Early treatment narcissism associated with later social and sexual functioning among psychotherapy clients

Abstract

Background Narcissism is a significant mental health concern with some evidence of rising prevalence rates in the United States. Treatments have been theorised, yet empirical research documenting psychotherapy effectiveness is lacking. To begin to address this gap, we used an exploratory, practice‐based design and investigated whether adults’ narcissistic symptom scores would decrease during outpatient treatment. Methodology Treatment occurred at a community mental health clinic in the North‐eastern United States and consisted of a contemporary relational psychoanalytic approach. We used paired‐sample t tests to examine whether narcissism improved from time 1 to time 2 and conducted path analysis of a cross‐lagged panel model for a half‐longitudinal design to determine mediation among variables. Results Data analyses revealed that narcissism scores improved during psychotherapy treatment, as did depression, social conflict and sexual functioning from time 1 to time 2. Findings suggested that depression mediated the association between time 1 narcissism and later sexual functioning and levels of social conflict. Conclusions Findings lay the groundwork for future longitudinal designs and highlight the importance of assessing connections between clients’ narcissistic symptoms and (a) mood regulation difficulties and (b) patterns of psychosocial impairment in social conflict and sexual functioning.

Exploring virtue ethics in psychodynamic psychotherapy: latent changes in humility, affect regulation, symptoms and well‐being

“…Humility has demonstrated associations with greater affect regulation, lower symptoms and greater well-being . Further, greater humility has shown associations with lower vulnerable and grandiose narcissism, whereas both greater grandiose and vulnerable narcissism have shown associations with higher levels of mental health symptoms and lower well-being (Bell et al, 2019;Jankowski, Sandage, Bell, Ruffing, et al, 2019). The present study synthesised existing empirical evidence with the theoretical premise that developing virtues reduces symptoms and promotes well-being (i.e.…”

“…Sandage and colleagues (2017) theorised that clients exhibiting narcissism, an inverse of humility, 'lack [ed] the internalized and differentiated capacities to selfregulate shame, anger, and other distressing emotions related to disappointments in self and other' (p. 4). Research involving clients in outpatient mental health treatment found that greater grandiose narcissism was associated with lower social well-being through greater affect dysregulation (Bell et al, 2019), and greater vulnerable narcissism was associated with lower humility through lower affect regulation capacities in a graduate student sample (Sandage et al, 2017). In multiple experimental studies, Tong and colleagues (2016) found greater humility to predict greater self-regulation capacity, and Lerner and colleagues (2020) reported that humility was positively associated with adolescents' ability to 'set goals and recruit resources to work toward those goals' (p. 2).…”

PTSD symptoms in religious leaders: Prevalence, stressors, and associations with narcissism

“…Hopwood et al, 2011; McCullough et al, 2003), greater narcissistic tendencies have placed these religious leaders at greater risk to be reactive to negative daily events that occur within the ministry. Narcissistic tendencies may also invite greater interpersonal conflict, since previous research indicates that narcissism is related to decreased interpersonal functioning (Bell et al, 2018; Ruffing et al, 2018). A leader with greater levels of exploitativeness, grandiose fantasies, and entitlement rage may not only invite greater levels of relational conflict, but may also be particularly reactive to the inevitable situations in ministry in which their leadership is challenged, hard work seems unrecognized, or a grandiose plan fails.…”

“…Many religious leaders carry a lasting impact from a variety of demanding and overwhelming aspects of their roles. These overwhelming experiences can threaten their sense of effectiveness and potentially their actual effectiveness in ministry, particularly since both narcissism (Bell et al, 2018; Ruffing et al, 2018) and PTSD symptoms (Beck et al, 2009) are associated with reduced interpersonal functioning. It is important for religious bodies to take intentional steps to address these concerning levels of ministry-related stress in their leaders, as well as to better prepare students pursuing vocational ministry.…”