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Journal of Adolescence
journal homepage: www.elsevier.com/locate/adolescence
Profiles of narcissism and self-esteem associated with
comprehensive mental health in adolescents
Xiaofeng Xu
a,b,c
, E. Scott Huebner
d
, Lili Tian
a,b,c,∗
a
School of Psychology, South China Normal University, Guangzhou, 510631, People's Republic of China
b
Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, People's Republic of China
c
Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, People's Republic of China
d
Department of Psychology, University of South Carolina, Columbia, SC, USA
ARTICLE INFO
Keywords:
Narcissism
Self-esteem
Profile
Comprehensive mental health
Adolescents
ABSTRACT
Introduction: This study firstly aimed to identify different profiles of narcissism and self-esteem in
adolescents using latent profile analysis (LPA). A secondary aim was to examine associations
between the identified profiles and subsequent measures of comprehensive mental health.
Methods: Chinese adolescents (N= 1009, 50.8%girls, M
age
= 12.99, SD = 0.66) completed a
packet of measures on two occasions at 6-month intervals. Narcissism and self-esteem were as-
sessed at Time 1. Positive and negative indicators of mental health were assessed at Time 2.
Results: Latent profile analysis of narcissism and self-esteem identified six profiles: (1) high
narcissism and high self-esteem; (2) high-moderate self-regard; (3) moderate self-regard; (4) low-
moderate self-regard; (5) high narcissism but low self-esteem; (6) low self-regard. Adolescents in
the high narcissism and high self-esteem and high-moderate self-regard profiles displayed posi-
tive mental health outcomes whereas adolescents in the high narcissism but low self-esteem and
low self-regard profiles reported problematic mental health outcomes.
Conclusion: Differing profiles of narcissism and self-esteem in adolescents were identified; these
profiles provide new insight into the structure of self-concept for adolescents. Further, the
identified profiles of narcissism and self-esteem were differentially related to subsequent com-
prehensive mental health outcomes.
1. Introduction
Narcissism represents one dimension of an individual's positive self-concept, characterized by an excessive positive self-image,
feelings of superiority, a sense of entitlement, and cravings for admiration (Bosson et al., 2008;Morf & Rhodewalt, 2001). Another
important dimension of an individual's positive self-concept is self-esteem. The type of self-esteem addressed in this study was explicit
self-esteem, which involves a global subjective evaluation of one's worth as a person, characterized by the feeling that one is satisfied
with oneself (Rosenberg, 1965). From adolescence onward, individuals become increasingly self-conscious and motivated to create
and maintain favorable self-views (Harter, 2012). They also have a strong desire to feel valued and respected by others (Harter,
2006). Therefore, adolescence is an important stage for the formation and rapid development of positive self-views, including nar-
cissism and self-esteem.
Given that narcissism and self-esteem represent subjective evaluations and perceptions of the self, individuals’self-reports are
https://doi.org/10.1016/j.adolescence.2020.03.007
Received 16 July 2019; Received in revised form 12 March 2020; Accepted 17 March 2020
∗
Corresponding author. School of Psychology, South China Normal University, Guangzhou, 510631, People's Republic of China.
E-mail addresses: tianlili@m.scnu.edu.cn,paipaishu@163.com (L. Tian).
Journal of Adolescence 80 (2020) 275–287
0140-1971/ © 2020 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
T
considered the most appropriate method of assessment. Employing self-report measures, many studies have demonstrated positive
correlations between narcissism and self-esteem (Bosson et al., 2008;Orth, Robins, Meier, & Conger, 2016); however, this association
is more complicated when differing types and facets of narcissism are considered (Barry & Wallace, 2010). Thus, the nature of the
associations between narcissism and self-esteem needs to be clarified. The positive relations observed between the two constructs
promote related questions; for example, whether adolescents reporting high narcissism necessarily have high self-esteem, and
whether adolescents with high self-esteem necessarily have high narcissism. Despite the importance of such questions, previous
researchers have not examined how narcissism and self-esteem interact within adolescents. In contrast to the more frequently used
variable-centered approach in the extant research base, the application of a person-centered approach is needed to enable the
identification of different combinations of high or low narcissism and self-esteem in adolescents, including distinguishing subgroups
who possess well-balanced and accurate, favorable self-views from those who possess inflated and defensive, favorable self-views.
Self-perception plays a crucial role in the psychological functioning of adolescents (Ali, Fang, & Rizzo, 2010). The effects of
narcissism and self-esteem on mental health have been examined independently (Ng, Cheung, & Tam, 2014;Orth et al., 2016).
However, little is known about how different combinations of narcissism and self-esteem are related to adolescents’mental health.
Assessing narcissism and self-esteem related profile-specific outcomes would contribute to the identification of specific high-risk
profiles, potentially leading to the development of unique interventions for students represented in the various profiles. Additionally,
there might be an adaptive tipping point along the narcissism and self-esteem dimensions, which leads to the identification of
individuals who show particularly high levels of psychological functioning (Orth et al., 2016;Thomaes & Brummelman, 2016). Thus,
we could identify the optimal combination of the levels of narcissism and self-esteem facilitating the most positive mental health,
providing new insights into nurturing healthy feelings of self-worth in adolescents.
1.1. Narcissism and self-esteem
Both narcissism and self-esteem include positive self-evaluations, suggesting conceptual overlap. The correlations between the
two constructs range from 0.26 to 0.50, showing moderate relations (e.g., Ackerman et al., 2011;Brown, Budzek, & Tamborski, 2009;
Orth et al., 2016). Moreover, it is commonly believed that narcissism represents an excessive form of self-esteem, which has raised
questions about the discriminant validity of the constructs. In fact, narcissism and self-esteem are conceptually distinct dimensions of
the self. Specifically, Morf and Rhodewalt (2001) describe narcissistic self-views as grandiose and inflated, but vulnerable. Narcissists
require continuous attention, approval, and admiration from others to maintain their favorable self-views, which represents an
interaction between intrapersonal and interpersonal aspects of the self (Morf & Rhodewalt, 2001). In contrast, individuals with high
self-esteem hold realistically positive self-views, and although they feel intrinsically worthy, they do not feel superior to others. They
also do not depend on others to regulate their self-views (Horvath & Morf, 2010), thus their self-views represent intrapersonal aspects
of the self. Moreover, the distinction between narcissism and self-esteem is also supported by empirical evidence, indicating that the
two constructs display differential relations to important outcomes. Narcissism is positively correlated with higher levels of ag-
gression, antisocial behaviors, and hostility, whereas self-esteem is negatively correlated with such behaviors (Barry, Lui, Lee-
Rowland, & Moran, 2017;Donnellan, Trzesniewski, Robins, Moffitt, & Caspi, 2005;Tracy, Cheng, Robins, & Trzesniewski, 2009).
