Are We Misreading Neurodiversity for Narcissism…Again?
Monday, April 21, 2025.
In the ongoing saga of “Why is this person so weird and hard to be around?”, researchers have once again trained their lenses on narcissists.
And fair enough—narcissism is often an elegant explanation for behavior that feels disorienting, self-centered, or socially clumsy.
But what if that elegance is a bit too convenient?
What if this body of research—while meticulously designed and statistically sound—is accidentally mistaking neurodivergent misattunement for narcissistic malevolence?
Let’s ask, as any decent, science-based therapist should: Are we conflating narcissism with neurodiversity?
The Study: Seven Samples, One Diagnosis
The US researchers behind the study in question reviewed data from over 77,000 participants across seven studies, some of which used experience sampling methods (like mobile app check-ins) to assess how narcissistic traits correlate with perceptions of ostracism.
Participants with elevated grandiose narcissism—particularly the rivalry subtype—reported feeling more socially excluded, misreading ambiguous cues as rejection (e.g., a delayed text), and even got themselves actually ostracized by others in post-task group settings.
This pattern supports earlier findings (Park et al., 2017) suggesting that narcissistic rivalry is linked to hostile attribution bias and rejection sensitivity.
The study authors suggest a feedback loop: narcissistic traits lead to behaviors that increase ostracism, which in turn strengthens those narcissistic traits.
Sounds neat and tidy. Except—neurodivergent people might describe that exact same feedback loop.
Wait—What If the Results were Skewed by Neurodivergence?
Let’s pause before dunking the narcissists in tar and consider an alternate hypothesis: What if a good portion of those surveyed were just undiagnosed autistic or ADHD?
Consider the specific traits measured:
Misreading Ambiguous Social Cues (Baron-Cohen, 1995)
Sensitivity to Perceived Rejection (Greenlee et al., 2022)
Difficulty nterpreting Intention from Neutral Expressions or Timing Delays (Sasson et al., 2017)
These are hallmark difficulties in autism spectrum disorder (ASD)—especially among those with camouflaging traits (Hull et al., 2020).
ADHD, too, is associated with rejection sensitivity, emotional dysregulation, impulsive aggression under perceived threat, and chronic shame masked by bravado (Shaw et al., 2014; Ramsay, 2020).
You’d think that the already established link between RSD and ADHD would give them pause, but, nah. Why bother.
Both profiles can easily be mistaken for grandiosity, especially when the person is trying not to drown socially.
Yet, these neurodevelopmental profiles were not screened out in the narcissism studies. That’s a problem. A huge one, in my assessment.
Narcissism vs. Camouflaging: Who’s Who in the Social Anxiety Zoo?
Imagine two people walk into a group task:
One has grandiose narcissism. They’re craving admiration, sensitive to criticism, and retaliate if they feel slighted.
The other is an autistic adult in a high-camouflage state. They’re scanning every interaction for signs of exclusion, trying to appear confident, and deeply unsure of how they’re coming across.
Both might:
Talk too much or too little
Misread jokes
Fixate on their own contributions
Become withdrawn or defensive when misunderstood
Now add in ostracism. One becomes more self-righteous.
The other spirals into a mask of “I’m fine, it doesn’t matter,” while secretly cataloging every micro-rejection as proof they don’t belong.
Which is narcissism? Which is trauma? Which is neurodiverse?
We don’t know. Because the study didn’t bother to ask.
What's Actually Being Measured?
Another concern: Narcissism inventories often measure behaviors that are context-dependent, such as:
Seeking status or admiration
Thinking others don’t appreciate your special qualities
Being sensitive to perceived slights
But context matters.
For someone with a history of chronic invalidation or developmental trauma, these beliefs aren’t signs of delusion—they’re protective schemas.
And for someone neurodivergent, they may reflect long-term misattunement in social systems (Milton, 2012; Botha & Frost, 2020).
What looks like entitlement might be an exhausted defense against constantly being misunderstood.
Conspiracy Theories, Paranoia, and the Trouble with Correlation
One eyebrow-raising section of the research links narcissistic traits with paranoia and belief in conspiracy theories, citing a 2015 study (Imhoff & Bruder, 2014).
