Skip to content
  • Mental Health Issues
    • Anxiety
    • ADHD
    • Bipolar Disorder
    • Depression
    • Grief
    • Narcissism
    • OCD
    • Personality Disorders
    • PTSD
  • Relationships
    • Dating
    • Marriage
    • Sex & Intimacy
    • Infidelity
    • Relationships 101
    • Best Online Couples Counseling Services
  • Wellness
    • Anger
    • Burnout
    • Stress
    • Sleep
    • Meditation
    • Mindfulness
    • Yoga
  • Therapy
    • Starting Therapy
    • Types of Therapy
    • Best Online Therapy Providers
    • Online Therapy Reviews & Guides
  • Medication
    • Anxiety Medication
    • Depression Medication
    • ADHD Medication
    • Best Online Psychiatrist Options
  • Reviews
    • Best Online Therapy
    • Best Online Therapy with Insurance
    • Best Online Therapy for Teens
    • Best Online Therapy for Anxiety
    • Best Online Therapy for Depression
    • Best Online ADHD Treatments
    • Best Online Psychiatry
    • Best Mental Health Apps
    • All Reviews
  • Therapy Worksheets
    • Anxiety Worksheets
    • Depression Worksheets
    • Relationship Worksheets
    • CBT Worksheets
    • Therapy Worksheets for Kids
    • Therapy Worksheets for Teens
    • ADHD Worksheets
    • All Therapy Worksheets
  • About Us
    • About Us
    • Editorial Policy
    • Advertising Policy
    • Find a Local Therapist
    • Join Our Free Directory

Join our Newsletter

Get helpful tips and the latest information

Choosing Therapy on Facebook
Choosing Therapy on Instagram
Choosing Therapy on Twitter
Choosing Therapy on Linkedin
Choosing Therapy on Pinterest
Choosing Therapy on Tiktok
Choosing Therapy on Youtube
ChoosingTherapy.com Logo

Newsletter

Search Icon
  • Mental Health Issues
    • Anxiety
    • ADHD
    • Bipolar Disorder
    • Depression
    • Grief
    • Narcissism
    • OCD
    • Personality Disorders
    • PTSD
  • Relationships
    • Dating
    • Marriage
    • Sex & Intimacy
    • Infidelity
    • Relationships 101
    • Best Online Couples Counseling Services
  • Wellness
    • Anger
    • Burnout
    • Stress
    • Sleep
    • Meditation
    • Mindfulness
    • Yoga
  • Therapy
    • Starting Therapy
    • Types of Therapy
    • Best Online Therapy Providers
    • Online Therapy Reviews & Guides
  • Medication
    • Anxiety Medication
    • Depression Medication
    • ADHD Medication
    • Best Online Psychiatrist Options
  • Reviews
    • Best Online Therapy
    • Best Online Therapy with Insurance
    • Best Online Therapy for Teens
    • Best Online Therapy for Anxiety
    • Best Online Therapy for Depression
    • Best Online ADHD Treatments
    • Best Online Psychiatry
    • Best Mental Health Apps
    • All Reviews
  • Therapy Worksheets
    • Anxiety Worksheets
    • Depression Worksheets
    • Relationship Worksheets
    • CBT Worksheets
    • Therapy Worksheets for Kids
    • Therapy Worksheets for Teens
    • ADHD Worksheets
    • All Therapy Worksheets
  • About Us
    • About Us
    • Editorial Policy
    • Advertising Policy
    • Find a Local Therapist
    • Join Our Free Directory
  • Is Narcissism Genetic?Is Narcissism Genetic?
  • Other Possible CausesOther Possible Causes
  • How Is NDP Diagnosed?How Is NDP Diagnosed?
  • Therapy for Narcissistic Personality DisorderTherapy for Narcissistic Personality Disorder
  • In My ExperienceIn My Experience
  • InfographicsInfographics
  • Additional ResourcesAdditional Resources
Narcissism Articles Narcissism Therapy for NPD Types of Narcissism Best Online Therapy

Is Narcissism Genetic? Causes & Risk Factors

Headshot of Maggie Holland, MA, MHP, LMHC

Author: Maggie Holland, MA, MHP, LMHC

Headshot of Maggie Holland, MA, MHP, LMHC

Maggie Holland MA, MHP, LMHC

Maggie predominantly serves women struggling with anxiety disorders, panic disorders, and perinatal mental health concerns.