Overall, theoretical and empirical findings suggest that narcissism and self-esteem are overlapping, but distinct constructs.
The nature of the association between narcissism and self-esteem depends on which form of narcissism is being conceptualized
and measured. Non-pathological narcissism is often assessed in social-personality psychology research. This form of narcissism
manifests with grandiose or overt narcissism, characterized by a sense of superiority, exhibitionism, grandiose self-assuredness, and
desire for attention (Wink, 1991). This non-pathological or normal form of grandiose narcissism is often measured by the Narcissistic
Personality Inventory (NPI; Raskin & Terry, 1988), and in this case, narcissism positively correlated with self-esteem (Brookes, 2015;
Miller et al., 2011).
1
In contrast, pathological narcissism is often assessed in clinical research and practice. This form of narcissism
manifests with vulnerable or covert narcissism, characterized by self-reported inferiority, fragile self-confidence, insecure grandi-
osity, and hypersensitivity to criticism (Wink, 1991). The core aspects of vulnerable narcissism are captured by the Hypersensitive
Narcissism Scale (HSNS; Hendin & Cheek, 1997); in this case, narcissism negatively correlated with self-esteem (Brookes, 2015). The
pathological form of narcissism can also be assessed by the Pathological Narcissism Inventory (PNI; Pincus et al., 2009), and in this
case, narcissism also demonstrates negative associations with self-esteem (Barnett & Womack, 2015).
2
Additionally, childhood
narcissism has been measured by the Child Narcissism Scale (CNS; Thomaes, Stegge, Bushman, Olthof, & Denissen, 2008), which is an
age-appropriate, unidimensional instrument that captures feelings of grandiosity as well as vulnerability in children and adolescents.
Some research has shown that CNS scores are virtually unrelated to measures of self-esteem (Muratori et al., 2018;Thomaes et al.,
2008), whereas other research found that CNS scores positively correlated with self-esteem (Barry & Wallace, 2010). Taken together,
1
NPI-based narcissism is itself multidimensional. Although the total score on the NPI has consistently indicated a positive correlation with
measures of self-esteem, the dimensions of the NPI differentially relate to self-esteem. Specifically, the adaptive dimensions of the NPI assessing
sense of self-sufficiency and authority tend to have positive associations with self-esteem, but maladaptive dimensions including features of ex-
hibitionism, exploitativeness, and entitlement often have negative associations with self-esteem (Barry & Wallace, 2010;Brown et al., 2009).
2
The PNI assesses both grandiose and vulnerable facets of pathological narcissism (e.g., Pincus & Lukowitsky, 2010). The associations between
facets of pathological narcissism and self-esteem have shown inconsistent results in the literature. Some research has found a negative relation
between the vulnerable facet and self-esteem, but no relation between the grandiose facet and self-esteem (Zeigler-Hill & Besser, 2013); other
research has found negative relations between both facets of pathological narcissism and self-esteem (Pincus et al., 2009).
X. Xu, et al. Journal of Adolescence 80 (2020) 275–287
276
the association between narcissism and self-esteem is complex, with conflicting results reported in the literature.
1.2. The profiles of narcissism and self-esteem
Most of the extant research on the correlates of narcissism and self-esteem has relied on variable-centered methodological ap-
proaches, which describe overall relationships between variables across individuals. In contrast, person-centered approaches, such as
those used in Latent Profile Analysis (LPA), identify groups of individuals who are more similar to each other on particular attributes
or relations among attributes than individuals from different groups (Laursen & Hoff, 2006). Such approaches help to address po-
tentially complex relations between constructs, such as personality traits (e.g., Daljeet, Bremner, Giammarco, Meyer, & Paunonen,
2017). LPA can group individuals into subpopulations that exhibit different combinations of high or low narcissism and self-esteem;
thus LPA can contribute to a more sophisticated understanding of the nature of the interrelations between the two constructs within
individuals. It is therefore important to apply LPA to examine the complicated relations between narcissism and self-esteem as LPA
may identify profiles with positive or negative associations between the two constructs, and potential additional profiles not yet
considered.
Literature review showed that only one study has employed LPA to examine the different combinations of levels of self-esteem
and narcissism (which was measured in this study as entitlement, reflecting a core feature of narcissism). Employing a sample of New
Zealand adults, Stronge, Cichocka, and Sibley (2016) identified five profiles, including narcissistic self-esteem, optimal self-esteem,
high-moderate self-regard, low-moderate self-regard, and low self-regard. They did not identify a profile with high narcissism but low
self-esteem. However, it is unclear whether these findings generalize to adolescence, which reflects a time when narcissism reaches its
developmental high and self-esteem reaches its developmental low (Thomaes & Brummelman, 2016). Adopting a person-centered
approach in adolescents would allow the identification of potential, additional profiles not yet considered in adults. Additionally,
researchers have not examined the associations between different profiles of narcissism and self-esteem and adolescents’mental
health outcomes.
1.3. Associations of narcissism and self-esteem with comprehensive mental health
Previous research has shown that self-esteem and narcissism associated with negative and positive indicators of mental health
(i.e., comprehensive mental health). Specifically, self-esteem has been negatively linked with depression (Orth et al., 2016), anxiety
(Sowislo & Orth, 2013), and loneliness (Vanhalst, Luyckx, Scholte, Engels, & Goossens, 2013) and positively linked with life sa-
tisfaction and subjective well-being in school (Joshanloo & Afshari, 2011;Yang, Tian, Huebner, & Zhu, 2018). Narcissism has been
associated with decreased depression, loneliness, anxiety, and increased subjective well-being (Sedikides, Rudich, Gregg, Kumashiro,
& Rusbult, 2004). Research findings on the relations between narcissism and internalizing problems in adolescents has been mixed,
however. Some research has shown that certain features of narcissistic personality (e.g., exhibitionism) appear positively related to
internalizing problems in adolescents (Washburn, McMahon, King, Reinecke, & Silver, 2004). However, narcissism, as assessed by the
Narcissistic Personality Inventory for Children (NPIC; Barry, Frick, & Killian, 2003), has shown negative associations with inter-
nalizing problems in adolescents (Barry & Wallace, 2010). Such conflicting findings have precluded a clear understanding the effects
of youths’narcissism on mental health.
