The Impacts of Narcissistic Leadership on Achieving the United Nations’ Sustainable Development Goals—A Scoping Review

: The United Nations’ Sustainable Development Goals (UN’s SDG) are a set of actionable frameworks, which can be achieved through collaboration among nations, emphasizing the significant role of leadership. Recent geopolitical trends have spotlighted leaders with pronounced sociopathic narcissistic characteristics, opposing any collaborative approach to achieving the UN’s SDGs. This study used a mix method (a scoping review and action research), to critically investigate the impact of leadership, narcissistic leadership in particular, on achieving the UN’s SDGs. The results showed that publications discussing the impacts of narcissism on achieving interconnected SDGs are scarce. The systemic negative factors enabling narcissistic leaders to rise above and keep power, and potential strategies to inhibit such leadership styles were critically discussed. The loss of the Sustainable Development Goals remains the best indicator of the global negative impact of narcissistic leadership and its influence on global health systems. It is not country-specific and is the only legitimate global measure available. Preventing the rise of such leadership, particularly in low-and middle-income countries may avert wars, conflicts, and their deadly outcomes from national and global perspectives. Novel global policies are urgently needed to safeguard global peace


Introduction
The United Nations' Sustainable Development Goals (SDGs) present an actionable framework to address the plethora of emergencies that today's world is grappling with [1].These goals, however, cannot be achieved without a system thinking and collaborative approach due to the existing complex web of global issues [2][3][4][5][6].A critical evaluation of the SDGs' agenda, particularly its pledge to "leave no one behind", shows that although the SDGs aim to tackle global poverty and environmental challenges, they give precedence to neoliberal policies and commercial interests over social justice and sustainability, promoting individualism over collectivism, and justifying problematic political agendas, calling for ongoing political efforts to achieve truly sustainable development [7].
The distinction between individualism and collectivism is crucial for achieving SDGs, especially, when an increasing number of team-based work during the last decades, shows a shift in working practice from individualism to collectivism [8], underscoring a need for integration among diverse partners/nations with specific abilities and specialties, collaboration, and significant leadership [9].Collaboration has been studied from diverse levels [10].However, the focus has often been on inter-organizational collaboration [11,12], while studies of interpersonal collaboration, which are more critical to team integration and governance, have been scarce.Colbry et al. define collaboration as "ongoing interpersonal interactions without significant power imbalances, all directed toward achieving common goals" [13].Their framework emphasizes the interplay between individual initiative and team dynamics, with effective collaboration, not a fusion, boosted by strong leadership and hindered by self-centered leaders lacking responsibility or empathy, maintaining team diversity to be crucial for problem-solving [14,15].
Studies have shown that one important factor, which may facilitate team integration, collaboration, comparison, and evaluation of development progress, is defined indicators, such as collaborative factors, which allow integration and comparison between two parties, planning, and evaluating the progress [15].In another study, the significance of sustainability indicators for standardizing and comparing development progress was studied.These indicators, revealing an organization's environmental, social, and economic aspects, were reported to be essential for national sustainability policy strategies.However, their effectiveness varied widely between countries, leaning towards national and individual approaches and thus contradicting their intended role as collaborative tools [16].In the face of these challenges, the dynamics of national and global leadership and its role in crises and conflicts, especially in establishing necessary grounds for peace, justice, strong institutions (Goal 16), and partnerships (Goal 17) become increasingly clear [17][18][19].
Leadership styles vary from command and control to follower empowerment, depending on the situation and group maturity [20]).Good leaders are defined by their abilities, skills, engagement, ethics, and collaborative decision-making [17,18,21].Bad leaders can be ineffective or destructive [22], with destructive leadership involving volitional harm-doing through abuse or passivity, intentionally or unintentionally, due to incompetence or reckless behavior [22][23][24][25][26]. Recent research has linked abusive leadership with narcissism [27].Narcissistic leaders are more prone to oscillate between good and bad leadership, probably affecting their actions and existence over time.They enjoy rivalry and seek admiration, which contradicts collaborative decision-making.This competitive nature appears to be the maladaptive dimension of narcissism [22,[26][27][28][29].
Narcissism, a complex personality trait and disorder, has been extensively studied in psychology, leading to various theories explaining its origins, characteristics, and dynamics.Sigmund Freud introduced narcissism, describing primary narcissism in infants and secondary narcissism in adults.Melanie Klein and D. W. Winnicott's Object Relations Theory emphasizes early caregiver relationships, where disruptions can lead to narcissism (Psychodynamic Theory).Heinz Kohut proposed that a lack of empathetic caregiver responses causes narcissism.Children need admiration and validation to develop a healthy self; without it, they may seek external validation, fostering narcissistic traits (Self-Psychology Theory).John Bowlby's Attachment Theory links early attachment experiences to future relationships and self-image.Insecure attachments can lead to narcissism as a defense against perceived rejection.Cognitive-behavioral theory focuses on thought patterns and behaviors.Narcissists often have distorted self-views and need constant validation, reinforcing their narcissistic traits over time.Sociocultural perspectives highlight the role of societal values and norms.Cultures emphasizing individualism and materialism, along with social media, promote narcissistic behaviors (Social and Cultural Theories).Genetic research indicates a hereditary component to narcissism, while neurobiological studies suggest brain abnormalities in areas related to empathy and self-regulation (Biological and Genetic Theories).Certain narcissistic traits, like confidence and dominance, may have evolved as advantageous, but when exaggerated, they become maladaptive (Evolutionary Theory) [43,44].
The recent geopolitical trends and research highlight leaders with sociopathic narcissistic traits.Despite the acknowledged impact of narcissistic leadership on organizational and societal levels, there is a dearth of literature specifically examining its effects on the UN SDGs.This study aims to fill this gap by critically analyzing whether and how narcissistic leadership hinders the fulfillment of the SDGs and proposing measures to mitigate these negative effects.Since all SDGs, especially SDGs 16 and 17, require collaborative leadership, the systemic factors enabling narcissistic leaders to rise above and keep power should be mitigated by potential strategies and measures to circumvent wars, conflicts, and their deadly global and public health outcomes.

