So I hope you continue to write on this topic. Voted up!
Leah Wells-Marshburn (author) from West Virginia on July 12, 2013:
Thank you so much! I appreciate you taking the time to read, commenting, voting, and sharing! I'm glad you found it interesting. I too find this topic extremely interesting! I will check out yours as well.
Mary Kelly Godley from Ireland on July 12, 2013:
Very interesting and a good read. I have written about NPD too and have met quite a few in my time. DIdn't know much about anti-social personality disorder before though so that is an area I must read more about starting with your link to an article on the topic. Voted up ans shared.