Studies have simultaneously examined the effects of narcissism and self-esteem on mental health. Results have shown that self-
esteem mediates the relation between normal narcissism and mental health (Brown et al., 2009;Sedikides et al., 2004), suggesting
the crucial role of self-esteem in narcissism's predictive utility to mental health outcomes. Researchers have also observed that
controlling for self-esteem decreased the protective effect of narcissism on depression to virtually zero (Orth et al., 2016). This finding
raises the question of whether the positive effect of narcissism on mental health is driven by concurrently high self-esteem. Moreover,
Washburn et al. (2004) found that high self-esteem exerted a protective effect against internalizing symptoms only in the absence of
certain features of narcissism (e.g., exhibitionism). However, research has also revealed that the effect of self-esteem on depression
remains regardless of the level of narcissism (Orth et al., 2016). Thus, whether the protective effect of self-esteem on mental health is
moderated by narcissism remains unclear.
Given that the effects of narcissism and self-esteem on mental health are intimately influenced by each other, the issue of how
narcissism and self-esteem interact in influencing mental health should be investigated. Although variable-based models of the effects
of narcissism and self-esteem on mental health have been informative, a lack of clarity remains regarding how different combinations
of narcissism and self-esteem specifically relate to mental health outcomes in adolescents. LPA would help reveal the effects of
qualitatively different profiles of narcissism and self-esteem on mental health outcomes in adolescents.
Considering possible cultural differences, the nature and magnitude of the relations between positive self-regard (i.e., narcissism
and self-esteem) and adolescents' psychological adjustment in collectivist cultures (e.g., China) needs to be clarified. Heine, Lehman,
Markus, and Kitayama (1999) have questioned whether the presumably universal need for positive self-regard exists in collectivistic
countries, which value humility and interpersonal harmony (Oyserman, Coon, & Kemmelmeier, 2002). One's feelings of worth in
collectivist cultures may depend less on generally positive self-evaluations and more on self-criticism as a functional means of
achieving social harmony (Schmitt & Allik, 2005). Furthermore, individuals in collectivistic cultures define themselves in part ac-
cording to the social groups to which they belong, with an emphasis on a sense of collective worth (Bettencourt & Dorr, 1997). Thus,
positive self-regard might be less central to psychological adjustment, because perceptions and appraisals about how one's accom-
plishments reflect on one's family and community (vs. the self) might be more critical in collectivistic cultures (Kwan, Bond, &
Singelis, 1997). However, in contemporary China with its ongoing social changes, adolescents currently appear more focused on
X. Xu, et al. Journal of Adolescence 80 (2020) 275–287
277
seeking personal goals and achievements, self-worth, and even a sense of superiority to others (Xue, 2011), reflecting a growing
tendency to make positive self-evaluations in China (Zhang, Noels, Guan, & Weng, 2017). Previous studies have found that the well-
established association between positive self-regard and psychological well-being in other cultures also occurs in China (Yang et al.,
2018). These findings seem inconsistent with Heine et al.‘s earlier assertion that positive self-regard is less central to psychological
adjustment in collectivist cultures. Positive self-evaluations in youth now seem more important for adaptive outcomes in con-
temporary China (e.g., Zhou, Li, Tian, & Huebner, 2018). Nevertheless, more studies are clearly needed to examine whether ado-
lescents' positive self-evaluations have protective effects on mental health in contemporary China.
Current, more comprehensive models of mental health, such as the dual-factor model (e.g., Keyes, 2005), conceptualize mental
health as incorporating two related, but distinguishable dimensions, negative and positive mental health. Negative mental health has
generally been measured by symptoms of psychopathology, including internalizing problems and externalizing behaviors. Ex-
ternalizing behaviors are directed outwardly at the social environment and are disruptive or harmful to others, and thus are easily
identified (Hunter, Chenier, & Gresham, 2014). In contrast, internalizing problems are directed inwardly at the individual and are less
disruptive to the social environment, making them more difficult to detect and therefore often unnoticed (Gresham & Kern, 2004).
The relative lack of detection and attention for internalizing problems represents a particularly salient issue in China. Parents and
teachers appear highly insensitive to adolescents' internalizing problems in the Chinese cultural context in which individual problems
and well-being are considered less important than the welfare and interests of the collective (Chen & Li, 2000). In contrast to
externalizing behaviors that may cause distress to others and threaten the harmony of the group (Chen & Li, 2000), Chinese ado-
lescents' internalizing problems are often overlooked and left untreated (Muhtadie, Zhou, Eisenberg, & Wang, 2013). Thus, it is
necessary to improve the detection of and attention to Chinese adolescents' internalizing problems. We chose measures of loneliness,
depression, and anxiety as indicators of negative mental health. For positive mental health, subjective well-being has represented
crucial indicators that correlated with narcissism and self-esteem (Giacomin & Jordan, 2016;Sedikides et al., 2004;Yang et al.,
2018). We chose measures of general life satisfaction and subjective well-being in school as indicators, which encompass well-being
in general and in a specific context (i.e., school), with the latter measure focusing on one of the most important contexts for ado-
lescents. In our study, we adopted negative indicators and positive indicators to measure comprehensive mental health, to obtain a
more encompassing and sophisticated understanding of the relations between narcissism and self-esteem and mental health. It should
be noted that all of the selected indicators of mental health reflected individual's internal and subjective experiences, which are
appropriately investigated with self-report measures.
1.4. The current study
The first aim of our study was to identify whether there were meaningfully different combinations of high or low narcissism and
self-esteem within adolescents, using Latent Profile Analysis methodology. We hypothesized that at least four profiles of narcissism
and self-esteem would be identified: (1) low levels of both narcissism and self-esteem; (2) high levels of both; (3) high levels of
narcissism and low levels of self-esteem; and (4) low levels of narcissism and high levels of self-esteem. We also acknowledged that
other profiles might emerge, such as moderate levels for both constructs.
The second aim was to explore how the different profiles of narcissism and self-esteem associated with adolescents’compre-
hensive mental health reports. We formulated three specific hypotheses: (1) Adolescents showing profiles characterized by low levels
of narcissism and self-esteem would display the most problematic scores across all indicators of comprehensive mental health; (2)
given that self-esteem mediates the positive relation between narcissism and mental health, we hypothesized that adolescents
showing profiles high in narcissism were only expected to display positive mental health outcomes when their high levels of nar-
cissism were accompanied by high levels of self-esteem; (3) adolescents showing profiles characterized by high self-esteem, regardless
of their narcissism levels, would report better comprehensive mental health than adolescents showing profiles low in self-esteem,
given that narcissism did not moderate the effect of self-esteem on mental health. Furthermore, we were also interested in de-
termining the combination of narcissism and self-esteem that would display the most optimal comprehensive mental health.
