{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T16:46:18Z","timestamp":1788972378841,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":42,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Psychology and Psychoth"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Narcissistic personality disorder (NPD) and pathological narcissism (PN) urgently need empirically supported treatment options. Mohajerin et\u00a0al. randomized controlled trial yielded promise in addressing this gap. However, in this commentary, an international group of personality disorder experts identify a number of issues with the trial methodology, reporting and interpretation: (i) the unlikeliness that consecutive sample recruitment would result in almost equal number of participants in grandiose vs. vulnerable subgroups; (ii) the unlikeliness that consecutive sample recruitment would result in almost equal number of participating men and women; (iii) the unlikely possibility that grandiose and vulnerable narcissism would appear as uncorrelated subtypes; (iv) dissimilar treatment responses to schema\u2010focused therapy vs. Unified Protocol; (v) absence of dropouts; (vi) unclear randomization procedure; (vii) poor screening and recruitment procedures and limited transparency in trial registration; (viii) exclusive reliance on self\u2010report measures; (ix) limited transparency in supervision and treatment fidelity procedures; (x) nonequivalence of treatment dose and duration; and (xi) lack of clarity on how the disclosure of NPD diagnosis to participants was handled in the trial. In light of these concerns, it is difficult to reconcile the results of this trial with the inherent challenges of treating NPD and PN. We therefore warrant against considering it a benchmark in NPD treatment innovation.<\/jats:p>","DOI":"10.1002\/cpp.70319","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T06:06:36Z","timestamp":1786601196000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Can All Oxygen Molecules Accumulate in One Corner of the Room? Treating Pathological Narcissism Requires High Standard Randomized Clinical Trials. A Commentary on the Trial by Mohajerin et\u00a0al."],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9289-8756","authenticated-orcid":false,"given":"Giancarlo","family":"Dimaggio","sequence":"first","affiliation":[{"name":"Centro di Terapia Metacognitiva Interpersonale  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0610-8170","authenticated-orcid":false,"given":"Felix","family":"Inchausti","sequence":"additional","affiliation":[{"name":"Department of Mental Health, Psychotherapy Research and Practice Unit San Pedro University Hospital  La Rioja Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1137-4609","authenticated-orcid":false,"given":"Anthony","family":"Bateman","sequence":"additional","affiliation":[{"name":"Department of Clinical, Educational and Health Psychology University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0498-2246","authenticated-orcid":false,"given":"Sune","family":"Bo","sequence":"additional","affiliation":[{"name":"Psychiatric Research Unit, Region of Southern Denmark, DK University of Copenhagen  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4459-0412","authenticated-orcid":false,"given":"Lois","family":"Choi\u2010Kain","sequence":"additional","affiliation":[{"name":"Gunderson Personality Research Institute, McLean Hospital, Belmont, Massachusetts Faculty of Medicine, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5837-8389","authenticated-orcid":false,"given":"Majse","family":"Lind","sequence":"additional","affiliation":[{"name":"Department of Communication and Culture Aalborg University  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1161-2817","authenticated-orcid":false,"given":"Patrick","family":"Luyten","sequence":"additional","affiliation":[{"name":"Faculty of Psychology and Educational Sciences KU Leuven  Leuven Belgium"},{"name":"Research Department of Clinical, Educational and Health Psychology University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0618-044X","authenticated-orcid":false,"given":"Angus","family":"MacBeth","sequence":"additional","affiliation":[{"name":"Clinical and Applied Psychology University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Juul","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Copenhagen  Copenhagen Denmark"},{"name":"Copenhagen Trial Unit, Centre for Clinical Intervention Research The Capital Region\u2014Copenhagen University Hospital, Rigshospitalet  Copenhagen Denmark"},{"name":"Stolpegaard Psychotherapy Center Copenhagen University Hospital\u2014Herlev and Gentofte  Gentofte Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3679-6085","authenticated-orcid":false,"given":"David","family":"Kealy","sequence":"additional","affiliation":[{"name":"Institute of Mental Health, Department of Psychiatry University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8349-4701","authenticated-orcid":false,"given":"Carla","family":"Sharp","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Houston  