Department of Psychology, University of British Columbia.
Department of Psychology, University of Waterloo.
Psychotherapy (Chic). 2024 Sep;61(3):234-240. doi: 10.1037/pst0000528. Epub 2024 May 9.
Several decades of theory suggest that pathological narcissism (PN) may limit psychotherapy success, but empirical evidence for such theories is limited and mixed. In addition, it has been proposed that individuals with high levels of PN may benefit more from supportive compared to interpretive psychodynamic therapies, but no studies thus far have investigated this question empirically. As such, our study aimed to extend past research by investigating (a) whether higher levels of pretreatment PN predict poorer treatment outcome and (b) whether the type of psychodynamic therapy (supportive or interpretive therapy) moderates these findings, in a sample of patients undergoing group psychodynamic psychotherapy for perfectionism. The sample was drawn from the University of British Columbia Perfectionism Treatment Study II (Hewitt et al., 2023) and consisted of 80 treatment-seeking adults with elevated perfectionism. Contrary to expectations, multilevel and multiple regression analyses showed that pretreatment PN did not significantly predict posttreatment changes in symptom severity, life satisfaction, or work and social impairment. We also did not find that either grandiose or vulnerable narcissism predicted likelihood of patient dropout. Finally, treatment type did not moderate the relationship between pretreatment PN and treatment outcome, suggesting that, contrary to our hypotheses, PN does not impact treatment outcome regardless of the interpretive nature of the psychodynamic group therapy. These results, taken together with past findings, suggest that PN may not be associated with poorer psychotherapy outcomes in certain contexts, such as in the case of supportive or interpretive psychodynamic group psychotherapy for perfectionism. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
几十年来的理论表明，病态自恋（PN）可能会限制心理治疗的成功，但这些理论的经验证据有限且存在矛盾。此外，有人提出，PN 水平较高的个体可能会从支持性而非解释性心理动力学治疗中获益更多，但迄今为止，尚无研究从实证角度探讨这一问题。因此，我们的研究旨在通过调查以下两个方面来扩展以往的研究：（a）治疗前 PN 水平是否预测治疗结果较差；（b）在接受团体心理动力学治疗的完美主义患者样本中，心理动力学治疗类型（支持性治疗或解释性治疗）是否调节这些发现。该样本来自英属哥伦比亚大学完美主义治疗研究 II（Hewitt 等人，2023），由 80 名寻求治疗的、具有较高程度完美主义的成年人组成。与预期相反，多层次和多元回归分析表明，治疗前 PN 水平并不显著预测治疗后症状严重程度、生活满意度或工作和社交障碍的变化。我们也没有发现夸大或脆弱的自恋症预测患者脱落的可能性。最后，治疗类型并没有调节治疗前 PN 与治疗结果之间的关系，这表明，与我们的假设相反，PN 并不影响治疗结果，无论心理动力学团体治疗的解释性质如何。这些结果与过去的研究结果一起表明，PN 在某些情况下可能与较差的心理治疗结果无关，例如在支持性或解释性心理动力学团体治疗完美主义的情况下。（PsycInfo 数据库记录（c）2024 APA，保留所有权利）。