In addition, results from meta-analyses have shown that men tend to report higher narcissism and self-esteem than women
(Grijalva et al., 2015;Kling, Hyde, Showers, & Buswell, 1999), and that the gender differences in narcissism remain stable across
different age groups (Grijalva et al., 2015). We thus aimed to explore the role of gender on the profiles of narcissism and self-esteem
in adolescents. Compared to girls, we expected that boys would report an increased likelihood of belonging to a high narcissism, high
self-esteem profile.
2. Methods
2.1. Participants
Participants were drawn from public middle schools in a mid-sized city of northern China. Almost all of the participants were from
middle-income families and resided in urban areas, with parents who earned at least a high school degree. We conducted two surveys
of students, and each survey was taken at a similar time in the middle of the semester. At Time 1 (second semester of Grade 7), 1009
students (50.8% girls, M
age
= 12.99 years, SD = 0.66) participated in the survey. At Time 2 (first semester of Grade 8, six months
after Time 1), 88.6% of the Time 1 participants completed the questionnaires. Overall, 894 students provided data across two
occasions; 115 provided data for Time 1 only. Attrition was mainly due to students transferring to other schools or being absent from
school at Time 2 or for other reasons. The Missing Completely at Random (MCAR) test (Little, 1988) was conducted on all variables
X. Xu, et al. Journal of Adolescence 80 (2020) 275–287
278
included in this study; it demonstrated data were missing completely at random, χ
2
/df = 0.79, p= .50. We employed Full In-
formation Maximum Likelihood (FIML) estimation to handle missing data. In total, 1009 cases were included in our analyses.
2.2. Procedure
The research was approved by the Human Research Ethics Committee of South China Normal University as well as relevant school
boards, principals, and teachers. We obtained both parental consent and student assent before the initial assessment. Moreover,
students were informed of the voluntary nature of participation, the confidential nature of the data collected, and their right to quit
the study at any time. At Time 1, students were instructed to complete the self-report instrument in a regular classroom environment.
At Time 2, students who participated in Time 1 were invited to join the study again. A specific ID number was assigned to each
student for data-matching purposes. Across the two occasions, the participants were given identical verbal and written instructions
from the trained graduate assistant, and they were allowed to take as much time as needed to complete the questionnaires.
2.3. Measures
Self-esteem (Time 1). Self-esteem was evaluated using Rosenberg's Self-Esteem Scale (RSES; Rosenberg, 1965). The RSES
consists of 10 self-report items (e.g., “I feel that I'm a person of worth, at least on an equal plane with others.“), all of which are rated
on a 4-point Likert scale (1 for strongly disagree and 4 for strongly agree). Total scores were calculated with higher scores indicating
higher levels of self-esteem. Previous studies have demonstrated good reliability and validity among Chinese youths (Guo, Tian, &
Huebner, 2018). In addition, the RSES is the most widely used self-esteem measure, and it is considered a good measure to differ-
entiate self-esteem from narcissism (Rosenthal & Hooley, 2010). In the current study, the Cronbach's coefficients alpha was .81 at
Time 1.
Narcissism (Time 1). Narcissism was assessed using Childhood Narcissism Scale (CNS; Thomaes et al., 2008). This 10-item
measure captures the major features of narcissism relevant to children and adolescents, assessing narcissism as a single underlying
dimension of normal personality, rather than as a personality disorder. A sample item from the CNS is “Without me, our class would
be much less fun.”Participants were asked to respond on a 4-point scale, ranging from 1 (strongly disagree)to4(strongly agree). Higher
total scores indicated higher levels of narcissism. Previous research has supported the reliability and validity of the CNS (Barry &
Wallace, 2010;Muratori et al., 2018). Moreover, the CNS has also shown sound psychometric properties in Chinese adolescents
(Zhao, 2012). In the current study, the Cronbach's coefficients alpha was .82 at Time 1.
Positive mental health outcomes (Time 2). General life satisfaction was assessed with the Brief Multidimensional Students' Life
Satisfaction Scale (BMSLSS; Seligson, Huebner, & Valois, 2003), which was designed to measure general and domain-specific life
satisfaction of children and adolescents (ages 8–18). The BMSLSS consists of five items, each representing one of the five life domains
that have been shown to be important to children and adolescents (e.g., “I would describe my satisfaction with my family life as …“).
Participants were asked to respond on a 7-point scale, ranging from 1 (terrible)to7(delighted). Mean scores were calculated with
higher scores indicating higher general life satisfaction. The BMSLSS has demonstrated good psychometric properties among Chinese
adolescents (Ye et al., 2014). In our study, the Cronbach's coefficients alpha was .77 at Time 2.
Subjective well-being in school was assessed with the Brief Adolescents' Subjective Well-Being in School Scale (BASWBSS; Tian,
Wang, & Huebner, 2015). The BASWBSS included subscales representing School Satisfaction (SS) and Affect in School (AS). The SS
subscale consists of six items, representing students' subjective evaluations regarding their school lives (e.g., “I perform well in
school.“). Items for the SS subscale were answered on a 6-point scale, ranging from 1 (strongly disagree)to6(strongly agree). The AS
subscale consists of two items assessing the frequency of students' positive and negative affect in school respectively. Items for the AS
subscale were also answered on a 6-point scale, ranging from 1 (never)to6(always). The score for the SS subscale was computed by
averaging the responses to the six items. The score for the AS subscale was computed by subtracting the NA from the PA score.
Finally, the SS and AS subscale scores were summed to create a total BASWBSS score. The BASWBSS has demonstrated good psy-
chometric properties among Chinese adolescents (Tian et al., 2015). In this study, the Cronbach's coefficients alpha for the SS
subscale was 0.78 at Time 2.
Negative mental health outcomes (Time 2).Loneliness was measured using the UCLA Loneliness Scale-Version 3 (UCLA-3;
Russell, 1996). The scale consists of 20 items, assessing how people perceive their social situation (e.g., “Do you often feel lonely?“).
Participants were asked to rate themselves on a 4-point Likert scale ranging from 1 (never)to4(often). Total scores were calculated
with higher scores indicating greater levels of loneliness. The UCLA has indicated adequate support for its reliability and validity
among Chinese adolescents (e.g., Guo, Cai, Wang, & Li, 2017). In the current study, the Cronbach's coefficients alpha was .90 at Time
2.
Depression was measured by the Depression Self-Rating Scale for Children (DSRSC; Birleson, 1981), which consists of 18 self-
report items (e.g., ‘‘I don't think life is interesting.“). Participants were asked to respond on a 3-point Likert scale ranging from 0
(never)to2(often). Higher total scores on the DSRSC were indicative of a stronger disposition toward experiencing depression.