Materials and Methods
Study design: This scoping review aimed to assess the size and scope of the available research literature and the existing gaps about the impact of narcissism on leadership and narcissistic leaders on achieving SDGs.Starting with a systematic search, we aimed to ensure the transparency and replicability of outcomes [45,46].However, since the scoping review process can be interactive, and to avoid missing critical studies, "Action Research" was conducted in the next stage to investigate and resolve critical issues simultaneously [47].The results were later synthesized narratively.Relevant studies were selected using eligible databases, and the predefined inclusion and exclusion criteria.Extracted data were organized, and the outcomes were summarized and reported as a table (see the result section) and in text.As part of action research, the reference lists of included papers were reviewed and additional studies from other sources were included in the final list of reviewed studies according to Munn et al. [48].
PRISMA statement: This research was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to ensure rigorous and transparent reporting.This research was registered in the Open Science Framework (DOI:10.6084/m9.figshare.26380726).
Research question: Does narcissistic leadership influence the achievement of the UN's Sustainable Development Goals?
Search keywords: Search keywords were used in isolation or combination, according to the recently published classification, covering four categories: (1) environmental factors; (2) infrastructural and economic factors; (3) social and health-related factors; (4) consequential factors (Table 1).

Consequential factors
Peace, Justice, Strong Institutions (Goal 16), and Partnerships for the Goals (Goal 17).

Search strings:
The following keywords were used based on the research question and SDGs categorization.The search process and results of each search string are presented in Supplementary Materials File.
"Narcissistic Leadership" AND "Environmental Impacts" "Narcissistic Leadership" AND "Infrastructure" AND "Economics" AND "Impacts" "Narcissistic Leadership" AND "Sociocultural" AND "Healthcare" AND "Impacts" "Narcissistic Leadership" AND "Peace" AND "Justice" AND "Strong Institutions" AND Partnership Databases and search engines: PubMed, Scopus, and Web of Science (WOS) databases.

Eligibility criteria:
The included papers must discuss narcissistic leadership and its impacts on different SDG categories.
Inclusion criteria: All published scientific papers, including reviews in English with no time restriction.At least two elements of each keyword should be discussed in the paper for each combination.
Exclusion criteria: Reports, conference papers, book chapters, dissertations, and publications in other languages were excluded.Conference papers were excluded because they often lacked the peer-review rigor and detailed methodology required for this study.A few dissertations were found but not included, since according to our psychiatrist expert in the group, they were not aligned with the aim of the study.

Review process and data charting:
Initial review: Two authors assessed the results obtained by screening all abstracts of included papers and choosing eligible studies for further review.The selected paper underwent a detailed review, allowing for a thorough exploration of each paper's key insights given the heterogeneous nature of the selected articles.
Secondary review: In this phase, two authors reviewed all selected papers.A collaborative effort was made to develop a data extraction form for all included studies, covering author names, geographic locations, study methods and populations, main results, and themes, as presented in Table 2.
Selection of sources of evidence: The authors assessed each article's title, content, and abstract.In cases where consensus was not reached, a third reviewer was consulted to make the final decision.The final search results were exported to an Excel file, where two reviewers examined the collected papers.Duplicate entries were eliminated, and the remaining papers were carefully evaluated for their relevance to the study's objectives.The authors did not assess the evidence of each article, due to the heterogenicity of the included studies.
Data and content analysis: The results were compiled, synthesized, and grouped under the search keywords, i.e., the four subcategories of SDGs (Supplementary Materials File).
Ethical approval: No ethical approval was necessary for this review.
Reporting checklist: Presented as Appendix A.

Results
A sum of 428 articles was obtained for the first review.After excluding 84 duplicates, and 168 irrelevant papers, 176 papers went to screening.A total of 62 papers were irrelevant or from unreliable sources, leaving 114 papers for the second review, of which 35 papers were included in the final list.Another 12 studies were also added through action research to this final list (Figure 1).The outcomes (n = 47) were grouped according to the four categories of SDGs, summarized, and presented in Table 2.   Table 2.The summary of all included literature in the review and keywords for content analysis.Qualitative study The authors contend that the conflict in Ukraine poses a significant threat to the attainment of the Sustainable Development Goals (SDGs).They identify various patterns within this crisis that have impeded progress toward the SDGs globally.Among all the SDGs, the authors emphasize SDG16, which pertains to peace and justice, as being indispensable for advancing other goals successfully.

