What Causes Narcissistic Personality Disorder?

hello this is dr. grande today's

question is what causes narcissistic

personality disorder now I'm going to

refer to narcissistic personality

disorder as NPD and we talked about

causation in mental health we use the

word etiology often times so if a factor

is ideological to NPD that means we

believe there's some sort of causal

component so when we consider narcissism

it's important understand that

narcissistic characteristics are part of

normal human development we would expect

to see narcissistic characteristics in

childhood and adolescence so quickly I'm

going to review the symptoms of MPD and

then we'll get to the possible

ideological factors so with NPD we see a

grandiose sense of self-importance

fantasies of unlimited power and success

feeling special or unique needing

excessive admiration a sense of

entitlement exploitive behavior in

relationships a lack of empathy or

reduced ability to experience empathy

envy and being perceived as arrogant or

engaging in arrogant behavior not all of

these symptoms are required for a

diagnosis of MPD and not all these

symptoms would be considered a normal

part of development but versions of

these symptoms versions of these

characteristics would be seen throughout

development childhood and adolescence as

I mentioned so when we talk about

etiology its first important to

understand that we don't really know

what causes really any mental health

disorder we have a lot of theories and

the evidence lines up with some of those

theories fairly well in the case of some

mental health disorders and not as well

with others one of the problems with

narcissistic personality disorder is

that there's not really a clear

definition of what the disorder is now

the DSM has a clear definition but not

everyone who conducts research on the

causality of narcissistic

characteristics agrees with that


so there are essentially three popular

theories about the causality of NPD the

first is that it's inherited

we call this heritability and we look at

male health disorders it's not unusual

that a percent of the contribution is

thought of as genetic in many cases we

look at this as heritability versus

environmental ility the amount of

variance that can be explained by

genetics versus the amount of variance

that can be explained by stressors for

the environment so we look at NPD the

heritability is somewhere between 40 and

65 percent so there's a fairly

significant contribution from genetics

to the development of NPD the next area

is the structural changes or differences

that we see in the brain a lot of

studies have been done using equipment

to scan the brains of individuals with

MPD and individuals who don't have MPD

and look at the various differences that

might be there now one of the problems

with these studies is that there have

been some structural differences

identified but it's not consistent

across all presentations of MPD now the

differences that have been identified

are related to areas of the brain

responsible for social behavior and

emotional regulation which would be

consistent of our understanding with

what we see in NPD in terms of the

symptom criteria the last area of

potential etiology of course is the

environment and a lot of focus with MPD

is on experiences during childhood we

see certain characteristics more

associated with MPD than others so

whenever we talk about ideological

factors and mental health disorders

we're oftentimes talking about

associations that we see just like the

heritability and the brain structure it

doesn't mean that genetics or the brain

structure cause MPD it just means

there's an association and the same is

true with the environmental factors

including the experiences in early

childhood however some of the factors

that seem to have an association with an

increased risk of developing MPD would

be a situation where child receives

a lot of praise excessive praise and

also excessive criticism so there's not

really much area in the middle we also

see lack of parental empathy as a factor

praise for abilities or appearance

instead of other characteristics and an

emphasis on status or achieving success

meaning an emphasis created by the

parents imposed on the child other

potential ideological factors include

emotional abuse and neglect and we see

these for a number of personality

disorders and a number of mental health

disorders that are not personally

disorders so emotional abuse and neglect

seem to cause a lot of mental health

difficulties later in life we also see

with NPD / evaluation by parents

so repeatedly over evaluating the

characteristics of a child without an

emphasis on balance without looking at

some of the areas of improvement as well

so consistent over evaluation we also

see inconsistent parenting

authoritarian parenting and parents who

don't supervise the child regularly so a

lack of supervision another theory with

NPD is that it's caused my learned

behavior and this one is really

consistent with the genetic piece so

what could explain the high heritability

in addition to genetics could be that

really what's happening is the parents

of individuals with NPD would be more

likely to have narcissistic

characteristics and the children are

simply learning that it's learned

behavior so they grow up learning to be

arrogant to lack empathy to require

excessive admiration and the other

symptoms we see of NPD so it's important

when we look at studies that examine

heritability that we make sure in that

research methodology that the research

is accounted for the possibility of

learned behavior we also notice as a

potential illogical factor that parents

of individuals with NPD have a higher

probability of being unable to wreck

name and regulate emotions so when

individuals growing up their parents

really couldn't identify and regulate

emotions and teach the child to be aware

of emotions now this is really

consistent with what we see in NPD a

number of individuals have suffered with

MPD lack emotional awareness not just

the empathy piece usually we do see a

deficit with empathy but they lack

emotional awareness in general

individuals with MPD often find

themselves looking to other people to

help identify emotions for them so again

this is quite consistent with the

possible ideological factor of having

parents that didn't do a good job

identifying and regulating emotions that

whole emotional awareness component

really isn't well-developed

often times and individuals with NPD so

those are some of the possible illogical

factors for a narcissistic personality


NPD is a destructive disorder it comes

with a lot of pain and suffering not

just from the symptom criteria but also

from comorbidity we see a lot of other

disorders that co-occur with NPD most

notably depression anxiety and substance

use disorders so it's important for

mental health clinicians to continue to

work to try to identify the ideological

factors of this disorder I hope you

found this description of the

ideological factors of NPD to be

interesting thanks for watching