Narcissism and Narcissistic Abuse in Relationships (Part XII)

Genetic

Narcissistic personality disorder is an inheritable psychological condition; research evidence indicates that a person is more likely to develop NPD if said personality disorder occurs in the medical history of his or her family. The results reported in A Twin Study of Personality Disorders (2000) indicate that the rate of occurrence of personality disorders in twins determined that there is a moderate-to-high likelihood of the heritability of NPD; and the research of The Genetic Epidemiology of Personality Disorders (2010) indicates that specific genes and genetic interactions (epistasis) contribute to the formation of NPD, and to the development of a narcissistic personality, yet how genetics influence the developmental and the physiologic processes underlying NPD remains undetermined.

Environment

Environmental and social factors also exert significant influence upon the onset of NPD in a person.  In some people, pathological narcissism may develop from an impaired emotional attachment to the primary caregivers, usually the parents.  That lack of psychological and emotional attachment to a parental figure can result in the child's perception of himself or herself as unimportant and unconnected to other people, usually family, community, and society. Typically, the child comes to believe that they have a personality defect that makes him or her unvalued and unwanted person; in that vein, either overindulgent or permissive parenting or insensitive and over-controlling parenting are contributing factors towards the development of NPD in a child.

In Gabbard's Treatments of Psychiatric Disorders (2014), the following factors are identified as promoting the development of narcissistic personality disorder:

·         An oversensitive temperament (individual differences of behavior) at birth.

·         Excessive admiration that is never balanced with realistic criticism of the child.

·         Excessive praise for good behaviors, or excessive criticism for bad behaviors in childhood.

·         Overindulgence and overvaluation by parents, family, and peers.

·         Being praised by adults for perceived exceptional physical appearance or abilities.

·         Severe emotional abuse in childhood.

·         Unpredictable or unreliable care-giving by the parents.

·          Learning the behaviors of psychological manipulation from parents or peers.

Moreover, the research reported in "Modernity and Narcissistic Personality Disorders" (2014) indicates that cultural elements also influence the prevalence of NPD, because narcissistic personality traits more commonly occur in modern societies than in traditional societies.

Pathophysiology

Studies of the occurrence of narcissistic personality disorder (NPD), such as Gray Matter Abnormalities in Patients with Narcissistic Personality Disorder (2013) and Narcissists' Lack of Empathy Tied to Less Gray Matter (2016) identified structural abnormalities in the brains of people afflicted with NPD, specifically, a lesser volume of gray matter in the left, anterior insular cortex.  The results of the study Brain Structure in Narcissistic Personality Disorder: A VBM and DTI Pilot Study (2015) associated the condition of NPD with a reduced volume of gray matter in the prefrontal cortex.  The regions of the brain identified and studied – the insular cortex and the prefrontal cortex – are associated with the human emotions of empathy and compassion, and with the mental functions of cognition and emotional regulation. The neurologic findings of the studies indicate that narcissistic personality disorder is related to a compromised (damaged) capacity for emotional empathy and emotional regulation.