Previous studies have supported the reliability and validity of the DSRSC in Chinese youths (Zhou, Han, & Fan, 2016). In the current
study, the Cronbach's coefficients alpha was .85 at Time 2.
Anxiety was assessed with the Screen for Child Anxiety Related Emotional Disorders (SCARED; Birmaher et al., 1997), which
includes 41 items (e.g., ‘‘When afraid, I have difficulty breathing.“). Participants were asked to respond on a 3-point scale ranging
from 0 (never)to2(often). Total scores were calculated with higher scores indicating a stronger disposition toward experiencing
anxiety. The SCARED has shown adequate support for its reliability and validity among Chinese adolescents (Su, Wang, Fan, Su, &
X. Xu, et al. Journal of Adolescence 80 (2020) 275–287
279
Gao, 2008). In the current study, the Cronbach's coefficients alpha was .94 at Time 2.
2.4. Statistical analysis
Descriptive statistics and correlations of all study variables were performed first. To identify distinct combinations of low/
moderate/high narcissism and self-esteem for adolescents at Time 1, Latent Profile Analysis was conducted using Mplus 8.0. Prior to
conducting LPA, we converted all study variables into Z scores (M=0,SD = 1) to promote interpretation. Models estimated between
2- and 7- profile solutions. Model fit was evaluated based on several informational criteria, including the Akaike Information
Criterion (AIC; Akaike, 1987); the Bayesian Information Criterion (BIC; Schwarz, 1978); and the sample size adjusted BIC (A-BIC;
Sclove, 1987). Lower values for these indices indicated better model fit. Models were compared using the Lo-Mendell-Rubin like-
lihood ratio test (LMR-LRT) and the bootstrap likelihood ratio test (BLRT). A significant pvalue on these two tests indicated an
improvement of a k profile model over a k-1 profile model (Dziak, Lanza, & Tan, 2014). In addition, entropy was examined, with
values closer to 1 reflecting better classification accuracy. Finally, we also considered the interpretability of the identified profiles or
the extent to which adding an extra profile to the model revealed a qualitatively distinct profile (Wang & Wang, 2012).
Once narcissism and self-esteem LPA models were established, we used the 3-step process for LPA with covariates and distal
outcomes to examine profile associations with demographic factors and comprehensive mental health at Time 2 (Asparouhov &
Muthén, 2014). Multinomial regression models were conducted to test the predictive effects of sex and age on profile membership,
without the demographic variables themselves influencing the estimation of the latent profiles. This analysis examined the degree to
which these demographic characteristics were linked with increased or decreased likelihood of being in one profile compared to
another. The BCH auxiliary function in M-plus was utilized to examine profile differences in positive and negative indicators of
mental health at Time 2 (Bakk, Tekle, & Vermunt, 2013). The Benjamini-Hochberg correction was applied to adjust for the multiple
testing problems (Benjamini & Hochberg, 1995).
3. Results
3.1. Descriptive statistics
The bivariate correlations, means, and standard deviations for all measures are presented in Table 1. Adolescents’self-esteem and
narcissism were positively correlated (r= 0.38, p< .001). This finding was consistent with the research of Barry and Wallace
(2010), but inconsistent with other research showing that CNS scores were virtually unrelated to measures of self-esteem (Muratori
et al., 2018;Thomaes et al., 2008). Moreover, self-esteem and narcissism both positively correlated with indicators of positive mental
health and negatively correlated with indicators of negative mental health, with the exception of narcissism and anxiety. Girls
reported significantly lower narcissism than boys (t= 3.25, p< .001). No statistically significant gender differences were found on
the other measures.
3.2. Latent profile analysis
We evaluated models that ranged from two-to seven-profile solutions; the fit indices are depicted in Table 2. The estimated means
for self-esteem and narcissism for the various profile solutions are shown in the online supplemental materials. AIC and A-BIC values
decreased as the number of specified profiles increased, and BIC values declined until the models with the specification of a six-profile
solution. Although the two-profile, three-profile, four-profile, and six-profile solutions demonstrated a significant LMR-LRT and
BLRT, the entropy values for the two-profile and four-profile solutions were lower than for the three-profile and six-profile solutions.
Although the three-profile solution was more parsimonious than six-profile solution, the six-profile solution yielded better fit indices
overall than the three-profile solution. The theoretical meaningfulness and interpretability were also important considerations to
determine the best solution. The three-profile solution only identified profiles in which people scored at similar levels across nar-
cissism and self-esteem, reflecting a positive association between the two constructs. The additional profiles identified by the six-
profile solution reflected distinct levels on the two measures, such as a profile of students reporting high narcissism and low self-
Table 1
Bivariate correlations, means, and standard deviations for the measures.
Measure M(SD) 123456
1.T1 Self-Esteem 28.72 (4.59) –
2.T1 Narcissism 24.45 (5.02) .38*** –
3.T2 LS 6.05 (0.90) .36*** .16*** –
4.T2 SWBS 6.23 (2.27) .37*** .13*** .57*** –
5.T2 Loneliness 40.50 (10.19) -.38*** -.17*** -.57*** -.56*** –
6.T2 Depression 10.19 (6.01) -.43*** -.20*** -.50*** -.55*** .59*** –
7.T2 Anxiety 18.50 (14.08) -.32*** -.03 -.34*** -.37*** .45*** .52***
Note. LS = Life Satisfaction; SWBS = Subjective Well-Being in School; T1 = Time 1; T2 = Time 2.
***p< .001.
X. Xu, et al. Journal of Adolescence 80 (2020) 275–287
280
esteem along with a profile of students reporting moderate self-esteem and low narcissism, reflecting a negative association between
the two constructs. Because theory and previous research have supported the notion that narcissism and self-esteem are overlapping,
but distinguishable constructs, the profiles identified in the six-profile solution were of great significance, reflecting the full com-
plexity of the relations between narcissism and self-esteem.
Estimated means for self-esteem and narcissism for the six-profile solution are displayed in Fig. 1. The identified six profiles were
interpreted on the basis of previous research and theory. Adolescents in the first profile (n = 80; 7.9%) reported high scores on both
narcissism and self-esteem, representing a high narcissism and high self-esteem profile. The second profile (n = 233; 23.1%) con-
sisted of adolescents who scored above sample means for both indicators, with moderate narcissism and relatively high self-esteem,
representing a high-moderate self-regard profile. The third profile (n = 587; 58.2%) included participants who scored close to the
sample means of narcissism and self-esteem, representing a moderate self-regard profile. Adolescents in the fourth profile (n = 33;
3.3%) scored below sample means for both indicators, with low narcissism and moderate self-esteem, representing a low-moderate
self-regard profile. The fifth profile (n = 18; 1.8%) reflected a clear ‘cross-over’profile with high levels of narcissism but low levels of
self-esteem, representing a high narcissism but low self-esteem profile. Adolescents in the sixth profile (n = 58; 5.7%) reported low
scores across narcissism and self-esteem, representing a low self-regard profile.