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3832-1769","authenticated-orcid":false,"given":"Igor","family":"Weinberg","sequence":"additional","affiliation":[{"name":"McLean Hospital, Belmont, Massachusetts, Department of Psychiatry Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_2_17_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psychotherapy.20210017"},{"key":"e_1_2_17_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jopy.12464"},{"key":"e_1_2_17_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2009.09.003"},{"key":"e_1_2_17_5_1","volume-title":"Treating Pathological Narcissism With Transference\u2010Focused Psychotherapy","author":"Diamond D.","year":"2021"},{"key":"e_1_2_17_6_1","doi-asserted-by":"publisher","DOI":"10.1521\/pedi.17.3.188.22146"},{"key":"e_1_2_17_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/int0000263"},{"key":"e_1_2_17_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.23652"},{"key":"e_1_2_17_9_1","volume-title":"Mentalization Based Therapy for Pathological Narcissism","author":"Drozek R. P.","year":"2023"},{"key":"e_1_2_17_10_1","doi-asserted-by":"publisher","DOI":"10.1037\/pspp0000510"},{"key":"e_1_2_17_11_1","doi-asserted-by":"publisher","DOI":"10.1037\/pspp0000370"},{"key":"e_1_2_17_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/pmh.70015"},{"key":"e_1_2_17_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215\u20100366(24)00445\u20100"},{"key":"e_1_2_17_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0000000000000764"},{"key":"e_1_2_17_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007668.pub3"},{"key":"e_1_2_17_16_1","doi-asserted-by":"publisher","DOI":"10.1037\/per0000181"},{"key":"e_1_2_17_17_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0038231"},{"key":"e_1_2_17_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40473-019-00193-2"},{"key":"e_1_2_17_19_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0087845"},{"key":"e_1_2_17_20_1","unstructured":"Inchausti F. A.MacBeth D.Kealy andG.Dimaggio.2026. \u201cImplementation of Psychotherapies: Tensions Between Scalability Fidelity to Models and Effectiveness.\u201d World Psychiatry."},{"key":"e_1_2_17_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jopy.12692"},{"key":"e_1_2_17_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjebm\u20102020\u2010111407"},{"key":"e_1_2_17_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/00030651070550020701"},{"key":"e_1_2_17_24_1","doi-asserted-by":"publisher","DOI":"10.1037\/cps0000141"},{"key":"e_1_2_17_25_1","first-page":"128","article-title":"Uber den Zustand des W\u00e4rmegleichgewichtes Eines Systems von K\u00f6rpern mit R\u00fccksicht auf die Schwerkraft 1. Teil","volume":"73","author":"Loschmidt J.","year":"1876","journal-title":"Sitzungsberichte der Kaiserlichen Akademie der Wissenschaften in Wien, Mathematisch\u2010Naturwissenschaftliche Classe"},{"key":"e_1_2_17_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jopy.12303"},{"key":"e_1_2_17_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.70247"},{"key":"e_1_2_17_28_1","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000436"},{"key":"e_1_2_17_29_1","doi-asserted-by":"publisher","DOI":"10.1521\/pedi.2023.37.3.337"},{"key":"e_1_2_17_30_1","volume-title":"Neuroticism: A New Framework for Emotional Disorders and Their Treatment","author":"Sauer\u2010Zavala S.","year":"2021"},{"key":"e_1_2_17_31_1","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000436"},{"key":"e_1_2_17_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012955.pub2"},{"key":"e_1_2_17_33_1","doi-asserted-by":"publisher","DOI":"10.1037\/per0000058"},{"key":"e_1_2_17_34_1","doi-asserted-by":"publisher","DOI":"10.22541\/au.169156625.54437956\/v1"},{"key":"e_1_2_17_35_1","first-page":"253","volume-title":"Good Psychiatric Management for Borderline Personality Disorder. A Practical Guide","author":"Weinberg I.","year":"2019"},{"key":"e_1_2_17_36_1","doi-asserted-by":"publisher","DOI":"10.1521\/pedi.2020.34.supp.122"},{"key":"e_1_2_17_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0000000000001777"}],"container-title":["Clinical Psychology &amp; Psychotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cpp.70319","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cpp.70319","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cpp.70319","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:58:07Z","timestamp":1787619487000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cpp.70319"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":36,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/cpp.70319"],"URL":"https:\/\/doi.org\/10.1002\/cpp.70319","archive":["Portico"],"relation":{},"ISSN":["1063-3995","1099-0879"],"issn-type":[{"value":"1063-3995","type":"print"},{"value":"1099-0879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-05-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70319"}}