Khorram-Manesh and Burkle, DMPHP, 2023 [19]
Narrative review There is a clear relationship between the psychological developments of individuals with narcissistic and psychopathological disorders and the implications of an abnormal progression of these individuals and their obsessive desire for singular leadership, which seriously impacts healthcare security and its essential elements provided by international humanitarian law and the Geneva Convention.

War, Decision-making, Leadership, International laws
Human rights 10 Devils at Job Environment: A study on employee ego depletion from abusive supervision to a workaholic coworker.
Jin, Int J Hosp Manag, 2023 [23] Quantitative Survey This study explores how abusive supervision and workaholic coworkers impact employee well-being and work motivations in the hospitality industry, and by performing three experiments.It showed that workaholic coworkers contribute more to stress than abusive supervisors, leading to increased ego depletion, interpersonal conflict, and turnover intentions.Supervisors focused on self-achievement also elevate conflict and turnover intentions, and when coworkers show self-achievement tendencies, these effects intensify.Interestingly, employees' disidentification with workaholic coworkers helps reduce ego depletion, thereby lowering conflict and turnover intentions.These findings highlight the importance of addressing both abusive supervision and workaholic coworker dynamics to promote a healthier workplace and improve employee retention.
Narcissism, Leadership, Social interaction, power, organization De Bruin and Finkelstein, J Psychol, 2023 [24] Quantitative Survey This study shifts the focus from viewing abusive supervision as a constant phenomenon to exploring its dynamic nature using a within-person approach.Surveying 102 full-time U.S. employees with 932 daily surveys, it finds that daily abusive supervision reduces perceptions of justice and increases retaliation on the same day, but these effects do not persist over time.Interestingly, employees who engage more in workplace deviance tend to report more abusive supervision, possibly to justify their behavior.Furthermore, the research uncovers a reciprocal relationship where perceptions of justice predict subsequent reports of abusive supervision, suggesting a circular influence rather than a one-way street.Additionally, narcissism intensifies these dynamics.
Narcissism, Leadership, and social interaction, Organization, Justice Quantitative survey study This study examines whether narcissism increases the risk of burnout.A sum of 1,461 employees completed the personal burnout subscale of the Copenhagen Burnout Inventory and the Narcissistic Personality Inventory to measure maladaptive and adaptive narcissism.Linear regression analysis showed that higher adaptive narcissism was associated with lower burnout scores, while higher maladaptive narcissism was linked to higher burnout scores.
Additionally, younger age, female gender, depressive symptoms, sleep problems, and stress at work and home were all independently associated with higher burnout scores.Thus, narcissistic traits significantly influence burnout risk: maladaptive narcissism increases burnout symptoms, while adaptive narcissism reduces them.
Narcissism, Social engagement 14 Putting Oneself Ahead of the Group: The Liability of Narcissistic Leadership

Lynch et al., Personal Social
Psychol Bull, 2023 [29] Quantitative survey study Drawing from interdependence theory and the concept of narcissistic admiration and rivalry, the authors suggest that narcissistic leaders face a significant challenge in maintaining benevolent perceptions over time.Their tendency to prioritize self-interests over collective ones may become apparent, tarnishing their reputation.In this study, narcissistic rivalry (but not admiration) was linked to increasingly negative ratings of leader effectiveness.Perceptions of prioritizing self-interests and lacking concern for others were closely tied to declines in leader effectiveness.These findings shed light on how perceived interpersonal motives contribute to the downfall of narcissistic leadership.

Tiwari and Jha,
Int J Organ Analysis, 2022 [30] Narrative/ descriptive study The findings highlight that narcissistic behavior not only directly leads to organizational deviance but also exacerbates it through its positive associations with toxic work culture and abusive supervision.This research provides substantial contributions to the literature by elucidating the complex relationships that underlie deviant behaviors in organizational settings.

Narcissism, Leadership, Organization 16
Multifaceted leaders: the double-edged sword effect of narcissistic leadership on employees' work behavior

Chen et al., Front
Psychol 2024 [31] Quantitative survey study This study offers a unique perspective on narcissistic leadership by exploring its potential positive effects, in contrast to previous research focusing mainly on its negative impacts.Drawing from the Conservation of Resources Theory, the study employs data from 450 employees and their direct leaders to examine the dynamics of narcissistic leadership.

Narcissism, Leadership 17
Arrogance in the workplace: Implications for mental health nurses.