3.3. Differences of gender and age
We examined differences between the reference profile (moderates) and each of the other profiles for gender and age. No dif-
ferences were found in relation to age among profiles. However, adolescent boys were significantly more likely than adolescent girls
to be classified into the high narcissism and high self-esteem profile, compared to the moderate self-regard profile. There were no
gender differences in other profiles relative to the moderate self-regard profile.
3.4. Latent profiles and comprehensive mental health outcomes at time 2
Table 3 and Fig. 2 depict the comparisons of comprehensive mental health outcomes across the six profiles. The adolescents in the
high-moderate self-regard profile experienced significantly higher life satisfaction and lower depression than adolescents in all other
Table 2
Fit indices for the various profile solutions.
Number of Profiles AIC BIC A-BIC LMR-LRT pvalue BLRT pvalue Entropy
2 5637.33 5671.75 5649.51 < .05 < .001 .59
3 5540.74 5611.45 5558.15 < .001 < .001 .78
4 5532.25 5603.97 5554.88 < .05 < .001 .72
5 5524.31 5598.02 5552.16 .12 < .01 .74
6 5510.56 5589.91 5543.63 < .05 < .001 .79
7 5503.28 5596.16 5541.58 .26 < .01 .75
Note. AIC = Akaike Information Criterion; BIC = Bayesian Information Criterion; A-BIC = Sample Size Adjusted BIC; LMR-LRT = Lo-Mendell-
Rubin Likelihood Ratio Test; BLRT = Bootstrap Likelihood Ratio Test.
Fig. 1. Mean Z-scores of self-esteem and narcissism for the six profiles solution.
X. Xu, et al. Journal of Adolescence 80 (2020) 275–287
281
profiles, except for the high narcissism and high self-esteem profile. The high-moderate self-regard profile reported significantly
higher subjective well-being in school than all other profiles. The high-moderate self-regard profile also rated their loneliness lower
than all other profiles, except for the high narcissism and high self-esteem and low-moderate self-regard profiles. Furthermore, levels
of anxiety in the high-moderate self-regard profile were significantly lower than those of all other profiles, except for the low-
moderate self-regard profile. Adolescents in the high narcissism and high self-esteem profile revealed higher life satisfaction and
lower depression than adolescents in all other profiles, except for the high-moderate self-regard profile. The high narcissism and high
self-esteem profile reported higher subjective well-being in school than the low self-regard profile. The high narcissism and high self-
esteem profile also experienced lower loneliness than the moderate and low self-regard profiles. Additionally, the high narcissism and
high self-esteem profile reported significantly lower levels of anxiety than all other groups, except for the high-moderate and low-
moderate self-regard profiles.
Adolescents in the low self-regard profile reported significantly lower life satisfaction than adolescents in all other profiles, except
for the low-moderate self-regard and high narcissism but low self-esteem profiles. The low self-regard profile reported lower sub-
jective well-being in school and higher depression than the high-moderate self-regard and high narcissism and high self-esteem
profiles. The low self-regard profile also reported higher loneliness than adolescents in all other profiles, except for the high nar-
cissism but low self-esteem profile. Moreover, the low self-regard profile reported higher anxiety than adolescents in all other profiles,
except for the moderate self-regard and high narcissism but low self-esteem profiles. Adolescents in the high narcissism but low self-
esteem profile revealed significantly lower life satisfaction and higher depression than adolescents in the high-moderate self-regard
and high narcissism and high self-esteem profiles. The high narcissism but low self-esteem profile reported lower subjective well-
being in school and higher loneliness than the high-moderate self-regard profile. Additionally, anxiety levels in the high narcissism
but low self-esteem profile were significantly higher than those of the other groups, except for the moderate and low self-regard
profiles.
The mental health status of the adolescents in the moderate and low-moderate self-regard profiles were worse than those of the
high-moderate self-regard and high narcissism and high self-esteem profiles, and better than those of the low self-regard and high
narcissism but low self-esteem profiles.
4. Discussion
Although previous research had indicated a positive relation between narcissism and self-esteem (e.g., Orth et al., 2016), it has
remained unclear how complex interactions between narcissism and self-esteem manifest within adolescents. We thus employed LPA
to identify different combinations of high or low narcissism and self-esteem in Chinese adolescents. Six narcissism and self-esteem
Table 3
Estimated means and standard errors of distal outcomes for each profile.
Profile T2 LS
M(SE)
T2 SWBS
M(SE)
T2 Loneliness
M(SE)
T2 Depression
M(SE)
T2 Anxiety
M(SE)
1 0.547 (0.096)
3456
0.844 (0.111)
23,456
−0.677 (0.108)
356
−0.858 (0.113)
3456
−0.702 (0.100)
2356
2 0.363 (0.132)
3456
0.148 (0.194)
16
−0.394 (0.169)
36
−0.420 (0.166)
3456
−0.141 (0.143)
1356
3−0.131 (0.057)
126
−0.281 (0.056)
1
0.236 (0.055)
126
0.304 (0.057)
12
0.244 (0.060)
12
4−0.364 (0.272)
12
−0.109 (0.371)
1
−0.129 (0.337)
6
0.451 (0.293)
12
−0.167 (0.268)
56
5−1.026 (0.576)
12
−0.635 (0.421)
1
0.494 (0.446)
1
0.617 (0.418)
12
0.892 (0.405)
124
6−1.061 (0.235)
123
−0.721 (0.192)
12
1.007 (0.240)
1234
0.699 (0.190)
12
0.608 (0.195)
124
Notes. 1 = High Moderates; 2 = High Narcissism and High Self-Esteem; 3 = Moderates; 4 = Low Moderates; 5 = High Narcissism but Low Self-
Esteem; 6 = Low Self-Regard. Numbers in superscript refers to groups significantly different (p< .05). LS = Life Satisfaction; SWBS = Subjective
Well-Being in School; T2 = Time 2.