While it’s true that some folks high in narcissistic traits endorse conspiratorial thinking, that doesn’t explain why—nor does it rule out cognitive rigidity, epistemic distrust, or a traumatized worldview as mediators.
In other words, not everyone who distrusts authority is delusional. Some people just have long experience being lied to.
Implications for Therapy: The Ideal Self Is a Survival Strategy
The research concludes by noting that narcissistic clients resist therapy because they are unwilling to give up their “ideal self.”
This, again, may be true—but what if that ideal self isn’t just a mask?
What if it’s an adaptive fiction, constructed in response to lifelong vulnerability, shame, or neurodivergent difference?
The idea of helping clients “reshape cognitive distortions” is noble, but what if those distortions aren’t errors—just alternate mappings of a deeply alienating world?
And what if our cultural fixation on narcissism is really just a way of punishing people for needing too much while being too weird?
Final Thoughts: Ostracism Is a Social Mirror, Not a Diagnosis
A better designed study might offer some insights into how grandiose narcissism interacts with social exclusion, and how perception gaps sustain dysfunction.
But this sure as sh*t wasn’t it.
But if we don’t account for neurodivergence, trauma, and cultural mismatch, we risk mistaking distress signals for grandiose narcissism. Yikes!
That way lies invisibility and really bad therapy.
As always, we must ask not just what people are doing, but why they might be doing it that way—especially if their behavior feels unbearable to most of us.
Unfortunately, After all our so-called wisdom, we humans are exquisitely skilled at mistaking pain for pride, and pride for pathology.
Be Well, Stay Kind, and Godspeed.
REFERENCES:
Baron-Cohen, S. (1995). Mindblindness: An essay on autism and theory of mind. MIT Press.
Botha, M., & Frost, D. M. (2020). Extending the minority stress model to understand mental health problems experienced by autistic people. Society and Mental Health, 10(1), 20–34. https://doi.org/10.1177/2156869318804297
Greenlee, J. L., Winter, D., & Moser, J. S. (2022). Social rejection sensitivity in ADHD: A review. Journal of Attention Disorders, 26(1), 3–15. https://doi.org/10.1177/1087054720943270
Hull, L., Petrides, K. V., & Mandy, W. (2020). The female autism phenotype and camouflaging: A narrative review. Review Journal of Autism and Developmental Disorders, 7(4), 306–317. https://doi.org/10.1007/s40489-020-00197-9
Imhoff, R., & Bruder, M. (2014). Speaking (un-)truth to power: Conspiracy mentality as a generalised political attitude. European Journal of Personality, 28(1), 25–43. https://doi.org/10.1002/per.1930
Milton, D. (2012). On the ontological status of autism: The ‘double empathy problem’. Disability & Society, 27(6), 883–887. https://doi.org/10.1080/09687599.2012.710008
Park, S., Ferrero, J., Colvin, C. R., & Carney, D. R. (2017). Narcissism and social rejection. Personality and Social Psychology Bulletin, 43(3), 355–368. https://doi.org/10.1177/0146167216684135
Ramsay, J. R. (2020). The Adult ADHD Tool Kit: Using CBT to Facilitate Coping Inside and Out. Routledge.
Sasson, N. J., Faso, D. J., Nugent, J., Lovell, S., Kennedy, D. P., & Grossman, R. B. (2017). Neurotypical peers are less willing to interact with those with autism based on thin slice judgments. Scientific Reports, 7, 40700. https://doi.org/10.1038/srep40700
Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotion dysregulation in ADHD. American Journal of Psychiatry, 171(3), 276–293. https://doi.org/10.1176/appi.ajp.2013.13070966
Weinberg I, Ronningstam E. Narcissistic Personality Disorder: Progress in Understanding and Treatment. Focus (Am Psychiatr Publ). 2022 Oct;20(4):368-377. doi: 10.1176/appi.focus.20220052. Epub 2022 Oct 25. PMID: 37200887; PMCID: PMC10187400.