Cleary, et al., Iss Mental Health
Nurs, 2015 [32] Narrative review Cultures of performativity can foster organizational and individual arrogance.In the workplace, arrogance manifests as an exaggerated sense of self-importance, dismissiveness, condescension, and impatience.This behavior, regardless of power or position, is detrimental to the work environment.Arrogance undermines advocacy and empowerment, harms relationships, and negatively impacts consumer outcomes.This paper introduces the concept of arrogance, highlights its potential consequences, and promotes awareness of its harmful behaviors.
Narcissism, Sociocultural, Leadership, Power Maccoby, Harv Bus Rev, 2000 [33] Narrative Review The study discusses the emergence of narcissism in leadership and strategies for dealing with it.It also discusses the pros and cons, which are to be considered in the evaluation of narcissism.
Narcissism, Leadership, Pros, Cons 19 Why tyrants go too far: Malignant narcissism and absolute power.
Glad, Pol Psychol, 2002 [34] Narrative Review The study delves into why power-hungry tyrants with malignant narcissism ultimately self-sabotage.Their severe superego deficiencies may contribute.While initially leveraging advantages to ascend, their grip on reality weakens post-power, leading to fantastical decision-making.Mistakes fuel paranoid defenses, worsening their downfall.Quantitative study This study suggests that followers' views of a narcissistic leader and their job attitudes depend on the leader's visibility.The more followers observe a narcissistic leader, the more they notice toxic behaviors, reducing the perceived effectiveness.Results showed narcissistic leaders had less organizational experience at hire.When followers had limited observation, leader narcissism correlated positively with perceived effectiveness and job attitudes.However, this positive relationship vanished with increased observation.
Leader narcissism did not affect absenteeism, while absenteeism declined under non-narcissistic leaders.
Narcissism, Social Engagement, and Culture

22
The Impact of Narcissistic Leader on Subordinates and Team Followership: Based on "Guanxi" Perspective.

Wang, Front Psychol
2021 [40] Quantitative survey Using two-wave data from 326 employees in the manufacturing, and technology industry in China, this study found narcissistic leaders negatively impact the followership (F), and Team Followership (TF) of subordinates.Supervisor-subordinate guanxi (SSG) and team leadership relationships identity and partially mediate the relationship between narcissistic leadership and subordinates and team followership.Additionally, individual and team values moderate this process; specifically, higher individual tradition and team power distance (PD) mitigate the negative impact of leader narcissism on SSG and team leadership relationship identity.2006 [50] Survey, quantitative The authors examine how narcissism affects self and other ratings of leadership, workplace deviance, and performance.Study 1 found that narcissism was linked to higher self-ratings of leadership, even when accounting for the Big Five personality traits.Study 2 confirmed this, showing narcissism was positively correlated with self-ratings but negatively with others' ratings of leadership.Narcissists also rated themselves more favorably in workplace deviance and contextual performance compared to supervisors' ratings.

Systematic review
Globally, sociopathic, narcissistic, and antisocial personality disorders are worryingly prevalent, with individuals exhibiting these traits often causing harm to society.However, when such individuals ascend to positions of power, particularly in politics, their sense of entitlement, grandiosity, and sensitivity to criticism can escalate conflicts, leading to wars, unrest, or social suffering.This pattern is often only recognized after they have assumed high office, especially among national and international politicians.This review seeks to explore the social, political, and healthcare security implications of sociopathic narcissistic leadership and suggest strategies to mitigate its adverse effects on leadership.

29
A meta-analytic investigation of the antecedents, theoretical correlates, and consequences of moral disengagement at work.Ogunfowora, J Appl Psychol, 2022 [55] Quantitative survey This study delves into how individuals navigate moral boundaries in the workplace through cognitive strategies that rationalize unethical actions.It reveals that traits like honesty-humility, guilt-proneness, and moral identity significantly influence these strategies, while factors such as abusive supervision and organizational politics exacerbate them.Interestingly, ethical leadership and organizational justice, though expected to mitigate moral disengagement, show limited effectiveness.The research underscores that moral disengagement correlates with increased workplace misconduct and turnover intentions, along with decreased organizational citizenship behaviors and task performance.
It explains that moral disengagement weakens moral awareness and judgment, crucial for ethical decision-making, while paradoxically heightening post-misconduct guilt and shame.Overall, this narrative emphasizes how moral disengagement shapes workplace ethics and behaviors, urging organizations to consider comprehensive strategies to foster ethical environments and mitigate their detrimental effects.

Commentary
Narcissism significantly impacts the education sector.However, narcissistic leaders are not entirely detrimental; they are often creative strategists willing to take risks to satisfy their egos and leave a lasting legacy.This commentary explores the complex mix of positive and negative outcomes associated with narcissistic leaders.The debate over whether these leaders yield a net gain or loss is ongoing, as it largely depends on the organizational climate and other contextual factors.
Narcissism, Leadership, Pros and Cons.[60] Quantitative Survey The influence of leaders' personality traits on employee behavior is an emerging research area.Leaders are crucial in organizations as team members look to them for policy and behavioral guidance.This study examines the relationship between employee-perceived leader narcissism and employee voice behavior.Analyzing 239 questionnaires, we found that leader narcissism significantly impacts leadership impression management, with narcissistic leaders focusing more on self-serving rather than pro-social motivations.This motivation affects the quality of leader-member exchange (LMX), which in turn influences employee voice behavior.[64] Survey, quantitative This paper investigates the mediating effect of information search efforts on the relationship between leader narcissism and team creativity in China and explores participative decision-making as a moderator in the relationship between leader narcissism and information search effort.Findings indicate that leader narcissism positively impacts team information search efforts, which enhances team creativity.This effect is stronger with higher participative decision-making.Practical implications suggest that narcissism should be considered in manager selection and promotion, especially in innovation-focused teams, and that companies should encourage participative decision-making to leverage the positive aspects of narcissistic leadership.

