Middle Eastern Journal of Disability Studies

Background & Objectives: Personality disorders are persistent patterns in the mind and behavior that do not conform to cultural norms and cause dissatisfaction and disruption of a person’s functions. Among personality disorders, narcissistic personality disorder, due to remaining in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, has a special diagnostic and therapeutic importance. People with this disorder arrogantly think they are very important and unique. Despite these feelings, they have fragile self–esteem and are vulnerable to even minor criticism. One of the treatments used for narcissistic personality is classical psychoanalytic treatment. An important part of the classical literature of classical psychoanalysis and the new wave of contemporary psychoanalysts have investigated this personality disorder. Another treatment used for narcissistic personality is schema therapy. Schemas are formed based on educational methods, cognitions and bodily feelings during childhood and adolescence and continue in other periods of life. Therefore, this study aimed to compare the effectiveness of schema therapy and psychoanalysis in treating narcissistic personality disorder.
Methods: The research method was quasi–experimental with a pretest–posttest design with a control group. The statistical population of the present study included all individuals referred to the Hamava Psychology Clinic and the Tehran Welfare Clinic who were diagnosed with narcissistic personality disorder in 2019. The study sample consisted of 20 patients from Hamava Clinic and 10 patients from Tehran Welfare Clinic who were diagnosed with the narcissistic disorder. The studied samples were randomly assigned to three groups: psychoanalytic group, schema therapy group, and control group. It should be noted that at the beginning of the study, 10 people were assigned to each group, and at the end of the test, three people remained in each group due to the drop in the subjects. The inclusion criteria were as follows: not receiving drug treatment and drug use, being literate in reading and writing, and providing informed consent. The exclusion criteria were as follows: not having acute mental disorders, participation in another intervention program, and absence of more than two sessions. The study data were collected in the pretest and posttest in three groups using Millon Clinical Multiaxial Inventory–III (Millon et al., 1994) and Narcissistic Personality Inventory (Raskin & Terry, 1988). The first experimental group received traditional psychoanalytic treatment. The second experimental group received schema therapy for 8 sessions, one 90–minute session per week, and the subjects in the control group did not receive any treatment. To analyze the collected data, descriptive (mean and standard deviation) and inferential statistics (univariate covariance analysis or ANCOVA) were performed in SPSS version 21 statistical software. The significance level of the tests was considered 0.05.
Results: The results showed a significant difference between the control group and the psychoanalytic treatment group in the mean scores of the variable of narcissistic personality disorder (p<0.001). While the examination of the averages in the two control and schema therapy groups (p=0.069) and the two psychoanalytic treatment and schema therapy groups (p=0.081) showed no significant difference between them. Also, the eta coefficient indicated that 76.6% of the changes in narcissistic personality disorder were due to the intervention of psychoanalytic treatment.
Conclusion: Based on the findings of this study, psychoanalytic therapy is more effective in reducing the symptoms of narcissism than schema therapy. As a result, clinicians and researchers can pay more attention to dynamic therapies in narcissistic personality disorder interventions.