Narcissism or narcissistic personality disorder is a mental health disorder. It is characterised by excessive feelings of self importance, craving for admiration and a poor ability to empathise with the feelings of others. Narcissistic personality disorder is a subtype of a broader category of health disorders known as personality disorders. Personality disorders are characterised by enduring and harmful patterns of behaviour that deviate away from norms accepted by any culture.
If you are concerned about suicide risk for a person with NPD, then seek medical advice urgently.
If you need help, talking to your doctor is a good place to start. If you’d like to find out more or talk to someone else, here are some organisations that can help:
In a review of 437 studies of narcissism and aggression involving a total of over 123,000 participants, narcissism was found to be related to a 21 percent increase in aggression and an 18 percent increase in violence (Kjærvik, S. L., & Bushman, B. J., 2021)
About 15% of people with narcissistic personality disorder also have depression, 13.5% have anxiety and around 17% have another mood disorder (The Journal of Clinical Psychology).
Bipolar disorder is also fairly common among people with narcissistic personality disorder. About 17% of people with pathological narcissism also have either bipolar I or bipolar II.
About 14% of people with narcissistic personality disorder also have an alcohol use disorder, while 24% misuse other types of drugs (Journal of Clinical Psychology, 2009).
Environmental factors, such as culture or parenting, may contribute to the development of narcissistic personality disorder.
Research conducted in 2018 found that narcissism scores were higher in individualistic cultures than they were in collectivistic cultures. In the same study, researchers compared narcissistic traits among people who had grown up in former West Germany (an individualistic culture) to those who had grown up in former East Germany (a more collectivist culture).
Childhood experiences may also play a role in developing narcissistic personality disorder. Negative childhood experiences like rejection or neglect may contribute to narcissistic personality disorder in adulthood. At the same time, too much praise from parents could also lead to narcissistic personality disorder.
There is a link between different parenting styles and narcissistic traits in adult children. While no “one” parenting style leads to narcissism, combinations of parenting behaviours contributing factors may coalesce to cause narcissistic personality disorder.
The follow parenting factors are positively correlated with higher levels of narcissism in children:
Genetics may also play a role in contributing to Narcissistic Personality Disorder (NPD). In a 2014 study involving 304 pairs of twins, researchers found that some NPD traits were somewhat heritable. Grandiosity was 23% heritable while entitlement was 35% heritable. However, these traits seemed to exist independently of each other.
Risk factors for narcissistic personality disorder are somewhat complex. Narcissistic personality disorder has been linked to a number of things, including parenting and environmental factors, as well as genetics but all in a variety of combinations.
Certain parenting styles could be a risk factor for higher levels of narcissism in children. However, they have often been studied in isolation or in different combinations, and with mixed findings.
Furthermore, simply being male may be a slight risk factor, as narcissistic personality disorder is diagnosed more often in men.
Psychotherapy, or talking to a therapist, is the most useful treatment approach, although more research is required to determine the most effective therapies. The aim is to develop a more realistic self-image and enable the person to relate to others more positively. The type of therapy used can include:
Psychodynamic therapy — long-term individual therapy that helps a person to understand their behaviours, moods and disruptive thoughts. These insights can help them find better ways to relate to others.
Cognitive behaviour therapy (CBT) — helps people identify negative, unhelpful behaviour patterns and replace them with more productive and positive ones.
Family or marital therapy — narcissistic personality disorder can affect families. Coming together for a session can help people in dealing with relationships, with problem-solving solutions and positive communication.