Narcissism
Narcissism, Leadership, Social engagement, and Decision-making 40 Vulnerable Narcissism in social networking sites: The role of upward and downward social comparisons.

Kong et al., Front
Psychol, 2021 [65] Survey, Quantitative This study aimed to investigate the mechanisms linking active and passive Social Networking Sites (SNS) use with vulnerable narcissism among college students, using media effect and social comparison theories.These results indicated both active and passive SNS use is positively related to upward and downward social comparisons.Additionally, these forms of SNS use indirectly predict vulnerable narcissism through the parallel mediation of upward and downward social comparisons.The study highlights the critical role of social comparison in the relationship between SNS use and vulnerable narcissism.A quantitative, retrospective study While leader characteristics' impact on international activities is well-documented, leader narcissism has been largely overlooked in international business research.This study examines Chinese construction firms from 2006 to 2016, finding that leader narcissism positively influences the pace of internationalization and the preference for expanding into developing countries.Additionally, factors like foreign listing and an anticorruption institutional environment mitigate these effects.These findings highlight the significant role of leaders' personalities in international management, contributing to upper echelons theory, and emphasizing the importance of personal decision-making in the strategic direction and performance of construction firms.

43
No benefits for paradox personalities?Narcissism and humility in new work careers.

Höflinger and
Büttgen, mRev Manag Rev, 2022 [68] Quantitative survey The results of this survey revealed that the interaction between narcissism and humility hurt achieving leadership positions, project responsibilities, and salary expectations.
However, in the context of new work paradigms, a three-way interaction between narcissism, humility, and the nature of work turned positive for salary outcomes.This suggests that in contemporary work environments, individuals characterized as humble narcissists may achieve success in material terms.These findings did not show significant associations between narcissism, humility, and subjective career success measures.[72] Narrative Review Narcissistic personality disorder has been one of the least studied personality disorders with no certain cure.In fact, because of the limited research literature, narcissistic personality disorder was initially slated to be omitted from DSM-5.A decision that was revered to be included in Section II of DSM-5 (Diagnostic Criteria and Codes) and reconstructed in Section III (Emerging Measures and Models).
Narcissistic personality disorder, Diagnostic Management

Narcissism and Its Impacts on Leadership
Narcissism is a natural part of human development, with some individuals displaying unique traits early in life.Healthy narcissism, emerging in childhood, fosters curiosity, critical thinking, and empathy through experiences like anxiety and guilt.However, a lack of supportive environments can lead to pathological narcissism, characterized by a disregard for rules and a desire for power, often resulting in attempts to control others, culminating in violence and posing a security threat [19,37,49].
Narcissistic leaders, driven by grandiosity and self-centeredness, contradict collaborative leadership frameworks [13,50,51].Studies often link narcissism with transformational leadership [51].However, narcissists' leadership qualities are limited by their emotional development, typically arrested between ages 10 and 15.This emotional arrest persists throughout life, affecting all relationships and leadership activities.Narcissistic traits are lifelong and can only be mitigated, not eliminated, usually under significant pressure.Despite various efforts, these traits remain fixed from adolescence, where the individual's confidence and responses to threats become internalized.Traditional therapy often fails because narcissists embrace their differences, reinforcing their personality traits rather than changing them [37,80].
Although Maccoby's study focused on the business community, it applies universally, highlighting the pros and cons of narcissistic leadership.While narcissistic leaders may bring gains and benefits, they often overlook the negative impact on small businesses and individuals [33,52,53].A recent study examined how narcissistic Chief Executive Officers (CEOs) behave regarding irresponsible environmental, social, and governance (ESG) strategies, influenced by their managerial power and the operational uncertainty of their firms.The research revealed that narcissistic CEOs avoid adopting irresponsible ESG practices to protect their reputations and garner positive recognition from stakeholders and society.Furthermore, CEO narcissism's impact on ESG practices was moderated, or limited by CEO power, the uncertainty of the business environment, and the presence of corporate social responsibility committees and or independent board of directors [53,54].
Leaders like presidents Donald Trump, Vladimir Putin, and Benjamin Netanyahu are perceived as narcissistic and have shown disregard for environmental concerns, as seen in Trump's denial of climate change, Putin's actions in Ukraine, and Netanyahu's performance in Gaza, resulting in irreparable damage, as they prioritize chaos over environmental protection to bolster their egos [53,59,60,78,82].Elsewhere, a lack of investment in infrastructure and public health in a rich country such as IR Iran, or the destruction of the existing minimal health security system in Palestine, highlights the need for peace, justice, and global collaboration for sound environmental planning, prevention, protection, and policymaking [83][84][85].

Narcissistic Leadership and Infrastructural and Economic Factors
SDGs 8, 9, 11, and 12 are infrastructural needs that stimulate economic growth and require substantial and long-term financial support, education, and commitments [20][21][22].While narcissistic leaders may initiate projects to showcase innovation and gain popularity, their short-term planning and self-centered management style can hinder long-term success [29,39,[61][62][63][85][86][87].Their reluctance to consider diverse opinions and prioritize sustainability jeopardizes project outcomes [20][21][22]63,64,79,88] and contradicts collaboration [13,25].For instance, the US administration's handling of the COVID-19 pandemic disregarded public health experts' advice [19,79,81].Projects led by narcissistic leaders may not align with public needs or sustainability goals [85,87].The Russian invasion of Ukraine exemplifies the devastating impact of conflicts initiated by narcissistic impulses, causing widespread damage to infrastructure and essential services [89].Autocratic regimes led by narcissistic leaders perpetuate chaos to maintain power, resulting in economic instability and social unrest, exacerbating economic hardships, hindering foreign investment, and compromising public health systems, leading to societal challenges and healthcare vulnerabilities, all of which contradict collaborative action [41,54,80].

