A Randomized Controlled Trial Comparing Two Treatments for Vulnerable and Grandiose Narcissism: Unified Protocol vs. Schema-Focused Therapy.
Level 2 - randomized trial
Individual randomized controlled trial comparing two active psychotherapy arms
PubMed 41792983 · doi:10.1002/cpp.70247
What was done
One hundred fourteen individuals with narcissistic personality disorder (NPD) were randomized to either schema-focused therapy (SFT) or the Unified Protocol (UP). The trial compared changes in overall NPD symptom severity, grandiose and vulnerable features, anger, shame, and emotion dysregulation over a 12-month follow-up period.
What was found
The abstract reports no numerical values, effect sizes, or exact p-values. Both treatment groups showed statistically significant and equivalent reductions in overall NPD symptom severity across 12 months. SFT demonstrated significantly greater reductions in narcissistic grandiosity, whereas UP demonstrated significantly greater reductions in narcissistic vulnerability, anger, shame, and emotion dysregulation. Patients with a vulnerable baseline presentation had greater reductions in fear of intimacy and shame severity, whereas those with a grandiose presentation had greater reductions in identity disturbance, anger control, and neuroticism.
Why it matters
This trial suggests that structured psychotherapies can effectively reduce NPD symptoms and indicates that treatment choice can be tailored to subtype: SFT for grandiose dimensions and UP for emotional dysregulation and vulnerability.
Limits
The abstract reports no effect sizes, baseline severity measures, or attrition rates. There was no inactive or treatment-as-usual control group to isolate non-specific time effects, and diagnostic criteria, blinding procedures, and participant demographics are not specified in the text.
Cited by
- supports Psychotherapy can effectively change narcissistic personality disorder such that a person's natural thoughts, worldview, and behaviors fundamentally change.