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

• Published in: Counselling and psychotherapy research 2019-03, Vol.19 (1), p.25-34
• Main Authors: Bell, Chance A., Jankowski, Peter J., Sandage, Steven J.
• Format: Article
• Language: English
• Subjects: Community mental health services; conflict; depression; Emotions; Mental depression; Mental health; Narcissism; Psychotherapy; Sexual disorders; Sexuality; Social conflict; Symptoms; Time; Treatment methods; treatment outcomes
• ISSN: 1473-3145; 1746-1405
• DOI: 10.1002/capr.12199

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.