Feasibility and Acceptability of a Group Psychoeducation Program for Patients With Pathological Narcissism With or Without a Diagnosis of Narcissistic Personality Disorder.

Pathological narcissism (PN) and narcissistic personality disorder (NPD) are common yet highly stigmatized conditions for which no empirically validated treatment currently exists, despite growing evidence of the central role of psychoeducation. The goal of this study was to evaluate the feasibility and acceptability of our recently published group psychoeducation program for patients with PN, with or without a diagnosis of NPD. Twenty-five adult patients, who met ≥3 NPD criteria or presented with mean grandiosity and vulnerability scores ≥3 on the Pathological Narcissism Inventory-Brief Form and who were participating in our psychoeducation program, were recruited from a psychiatric outpatient center. Feasibility outcomes included attendance, completion, drop-out rates, as well as safety measures (between-session changes in state narcissism and hospitalization rates). Acceptability was assessed using a mixed-methods satisfaction questionnaire and by comparing pre- and post-group levels of trait narcissism using the Pathological Narcissism Inventory-Brief Form. Overall, attendance and completion rates were high (83% mean attendance with only 1 dropout). There were no between-session narcissistic activations and only 1 hospitalization unrelated to the group program; however, participants did report substantial emotional activation and a need for concomitant individual support. They also reported high levels of satisfaction and perceived usefulness. Exploratory pre-post changes suggested a decrease in self-reported grandiosity but not vulnerability, even though no causal conclusions could be drawn due to the uncontrolled design of the study. A major limitation of the study was the high rate of comorbidity with borderline personality disorder (92%), which limits the generalizability to all narcissistic patients. Overall, these findings support the feasibility and acceptability of a brief group psychoeducation program for PN.