Narcissistic Leadership and Social and Health-Related Factors
Under narcissistic leadership, achieving social and healthcare-related SDGs, such as Goals 1-5 and 10 becomes challenging due to environmental degradation, economic instability, and social unrest.The rise of individualism under narcissistic regimes diminishes collectivism, hindering progress toward goals like poverty reduction, hunger eradication, gender equality, and the spirit of collectivism and collaboration [55,59,60,[81][82][83][84].Narcissists also exploit social media to propagate their ideas and engage in bullying and revenge, further worsening social divisions [65,66,[88][89][90][91]. Narcissistic leadership poses a direct threat to healthcare security, with continual violence straining healthcare systems and triggering refugee crises.The management of global health crises like COVID-19 is also compromised by narcissistic decision-making, affecting mental health and healthcare on local, regional, and global scales [19,65,92].For instance, the use of vaccines made in the West was banned by the supreme leader of IR Iran [93].Narcissistic leadership undermines social well-being and poses a significant risk to healthcare security and collaboration at all levels [67][68][69]94].Fomenting a chaotic situation lets the narcissistic leadership grow and keep its power.Under narcissistic leadership, hybrid warfare (HW) tactics are employed through nonmilitary means such as cyberattacks and lawfare, coupled with limited conventional force usage [19,70,89,91,[95][96][97][98][99].These strategies create chaos while evading legal consequences, undermining SDGs related to peace, justice, and strong institutions (Goal 16) and global partnerships (Goal 17) [1,19,97,99].
The Russian invasion of Ukraine exemplifies how such actions result in global chaos, environmental damage, and humanitarian crises, with significant implications for healthcare security and human rights [89,98], including the illegal use of a peacekeeping unit by Russia to annihilate the UN peacekeeping process, keeping international organizations out of the scene, and destroying global health and peace accomplishments that gave the global population some trust and hope [41,[97][98][99][100].
A narcissistic leader strengthens his power while denying the resulting social misery, using more force [101,102].As the world condemns the brutality of the Russian-Ukrainian war and its social consequences [89,99], elsewhere, other conflicts result in human rights violations and violent suppression, mirroring tactics seen in HW [100][101][102][103][104][105][106].The use of force against civilians by using "non-lethal weapons", worsens human suffering, injuries, and deaths due to the increasing physical and mental consequences of their use, requiring years of rehabilitation and creating inequality in healthcare access [89,107].
Physical and psychological violence, including sexual assault, is used to intimidate and weaken the opposition, particularly targeting women and children [103,105,106,108].The toll of such violence is devastating, with thousands of civilian casualties reported in conflicts like the Ukrainian war and civilian uprising, e.g., in IR Iran [109,110].These events disrupt public health security and sociocultural infrastructure, leading to poverty, food and water insecurity, and restricted access to healthcare [41].Social media manipulation exacerbates misinformation, while internet disruptions impede communication and access to vital information [66,111,112].Finally, attacking hospitals and healthcare professionals, forbidden by international laws, has resulted in insufficient access to medical facilities, migration of specialists, civilians suffering, and inequality in healthcare [89,91,108].

