The research, published in the journal Psychological Bulletin, analyzed the results of more than 400 studies from around the world and found that people high in narcissism were more likely to be aggressive, even when nothing provoked them. It also uncovered a nearly equally strong link between narcissism and violence intended to cause someone physical harm. Here’s what the research found on the link between narcissism and aggression.

The Study

For the meta-analytic review, researchers from The Ohio State University looked at 437 studies on narcissism conducted worldwide. The research involved a total of 123,043 participants. The average age of participants ranged from 8 to 62 years old, depending on the study they were involved in. The results showed that narcissism is a strong risk factor for aggressive behavior, such as cyberbullying, pushing others around, name calling, and spreading rumors. The study also found a robust link between narcissism and violence (defined as “aggressive behavior intended to cause extreme physical harm, such as injury or death”). The connection between narcissism and violence was slightly weaker than its association with aggression, but still strong. Interestingly, the researchers discovered that these results held true regardless of whether a narcissistic person was provoked. However, their “thin skins” made them even more likely to lash out in aggressive or violent ways when they were threatened, humiliated, insulted, criticized, or provoked in other ways, or did not receive special treatment they felt entitled to, the authors say. “‘Thin skin’ is explained as a fragile ego or a poor self-image. This negative view of oneself results in a superficially inflated ego,” says Lina Haji, PsyD, a licensed clinical psychologist, licensed mental health counselor, and founder of Rise Psychological Services in Miami, Florida. “As a result, narcissists are prone to aggress against others who evaluate them negatively.” The researchers found little to no difference in the results among participants of different genders or ages, or based on when and where the original study took place. “This is a well-written and methodologically sound investigation,” says Samuel Hawes, PhD, a licensed clinical psychologist and assistant professor of psychology at Florida International University. “The large number of studies included in this meta-analysis (more than 400) offers relatively robust statistical support for the finding of a significant and modest association between narcissism and aggression.”

While not the first to review earlier studies on narcissism and aggression, this research deepens scientific understanding of the ways in which even undiagnosed narcissism can result in violent tendencies. “It goes beyond previous attempts by considering sub-clinical narcissism, various ways in which it manifests, and aggression that is unprovoked versus being provoked,” says Michael Roeske, PsyD, a licensed clinical psychologist and executive director at Newport Academy, a mental health treatment center. Experts say that narcissists’ limited capacity to empathize with others and feeling exempt from certain rules and social norms may drive them toward aggression when they aren’t treated like the “center of the universe.”  “The reasons for this largely center around the need to protect a fragile self-image and maintain their inflated self-views,” explains Dr. Haji. “The aggression serves as attention-seeking, a sense of entitlement, to bolster self-esteem, and display a need to have their own way. In addition, the aggression toward others is self-indulgent.” Other underlying mental health disorders—such as psychopathy—may also make some narcissistic individuals more prone to violence and aggression, but further study is needed, says Dr. Hawes. “Psychopathy and narcissism are both marked by several underlying vulnerabilities, such as callousness, grandiosity, and manipulativeness,” he says. “These features, sometimes referred to as ‘psychopathy-linked narcissism,’ have been shown to be uniquely related to unprovoked aggression.” Dr. Hawes adds: “It would be interesting to know how much the relationship between narcissism and aggression is attenuated when statistically controlling for psychopathy.”

Curbing Aggression and Violence

Directing more mental health resources toward people high in narcissism could, in theory, help reduce aggression and violence. But that doesn’t necessarily mean narcissistic individuals will be receptive to therapy, let alone recognize they may have a personality disorder. “Because of their limited insight into how they are perceived by others, those high in narcissism will rarely seek treatment for that issue,” says Dr. Roeske. “Instead, other things will bring them into our care, such substance misuse, depression, or other mental health concerns.” Fortunately, therapists have tools that can help people high in narcissism cultivate empathy and reduce rage. Looking for signs of narcissism—even if that’s not what drove a person to seek mental health support—could give therapists an opportunity to help people work through these issues and avoid aggression. “Narcissists need to work on being able to engage and collaborate with others, cultivate empathy for others, appreciate others, and appreciate constructive feedback,” says Katherine M. Hertlein, PhD, LMFT, professor in the couple and family therapy program at the University of Nevada, Las Vegas. If you find yourself at the receiving end of aggression or violence from a narcissistic person, it’s important to distance yourself physically, set boundaries, and seek support from others.  “A victim of aggression can benefit from having an ally present or informing an ally (like a friend, family member, or co-worker) of the behaviors in order to avoid gaslighting and other techniques that narcissists tend to use,” says Dr. Haji. Finally, Dr. Roeske says, “It’s important to understand that this is not about you, even if the individual high in narcissism tries to blame you.” If you are dealing with aggressive behavior from a narcissistic person, it’s important to remove yourself from the situation right away and tell someone about it. That can help you avoid the gaslighting and other techniques narcissists sometimes use to further victimize others.