Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 0 0 2026 08 18 1 10 Reyhaneh Miralikhani Student Research Committee, Department of Clinical Psychology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. Gholamreza Ahmadi Department of Psychology, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, Iran. Mohadese Shiyasi Student Research Committee, Department of Clinical Psychology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. Zahra Safikhani Student Research Committee, Department of Clinical Psychology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. Seyedeh Elnaz Mousavi Department of Clinical Psychology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. 2025 12 31 2026 07 15 Objective: This cross-sectional study compared early maladaptive schemas, emotion regulation, and forgiveness across healthy, narcissistic traits, and narcissistic personality disorder (NPD) groups. Method: Convenience sampling yielded 492 adults: healthy individuals (n=205), individuals with narcissistic traits (n=196), and NPD (n=91). NPD classification required meeting the Structured Clinical Interview for DSM-5 Screening Personality Questionnaire (SCID-5-SPQ) threshold and telephone-based diagnostic confirmation. The traits group scored ≥8 on the Narcissistic Personality Inventory-16 (NPI-16) but did not meet the SCID-5-SPQ threshold; healthy participants scored below both thresholds. Participants completed Persian versions of the Young Schema Questionnaire-Short Form 3, Emotion Regulation Questionnaire, Interpersonal Emotion Regulation Questionnaire, and Heartland Forgiveness Scale. Multivariate analysis of covariance controlled for age, education, and marital status. Results: Both narcissistic groups scored higher than healthy participants on emotional deprivation, F (2, 486) = 6.65, P = 0.001, η²p = 0.027; defectiveness/shame, F (2, 486) = 7.00, P = 0.001, η²p = 0.028; and entitlement/grandiosity, F (2, 486) = 28.52, P < 0.001, η²p = 0.105. NPD participants reported higher perspective-taking than both groups, F (2, 486) = 10.57, P < 0.001, η²p = 0.042, and higher soothing than healthy participants, F (2, 486) = 6.87, P = 0.001, η²p = 0.027. Healthy participants reported higher self-forgiveness than NPD participants, F (2, 486) = 5.14, P = 0.006, η²p = 0.021, and higher forgiveness of others than both narcissistic groups, F (2, 486) = 13.33, P < 0.001, η²p = 0.052. Situational forgiveness differed, F (2, 486) = 11.07, P < 0.001, η²p = 0.044, with healthy > traits > NPD. No differences emerged in enhancing positive affect, social modeling, suppression, or cognitive reappraisal. Conclusion: schema vulnerabilities and forgiveness difficulties may be associated with narcissistic traits and NPD, while perspective-taking and situational forgiveness may differentiate NPD from trait-level narcissism. Findings are associative, not causal. https://ijps.tums.ac.ir/index.php/ijps/article/view/4529 https://ijps.tums.ac.ir/index.php/ijps/article/download/4529/1350