Discussion
This study aimed to assess the influence of narcissistic leaders on achieving the UN's Sustainable Development Goals (SDGs).The findings indicate that political decisions made by global leaders can potentially lead to conflicts with serious social, environmental, infrastructural, healthcare, and health security repercussions, thereby impeding SDG attainment.Making such decisions necessitates careful, collaborative, expert-guided approaches, and democratic procedures.Effective leadership should align individual goals with collective aspirations [13,111].The absence of collaborative leadership due to narcissism significantly hampers team performance and member effectiveness.Leaders who prioritize themselves undermine team spirit and cooperation, fostering distrust and reducing the collective commitment needed to achieve overarching goals.
From a global perspective, the unwillingness to collaborate, the self-centeredness in collective teamwork, and the lack of "responsibility" for actions, as part of narcissistic traits, worsen the outcomes of global health and well-being and calls for urgent global actions and policy change to promote leadership committed to public welfare and the achievement of SDGs [1,112].The failure to obtain proper preventive and responsive measures to manage the diverse consequences of global emergencies is often caused or fueled by the choices made by political leaders, resulting in injustice, and inequity in need of societal and medical interventions [101].These consequences are far more significant and magnified by narcissistic leadership [27].
Narcissistic global leaders often lack the conscientiousness to prevent or may even contribute to disasters, as seen in the ongoing conflict in Ukraine, which has targeted infrastructure and healthcare facilities [33,34,64,71].Attacks on medical facilities violate international laws, posing threats to global security and health.Autocratic regimes exacerbate these issues by prioritizing weaponry over public health, leading to increased disease outbreaks in our interconnected world.The targeted bombings in Syria and Ukraine highlight these critical concerns [1,41,101,113,114].Even decisions made within democratic frameworks can have global repercussions if leaders exhibit harmful traits [59].
It is essential to acknowledge the diversity and complexity of global leadership, where some leaders prioritize public welfare and international harmony.However, the risks associated with narcissistic leadership necessitate attention and mitigation.Political decisions and policies influencing global health and security should be deliberated at forums like the UN Security Council, where responsible decision-making is critical amidst uncertain future challenges [41,101,115,116].The disregard for international laws, particularly International Humanitarian Law (IHL), due to political maneuvering by repressive states, is irresponsible and alarming.The Rohingya crisis in Myanmar exemplifies the severe humanitarian consequences of such violations [117].
Armed conflicts trigger mass migration and significantly shape the futures of affected countries, straining host countries' various sectors, especially healthcare, with ethnic and socioeconomic tensions.Competition for financial support, resources, and services further exacerbates these challenges [71,116].Recent events in Ukraine, IR Iran, and Palestine disrupt global order, erode trust and confidence, and result in widespread human suffer-ing, injustice, and the weakening of democratic institutions and partnerships, hindering progress toward the UN's SDGs.
While focusing on the characteristics of narcissistic leaders is crucial in understanding their role in causing distress, it is equally important to examine systemic factors within socio-political structures that facilitate their rise to power and perpetuation.Understanding who bears responsibility for the ascent and decline of narcissistic leaders is essential for a comprehensive approach to addressing this issue.Analyzing socio-political conditions that foster such leadership may reveal underlying patterns that, if addressed, could prevent harmful leadership in the future [117,118].Narcissistic leaders do not emerge in isolation but are often products of broader socio-political dynamics, sustained by specific structures within these systems.Recognizing this interplay between individual traits and systemic conditions is critical for devising effective strategies to tackle the global implications of narcissistic leadership [19].
Narcissism is viewed through multiple perspectives, each providing distinct insights into its origins and expression.Psychodynamic theories stress the importance of early childhood experiences and relationships, while cognitive-behavioral theories concentrate on thought patterns and behaviors.Sociocultural theories examine the impact of societal norms, and biological theories investigate genetic and neurological factors.Considering narcissism from these varied viewpoints offers a more complete understanding of this complex trait and disorder.Although this paper does not follow any specific theory, it suggests that the cause of narcissism is multifactorial, and narcissism is best understood through a mix of theories, considering early experiences, cognitive distortions, societal influences, and biological factors.This multi-faceted approach provides a comprehensive understanding of narcissism's development and manifestation.
The novelty of this study lies in its specific focus on the intersection between narcissistic leadership and global sustainability goals, an area previously underexplored.The findings of this study have significant practical implications for global governance and policymaking.To mitigate the detrimental effects of narcissistic leadership on achieving the SDGs, it is crucial to implement strategies that promote collaborative and empathetic leadership.Organizations and international bodies should develop training programs, emphasizing emotional intelligence, ethical decision-making, and long-term strategic thinking.Furthermore, establishing robust systems of accountability and transparency can help curb the rise of narcissistic leaders.Considering the interconnected goals of SDG, future multitasking challenges require cross-disciplinary, transdisciplinary, and multidisciplinary collaborative solutions [72,119,120].Policymakers should consider creating frameworks that foster inclusive leadership and encourage participation from diverse stakeholders to ensure the achievement of sustainability and global health security goals (Table 3).

Limitations
The main limitation of this study is the study's method.Although we expanded our search across multiple search engines and databases, completed with action research, some relevant studies might have been overlooked unintentionally due to our focus on English-language publications.Furthermore, our emphasis on leadership's role in global health may have overshadowed other significant factors like systemic inequalities and socio-political dynamics.The complexity of the relationship between leadership styles and their impacts, influenced by various contextual factors, poses another challenge.Despite these limitations, this review contributes valuable insights to the discussion on future leadership and global health.Future research can further build upon these findings to address these complexities effectively.

Conclusions
Although some SDGs have been targeted for investigation, discussion, and research, this original approach of this study to cover all SDGs, as far as we know, is a novel and original approach and has never been conducted before.This paper's insights involve an acknowledgment of the dearth of literature on this subject and present the systematic factors that promote narcissistic leaders, urging future research to investigate the broader socio-political factors contributing to the rise of narcissistic leaders and their ability to maintain power.Examining these extensive processes can provide deeper insights into the connection between individual personality traits and the environmental conditions of an organization, thereby helping to address the global impacts of narcissistic leadership.
Today's conflicts and emergencies are managed by a blend of military and non-military tactics, leveraging asymmetrical methods amplified by modern technology and social media.These actions, coupled with narcissistic leadership, escalate violence against civilians, and undermine global security.Leadership decisions directly impact outcomes in different regions, endangering innocent lives and violating international humanitarian law.The destructive influence of narcissistic leadership poses a significant threat to global health and the UN's Sustainable Development Goals and contradicts collaborative efforts for globalization and global harmony.Human rights violations are intertwined with narcissistic leadership traits, highlighting the urgency to cultivate leaders committed to public welfare and SDG achievement.As global citizens, we must address these challenges by implementing preventive and corrective measures.Addressing the challenges posed by narcissistic and abusive leadership and promoting global health and sustainable development, several actions are imperative at collective and individual levels, as suggested in Table 3.
Questing solutions to combat narcissistic leadership is not a philosophical debate but an urgent call to action.By promoting conscientious and empathetic leadership, we can effectively address global health crises and advance sustainable development goals.

