Graduate student perspectives on training and clinical experiences with antagonism treatment

The objective of this preregistered study was to gather evidence on training and clinical experiences offered by clinical psychology doctoral programs on the treatment of antagonism-a construct from the personality and psychopathology literature that captures individual differences in aggressiveness, callousness, grandiosity, domineering, and manipulativeness. We surveyed current graduate students (N = 376) in APA-accredited clinical psychology doctoral programs (M_age = 28.4; 83.2% female; 65.2% White) about their experiences in training and treatment of antagonistic patients (ANT-patients) as well as experiences with patients with predominant negative affect (NA; e.g., anxious and depressed). Students reported significantly less training to treat antagonism compared to NA (|ds| = 0.43-2.88), as well as lower rates of direct clinical experience, generally poorer treatment experiences, and stronger countertransference reactions (|ds| = 0.53-1.40). These discrepancies were especially large for adult-focused students compared to child/adolescent-focused students. In fact, adult-focused students reported a mean competency rating of M = 1.71, between the scalar points not competent at all (1) and a little bit competent (2). Overall, these results indicate a lack of training and competence to treat antagonism among current graduate students, especially adult-focused students. We believe the crux of this issue is a field-wide lack of robust empirical work on antagonism treatments (for adults). Moving forward, we implore researchers and funding agencies to help address this substantial gap, which is both an ethical and practical imperative. (PsycInfo Database Record (c) 2025 APA, all rights reserved).