See My Bio Editorial Policy
Headshot of Kristen Fuller, MD

Medical Reviewer: Kristen Fuller, MD Licensed medical reviewer

Headshot of Kristen Fuller, MD

Kristen Fuller MD

Kristen Fuller, MD is a physician with experience in adult, adolescent, and OB/GYN medicine. She has a focus on mood disorders, eating disorders, substance use disorder, and reducing the stigma associated with mental health.

See My Bio Editorial Policy
Published: April 4, 2025
  • Is Narcissism Genetic?Is Narcissism Genetic?
  • Other Possible CausesOther Possible Causes
  • How Is NDP Diagnosed?How Is NDP Diagnosed?
  • Therapy for Narcissistic Personality DisorderTherapy for Narcissistic Personality Disorder
  • In My ExperienceIn My Experience
  • InfographicsInfographics
  • Additional ResourcesAdditional Resources

Narcissistic personality disorder (NPD) is a complex Cluster B personality disorder of which the exact cause has not been pinpointed. It is believed to result due to a combination of genetic and environmental factors, as well as parenting styles. While personality disorders are considered to remain stable over time, they can be managed with an effective and inclusive treatment plan.

ADVERTISEMENT

You Can Escape from a Narcissist

Therapy can help you leave and recover from a narcissistic relationship. BetterHelp has over 30,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $65 per week and is FSA/HSA eligible by most providers. Take a free online assessment and get matched with the right therapist for you.

Free Assessment

Is Narcissistic Personality Disorder Genetic?

There is some research suggesting that genetics do play a role in the development of NPD, although this is only one of the influence factors to consider in the overall puzzle. Research suggests that NPD is more impacted by genetics than other personality disorders.2 A 2014 study of twins also hints that there are certain traits of NPD that could be hereditary, such as grandiosity and entitlement, core aspects of NPD.3

Does Narcissism Run in Families?

Having a close family member with NPD could increase the risk of developing this personality disorder; although, this close family member could contribute both in terms of heredity and environmental impacts (particularly if this close family member is a parent).

What Does It Mean For Something to Be Hereditary?

When something is described as hereditary, it means it can be passed down biologically from one generation to the next—typically from parent to child—through shared DNA. This includes specific traits inherited from parents and ancestors. While we often think of physical characteristics like eye color, hair color, blood type, or genetic conditions, hereditary traits can also involve behavioral tendencies, such as temperament, stress reactivity, or susceptibility to mental health challenges.

Other Possible Causes

As with many mental health disorders, NPD is generally considered to be a product of a combination of factors. These contributing factors include genetics, parenting, environmental factors, and neurobiology. Not all factors need to be present for NPD to occur, and the specific combination of contributing factors is likely to look different for each individual.

Parenting

Genetic contributions are not the only way that parents can contribute to the development of NPD–parenting style can also have an impact as well. A child feeling like their parents were overprotective or did not provide much structure and boundaries may indicate a higher possibility of the development of NPD.4 While these traits are often associated with helicopter parenting and snowplow parenting, they can display in any parenting style. It’s also important to note that abusive and neglectful parenting (emotional, physical, or psychological) can also contribute to NPD.

Environmental Factors

Other family members, caretakers, and even interactions within school and extra-curricular activities are environmental factors to consider as well. On a broader scale, cultural factors can influence the onset of NPD, such as the rise in social media usage and consumption, celebrated narcissistic behaviors in celebrities, and even a cultural pattern of “collective narcissism”–-the overvaluation of oneself and the groups to which they belong.5 Additionally, individualistic societies seem to show higher levels of narcissism than collectivist societies that prioritize the good of the group over the individual.6

Neurobiology

A person’s brain composition can also play a role in NPD, including one’s brain chemistry and structural development. One area of the brain that has been specifically studied in relation to NPD is the insular cortex–a lobe within the cerebral cortex responsible for translating sensory information into either emotional pleasantness or unpleasantness of that sensory information.

Often, the brains of those with NPD reflect lower levels of grey matter within their insular cortex.7 The more grey matter that is present in an area of the brain, the more efficiently and effectively it is able to operate.

