Depressive symptoms are known to co-occur in patients with narcissistic personality disorder (NPD). From a psychodynamic perspective, perfectionism, shame, and aggression are regarded as prominent in depressed patients. The authors investigated the occurrence of perfectionism, shame, and aggression in patients with NPD, and whether shame is a mediating or a moderating factor for aggression. Two groups of patients with depression, 61 diagnosed with NPD and no other personality disorders (PD) were compared with 56 without any PD, using the SCID screening questionnaire and a semistructured interview. All participants were administered the Multidimensional Perfectionism Scale, the Internalized Shame Scale, and the Buss-Perry Aggression Questionnaire. The NPD group showed significantly higher scores for self-oriented and socially prescribed perfectionism, shame, and aggression (i.e., physical, verbal, anger, and hostility). Shame was found to act as a mediating factor, reducing levels of aggression in patients with perfectionistic traits.

中文翻译：

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患有自恋型人格障碍的抑郁症患者的完美主义、羞耻感和攻击性

众所周知，自恋型人格障碍 (NPD) 患者会同时出现抑郁症状。从心理动力学的角度来看，完美主义、羞耻和攻击性在抑郁症患者中很突出。作者调查了 NPD 患者完美主义、羞耻和攻击性的发生情况，以及羞耻感是攻击性的中介还是调节因素。使用 SCID 筛查问卷和半结构式访谈，对两组患有抑郁症的患者（61 名被诊断患有 NPD 且没有其他人格障碍 (PD) 的患者与 56 名没有任何人格障碍 (PD) 的患者进行比较）。所有参与者都接受了多维完美主义量表、内化羞耻量表和 Buss-Perry 侵略问卷。NPD 组在自我导向和社会规定的完美主义、羞耻和攻击性（即身体、言语、愤怒和敌意）方面的得分显着更高。发现羞耻是一种中介因素，可以降低具有完美主义特征的患者的攻击性水平。