Fig. 2. Distal outcomes of each latent profile
Notes. 1 = High Moderates; 2 = High Narcissism and High Self-Esteem; 3 = Moderates; 4 = Low Moderates; 5 = High Narcissism but Low Self-
Esteem; 6 = Low Self-Regard. LS = Life Satisfaction; SWBS = Subjective Well-Being in School; T2 = Time 2.
X. Xu, et al. Journal of Adolescence 80 (2020) 275–287
282
profiles were identified. It has also remained unclear how differing profiles relate to later comprehensive mental health outcomes.
Our findings showed that narcissism and self-esteem profiles were indeed differentially related to subsequent comprehensive mental
health outcomes, yielding a more complete picture of adolescents’self-views and mental health.
4.1. Latent profiles of narcissism and self-esteem
LPA identified two different profiles with high narcissism. The first of these, the high narcissism and high self-esteem profile, also
scored high on self-esteem. The adolescents in this high narcissism and high self-esteem profile represented a sense of grandiosity,
superiority, and entitlement that was also accompanied by high self-acceptance and self-respect. These adolescents with high self-
esteem may have employed narcissistic self-regulatory strategies, such as self-enhancement, superiority to others, and carving for
attention and admiration, to regulate their self-views. Another profile with high narcissism scored low on self-esteem, although
previous studies had suggested that narcissists' grandiosity would result in high scores on self-esteem (Bosson et al., 2008). Ado-
lescents in this group displayed levels of grandiosity, arrogance, and superiority that were unaccompanied by genuine self-approval,
reflecting a combination of grandiose self-images, intrapersonal inferiority, and fragile self-concept. The narcissism displayed by the
adolescents in this group may represent a defense against negative self-perceptions. These results suggest that adolescents’high levels
of narcissism are not necessarily accompanied by high levels of self-esteem.
We did not identify a profile with high self-esteem but low narcissism. This finding was inconsistent with that of Stronge et al.
(2016) in adults. Developmental factors that manifest in adolescence may account for this inconsistency. Specifically, adolescents are
confronted with the developmental demands of forming an autonomous identity; however, due to the occurrence of broad physical,
cognitive, emotional, and social changes during adolescence, it can be difficult for them to construct a coherent identity and a
realistic and authentic self-esteem. Adolescence also represents a period of increases in self-centeredness, need for attention, and
grandiosity (Hill & Lapsley, 2011), all of which share features with narcissism. Given that narcissism is more common in adolescence
than in other developmental stages, it might represent a normative adaptation among adolescents in meeting developmental chal-
lenges (Hill & Roberts, 2011;Lapsley & Aalsma, 2006). The characteristics of narcissism, such as self-enhancement, exhibitionism,
and superiority, would give adolescents a grandiose identity and sense of self-worth (Anastasopoulos, 2007), which might play a
compensatory role in supporting adolescents’self-esteem development, especially when they have not developed an optimal and
genuine self-esteem that is free from narcissism.
The result of failing to identify a profile with high self-esteem but low narcissism suggests that high self-esteem in adolescents is
consistently accompanied by high narcissism. This finding may be partly explained by cultural differences in expressions of self-
esteem. Specifically, the personal self-esteem measured by Rosenberg's Self-Esteem Scale (RSES) is likely more salient in in-
dividualistic cultures in which individual competence and success is emphasized (Yu, Zhou, Fan, Yu, & Peng, 2016). In contrast,
personal self-esteem may be less salient to those individuals from collectivistic cultures who tend to rely more on relational and
collective self-esteem (Du et al., 2013) because interpersonal harmony and group goals are emphasized more in the collectivistic
cultures. In collectivistic cultures, individuals also tend to exhibit self-effacing and modest behavior when evaluating individual
attributes and self-worth, which may lead to lower scores on measures of personal self-esteem (Kim, Peng, & Chiu, 2008). In ac-
cordance with such cultural values, individuals from collectivist societies who score high on measures of personal self-esteem might
value the personal aspects of oneself more and pursue positive self-regard more than others. Combined with the developmental
demands of adolescence, Chinese adolescents with high personal self-esteem are perhaps more likely to manifest self-enhancing
strategies, feelings of superiority over others, and self-centeredness.
Adolescents in the high-moderate self-regard profile reported relatively high self-esteem and moderate narcissism. This high-
moderate self-regard profile represented a somewhat similar configuration to an optimal self-esteem profile, showing just slightly
higher narcissism, which could be considered a less exaggerated version of optimal self-esteem. Moreover, the profile with average
levels of narcissism and self-esteem accounted for the largest proportion (approximately 58%) of the sample, showing that moderate
self-regard was the most commonly reported self-evaluation among adolescents.
In addition, adolescent males were more likely than adolescent females to be members of the high narcissism and high self-esteem
profile. This was supported by previous findings showing that men tend report both higher narcissism and self-esteem (Stronge et al.,
2016). This finding highlights the importance of taking gender into account when studying narcissism and self-esteem among
adolescents.
4.2. Comprehensive mental health differences across profiles
The six profiles of narcissism and self-esteem identified in the present study could be meaningfully distinguished by their sub-
sequent positive and negative mental health outcomes. Specifically, adolescents in the low self-regard profile revealed the most
problematic comprehensive mental health outcomes, a finding which is supported by existing research (Swann, Chang-Schneider, &
McClarty, 2007). It is possible that these multiple negative beliefs about the self trigger individuals’maladaptive perceptions and
cognitions related to life events and social interactions, which may increase the risk for poor mental health. Adolescents in the high
narcissism but low self-esteem profile also represented poor mental health status, which did not differ from adolescents in the low
self-regard profile. The narcissists with low self-esteem may oscillate between feelings of grandiosity and inflated self-views versus
feelings of inferiority, self-doubt, and shame, and the resulting affective variability might contribute to psychological distress and
negative mental health (Thompson, Berenbaum, & Bredemeier, 2011;Thompson et al., 2012). Adolescents in the low self-regard and
high narcissism but low self-esteem profiles reported the highest levels of subsequent psychopathological problems and lowest levels
X. Xu, et al. Journal of Adolescence 80 (2020) 275–287
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of subjective evaluations of overall and school life. Thus, these adolescents need the most attention from schools and parents.
Our results showed that high-moderate self-regard and high narcissism and high self-esteem profiles represented adaptive pat-
terns of self-views for adolescents’well-being. Adolescents in the high-moderate self-regard profile reported the most optimal
comprehensive mental health. Similarly, adolescents in the high narcissism and high self-esteem profile experienced higher levels of
life satisfaction and lower levels of depression than adolescents in all other profiles except the high-moderate self-regard profile.
Previous studies also found that the narcissists with high self-esteem tend to report higher life satisfaction and lower internalizing
symptoms (Ng et al., 2014;Papageorgiou, Denovan, & Dagnall, 2019).
