Can Patients With Narcissistic Personality Disorder Change? A Case Series.

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Nervous and Mental Disease Pub Date : 2024-07-01 DOI:10.1097/NMD.0000000000001777

Igor Weinberg, Elsa Ronningstam, Caitlin Ravichandran, John G Gunderson

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Abstract

Abstract: The study was set out to establish the potential for psychotherapy to effect improvements in patients with narcissistic personality disorder (NPD). Eight patients with NPD who improved in treatment were identified. Consensus clinician/investigator diagnostic scores from before and after the psychotherapies were retroactively established on the Diagnostic Interview for Narcissism (DIN) and the Diagnostic Statistic Manual for Psychiatric Disorders, 5th Edition (DSM-5) Personality Disorder Section II criteria. Psychosocial functioning (work or school, romantic relationships) before and after the psychotherapies was retroactively evaluated as well. At the completion of the therapies after 2.5 to 5 years, all patients had improved, no longer met DIN or DSM-5 criteria for NPD, and showed better psychosocial functioning. Symptomatic improvements were associated with large effect sizes. In conclusion, changes in NPD can occur in treatment after 2.5 to 5 years. Future research should identify patient characteristics, interventions, and common processes in such improved cases that could help with development of treatments.

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自恋型人格障碍患者能否改变？病例系列。

摘要：这项研究旨在确定心理疗法对自恋型人格障碍（NPD）患者的潜在改善效果。研究确定了八名在治疗中有所改善的 NPD 患者。根据自恋诊断访谈（DIN）和《精神障碍诊断统计手册》第五版（DSM-5）人格障碍第二部分标准，对心理治疗前后的临床医生/调查员诊断评分进行了追溯。此外，还对心理治疗前后的社会心理功能（工作或学习、恋爱关系）进行了追溯评估。在 2.5 至 5 年的治疗结束后，所有患者的病情都有所改善，不再符合 DIN 或 DSM-5 NPD 标准，社会心理功能也有所改善。症状的改善与较大的效应大小有关。总之，经过 2.5 至 5 年的治疗，NPD 可以发生变化。未来的研究应确定患者的特征、干预措施以及此类改善病例的共同过程，这将有助于治疗方法的开发。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Nervous and Mental Disease 医学-精神病学

CiteScore

2.90

自引率

5.30%

发文量

233

审稿时长

3-8 weeks

期刊介绍： The Journal of Nervous and Mental Disease publishes peer-reviewed articles containing new data or ways of reorganizing established knowledge relevant to understanding and modifying human behavior, especially that defined as impaired or diseased, and the context, applications and effects of that knowledge. Our policy is summarized by the slogan, "Behavioral science for clinical practice." We consider articles that include at least one behavioral variable, clear definition of study populations, and replicable research designs. Authors should use the active voice and first person whenever possible.