Banafsheh Mohajerin, Richard Howard, Aaron L Pincus
Our randomized controlled trial comparing Unified Protocol (UP) and Schema-Focused Therapy (SFT) for grandiose and vulnerable presentations of narcissism has recently been critiqued in a commentary by Dimaggio et al. (2026). These authors raised concerns regarding the study's recruitment and subgroup classification, gender distribution, treatment response patterns, absence of dropouts, randomization, screening and recruitment procedures, trial registration, outcome assessment, supervision and treatment fidelity, treatment dose and duration, and disclosure of the NPD diagnosis. In this response, we clarify these methodological and procedural issues and provide additional information that was not fully described in the original article. We maintain that while both treatments were effective in ameliorating symptoms of narcissism, SFT was more effective in treating grandiose features, while UP was more effective in treating vulnerable features. Trial Registration: Iranian Registry of Clinical Trials identifier: IRCT20231106059970N3.