Our findings demonstrated that adolescents in profiles characterized by high or relatively high levels of self-esteem (i.e., high
narcissism and high self-esteem and high-moderate self-regard profiles) experience better mental health status than adolescents in
other profiles regardless of their levels of narcissism, indicating that levels of narcissism might not moderate the effect of self-esteem
on mental health. Although high narcissism and high self-esteem also represents a healthy self-view, the mental health status of the
adolescents in this profile was worse than that of the high-moderate self-regard profile in terms of lower subjective well-being in
school and higher anxiety. These results indicated that relatively high self-esteem and moderate narcissism might represent the
optimal patterns of self-regard for adolescents’comprehensive mental health.
The two profiles with high narcissism identified in our research displayed contrasting mental health status. The high narcissism
and high self-esteem profile displayed positive mental health outcomes, whereas the high narcissism but low self-esteem profile
displayed problematic mental health outcomes. These results are particularly relevant to the issue of whether narcissism is adaptive
for adolescents’well-being. Our findings suggest that narcissism is beneficial for psychological health only when also combined with
high self-esteem. Previous studies have established self-esteem as a promising mediator of the relation between narcissism and
psychological health (Rose, 2002;Sedikides et al., 2004). Thus, self-esteem should be controlled as a confounding variable when
studying narcissism and psychological health in future research (Rosenthal & Hooley, 2010). In addition, adolescents in the low-
moderate and moderate self-regard profiles displayed less positive mental health and mild negative mental health. More studies are
needed to examine the longer-term consequences of membership in the two profiles.
Overall, we found that positive self-evaluation (e.g., high narcissism and high self-esteem and high-moderate self-regard profiles)
is associated with psychological health, whereas negative self-evaluation (e.g., low self-regard) is associated with psychological
maladjustment. The present research demonstrated that the protective effect of positive self-regard on psychological health holds in
China, a typical collectivistic country, as well as in individualistic countries. Although there have been dramatic social changes in
China over the past decades, interpersonal harmony and collective worth may maintain great importance for individuals.
Nevertheless, contemporary youths in China appear more concerned with their own values and achievement and place greater
importance on developing and maintaining a positive view of the self, perhaps reflecting a universal need for positive self-regard (Cai,
Wu, & Brown, 2009;Cai, Wu, Shi, Gu, & Sedikides, 2016). The positive self-regard is also central to Chinese adolescents’mental
health, which implies that the development of positive self-regard is equally important in individualistic and collectivistic cultures.
4.3. Strengths, limitations and future research
One major strength of our study was that we identified six different profiles with distinct relations between narcissism and self-
esteem, as well as different mean levels of positive self-views. These profiles provide new insight into the structure of the self-concept
for adolescents. Another important strength of our research was that we identified meaningful differences among the profiles on both
negative and positive mental health indicators via a relatively large, heterogeneous sample and a 2-wave longitudinal design. The
patterns of narcissism and self-esteem and their consequences for mental health in adolescents should contribute greatly to our
understanding of self-concept and its role in psychological functioning.
Several limitations of this research should be considered. First, this study relied exclusively on self-report measures. Although self-
report method is appropriate for the measurement of all our variables, the exclusive use of this methodology may limit the gen-
eralization of the findings. Second, our research assessed narcissism using a measure that conceptualized narcissism as a normal
personality trait (rather than as a personality disorder); thus conclusions regarding the relations between characteristics of students
with narcissistic personality disorder and mental health are limited. Third, there was small number of adolescents in some profiles
(especially the high narcissism but low self-esteem and low-moderate self-regard profiles), which may have limited our capacity to
detect significant differences among profiles in relation to comprehensive mental health outcomes. Finally, this research focused only
on the effect of interactions between narcissism and self-esteem on adolescents’comprehensive mental health. Given that narcissism
and self-esteem are also related to externalizing problems (Muratori et al., 2018), the links between profiles of narcissism and self-
esteem and externalizing behavioral problems should be addressed in future research.
4.4. Implications
This research yielded several important implications for developing healthy self-views and psychological adjustment in adoles-
cents. We identified six profiles of narcissism and self-esteem in adolescents, but did not identify a profile with high self-esteem but
low narcissism. Adolescence is considered to represent the period when identity confusion peaks (Erikson, 1968), and self-esteem
levels drop (Robins & Trzesniewski, 2005). Thus, it is important to apply effective assessment and intervention strategies to guide
adolescents to form positive and realistic self-evaluations, rather than grandiose or negative self-views. However, some interventions
attempt to raise self-esteem by focusing on overpraising adolescents, which may inadvertently lower self-esteem, yet raise narcissism
(Brummelman, Nelemans, Thomaes, & Orobio de Castro, 2017). Self-esteem interventions should not convey to adolescents that they
X. Xu, et al. Journal of Adolescence 80 (2020) 275–287
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are superior to others, reflecting the need to garner external validation; rather interventions should convey to adolescents that they
are worthy in their own right. To recapitulate, the identification of distinct patterns of self-views based on narcissism and self-esteem
should help parents, teachers, and mental health practitioners develop targeted interventions that nurture healthy feelings of self-
worth for adolescents.
Furthermore, our research indicated that distinct structures of self-concepts were differentially related to subsequent compre-
hensive mental health outcomes, implying the need for subsequent intervention programs to be tailored to the members of the
specific profiles. These findings would spur further efforts to better clarify how the self-concepts of adolescents affect their psy-
chological well-being and how they can be dealt with in treatment. Specifically, if adolescents’self-concepts are characterized by low
narcissism and low self-esteem or high narcissism and low self-esteem, the students in these groups should display the most pro-
blematic comprehensive mental health outcomes. Thus, these adolescents will need the most assistance from schools and parents.
Crucially, this research also indicated that the combination of relatively high self-esteem and moderate narcissism might represent
the optimal pattern of self-regard for adolescents, yielding the most positive comprehensive mental health outcomes and providing
new insight into nurturing healthy adolescents.
Declaration of competing interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be
construed as a potential conflict of interest.
Acknowledgements
This work was supported by the National Natural Science Foundation of China, China (NO. 31971005), and “13th Five-Year”Plan
of Philosophy and Social Science Development in Guangzhou, 2018, Guangzhou, China (No. 2018GZGJ22). This work was also
supported by the Postgraduate Research and Innovation Fund from School of Psychology South China Normal University.
Appendix A. Supplementary data
Supplementary data to this article can be found online at https://doi.org/10.1016/j.adolescence.2020.03.007.
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