The Effectiveness of Schema Mode Therapy on Agreeableness and Ambivalence in Emotional Expressivity among Individuals with Narcissistic Personality Disorder

Abstract

This study aimed to investigate the effectiveness of schema mode therapy in improving agreeableness and reducing ambivalence in emotional expressivity among individuals with narcissistic personality disorder. This quasi-experimental study utilized a pretest–posttest design with a two-month follow-up and control group. The statistical population included individuals diagnosed with narcissistic personality disorder who attended counseling centers in Shiraz during 2023–2024. Sixty participants were selected using purposive sampling, screened through structured clinical interviews (SCID-I and SCID-II), and randomly assigned to experimental and control groups (n=30 each). The experimental group received twelve 60-minute weekly sessions of schema mode therapy, while the control group received no intervention. Instruments included the Narcissistic Personality Inventory (NPI-16), the Emotional Expressivity Questionnaire (EEQ), and the Agreeableness subscale of the NEO Personality Inventory. Data were analyzed using repeated measures ANOVA and Bonferroni post-hoc tests. Significant between-group differences were found in positive emotional expressivity, intimacy, negative emotional expressivity, and agreeableness (p<0.05). The experimental group showed marked increases in positive expressivity, intimacy, and agreeableness, and a significant reduction in negative emotional expressivity compared to the control group. These improvements remained stable at follow-up. Schema mode therapy effectively enhanced emotional expressivity, reduced emotional ambivalence, and improved agreeableness among individuals with narcissistic personality disorder by restructuring maladaptive modes and strengthening the Healthy Adult mode.