Rationale 3
Describe the rationale for the review in the context of what is already known.Explain why the review questions/objectives lend themselves to a scoping review approach.
Page 3, last paragraph in the introduction Objectives 4 Provide an explicit statement of the questions and objectives being addressed with reference to their key elements (e.g., population or participants, concepts, and context) or other relevant key elements used to conceptualize the review questions and/or objectives.Page 3,last paragraph in the introduction

Protocol and registration 5
Indicate whether a review protocol exists; state if and where it can be accessed (e.g., a Web address); and if available, provide registration information, including the registration number.

Eligibility criteria 6
Specify characteristics of the sources of evidence used as eligibility criteria (e.g., years considered, language, and publication status), and provide a rationale.

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Information sources * 7 Describe all information sources in the search (e.g., databases with dates of coverage and contact with authors to identify additional sources), as well as the date the most recent search was executed.

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Search 8 Present the full electronic search strategy for at least 1 database, including any limits used, such that it could be repeated.

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Selection of sources of evidence † 9 State the process for selecting sources of evidence (i.e., screening and eligibility) included in the scoping review.

Data charting process ‡ 10
Describe the methods of charting data from the included sources of evidence (e.g., calibrated forms or forms that have been tested by the team before their use, and whether data charting was performed independently or in duplicate) and any processes for obtaining and confirming data from investigators.

Selection of sources of evidence 14
Give the numbers of sources of evidence screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally using a flow diagram.
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Characteristics of sources of evidence 15
For each source of evidence, present characteristics for which data were charted and provide the citations.For each included source of evidence, present the relevant data that were charted that relate to the review questions and objectives.
Table 2 Synthesis of results 18 Summarize and/or present the charting results as they relate to the review questions and objectives.Page 5-8

Summary of evidence 19
Summarize the main results (including an overview of concepts, themes, and types of evidence available), link to the review questions and objectives, and consider the relevance to key groups.Describe sources of funding for the included sources of evidence, as well as sources of funding for the scoping review.Describe the role of the funders of the scoping review.Not Applicable, page 24 JBI = Joanna Briggs Institute; PRISMA-ScR = Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews.* Where sources of evidence (see second footnote) are compiled from, such as bibliographic databases, social media platforms, and Web sites.† A more inclusive/heterogeneous term used to account for the different types of evidence or data sources (e.g., quantitative and/or qualitative research, expert opinion, and policy documents) that may be eligible in a scoping review as opposed to only studies.This is not to be confused with information sources (see first footnote).‡ The frameworks by Arksey and O'Malley (6) and Levac and colleagues (7) and the JBI guidance (4,5) refer to the process of data extraction in a scoping review as data charting.
The process of systematically examining research evidence to assess its validity, results, and relevance before using it to inform a decision.This term is used for items 12 and 19 instead of "risk of bias" (which is more applicable to systematic reviews of interventions) to include and acknowledge the various sources of evidence that may be used in a scoping review (e.g., quantitative and/or qualitative research, expert opinion, and policy document) [121].

Figure 1 .
Figure 1.PRISMA 2020 flow diagram for new systematic reviews which included searches of databases, registers, and other sources [48].

Figure 1 .
Figure 1.PRISMA 2020 flow diagram for new systematic reviews which included searches of databases, registers, and other sources [48].

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interpretation of the results with respect to the review questions and objectives, as well as potential implications and/or next steps.Funding 22

the current war in Ukraine, the authors argue that this conflict is severely threatening the achievement of
the SDGs.They also emphasize that SDG 16 (i.e., peace and justice) is an absolute prerequisite to sustaining other goals.Further, refugees should be economically empowered, resilient, and sustainable food systems need to be put in place and a renewable energy transition is needed.
Using general theories of despotic leadership, counterproductive work behavior, and organizational behavior, this study suggests and tests a model where self-efficacy, autonomy, and narcissism mediate the effect of destructive leadership on counterproductive work behavior.Survey data from 845 respondents in various Israeli industries showed that autonomy and self-efficacy reduce the negative impact of destructive leadership on counterproductive work behavior, while narcissism worsens the effect.

Table 2 .
These traits arise from cognitive and emotional developmental stagnation in childhood and adolescence, leading to fixed, lifelong thinking patterns and a limited capacity for empathy, love, guilt, or anxiety.Sociopathic and narcissistic behaviors further perpetuate their rule, masking deep insecurities and an insatiable thirst for power.Once in power, leaders with antisocial personality disorders thrive on perpetual conflict, eschewing peace.Cont.
If performed, provide a rationale for conducting a critical appraisal of included sources of evidence; describe the methods used and how this information was used in any data synthesis (if appropriate).

Table 2
Critical appraisal within sources of evidence 16If performed, present data on critical appraisal of included sources of evidence (see item 12).