Free Worksheets for Coping With a Narcissist

This collection of worksheets is designed to help you identify and navigate narcissistic behavior, recognize gaslighting tactics, set healthy boundaries, and reinforce your personal strengths to protect your emotional well-being. Find the one you need, or download the entire worksheet collection here.

Narcissist workbook cover page
Complete Workbook Download
Identify Narcissistic Traits Worksheet
Identifying Narcissistic Traits Download
Identifying Gaslighting Tactics Worksheet
Identifying Gaslighting Tactics Download
How to Set Healthy Boundaries Around Arguing Worksheet
Setting Healthy Boundaries Download
Personal Strengths Inventory - Dealing With Narcissists
Personal Strengths Inventory Download
Narcissistic Abuse Cycle Download

How Is NPD Diagnosed?

Narcissistic personality disorder is typically diagnosed by a mental health professional, which can include a licensed therapist, psychologist, or psychiatrist. They typically do this by talking through an individual’s thoughts, feelings, behaviors, and personal history. It can also be helpful to include close friends and family who can provide an external view of a person’s behaviors and overall patterns. Sometimes a mental health professional will also conduct personality tests/questionnaires to check for narcissistic traits.

To receive an NPD diagnosis, a person must display at least five of the following traits:

  • Overinflated sense of self-importance
  • Fantasies about being more successful, powerful, smart, loved, or attractive than others
  • Feelings of superiority to others that leads to only associating with high-status people
  • Need for excessive admiration
  • Feelings of entitlement
  • Using others for self-gain
  • Lack of empathy
  • Arrogance or snobbery

Therapy for Narcissistic Personality Disorder

NPD is difficult to treat for a couple of reasons. The first is that most narcissists are naturally avoidant of treatment because they don’t see an issue with their beliefs and behaviors; they typically feel they do not need help. Narcissists will more often seek treatment for a co-occurring mental health concern, such as depression or anxiety. While it’s challenging for someone with NPD to seek and work through treatment specifically for NPD, it isn’t impossible, and there are options available.

If you think you or a loved one may have narcissistic personality disorder, it’s important to connect with a therapist that is specifically trained to work with this disorder. You can start your search to find the right therapist using an online therapist directory or meet with a therapist through an online therapy platform.

Here are some therapy options for the treatment of NPD:

  • Individual therapy: Individual therapy includes one-on-one work with a therapist. This allows a person the opportunity to examine the parenting styles and adverse childhood experiences that could have contributed to the development of their NPD, without worrying about judgment from others.
  • Cognitive behavioral therapy (CBT): In cognitive-behavioral therapy, one challenges their distorted thoughts and beliefs about themselves.
  • Dialectical behavior therapy (DBT): Dialectical behavior therapy (DBT) can help a person accept and manage intense emotions
  • Psychoanalysis: Psychoanalysis allows clients to examine the reasoning behind thoughts and feelings.
  • Family therapy: Once a person has addressed their distorted thoughts, started regulating their emotions, and is working to improve their interactions with others, family therapy may be helpful to address emotional and attachment wounds from childhood.
  • Group process therapy: After a person has worked through some of their interpersonal struggles in individual therapy, engaging in group process therapy can be helpful to practice new engagement tools and help set healthier relational patterns in a more controlled environment.
ADVERTISEMENT

Are You Dating or Married to a Narcissist?

Whether you’re trying to move on or rebuild a relationship, a licensed therapist can guide you. BetterHelp has over 30,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $65 per week and is FSA/HSA eligible by most providers. Take a free assessment

In My Experience

“While narcissistic personality disorder can be a difficult diagnosis to receive, it’s important to remember that this is a complex disorder with many contributing factors. Although those factors often are not choices made by the individual, remember that there are many options for therapy and support to move forward in a healthy and meaningful way.”

Headshot of Maggie Holland, MA, MHP, LMHC Maggie Holland, MA, MHP, LMHC

Frequently Asked Questions

What Is Narcissistic Personality Disorder?

Click here to open the answer container. Click here to close the answer container.

When people think of NPD, they often think of grandiose narcissism, which hosts the primary characteristics of the disorder such as a belief of being superior to others; frequent exaggerations of talents and achievements; fantasies of unlimited power and success; maneuver tactics to attain admiration and praise; a sense of entitlement; and struggles with empathy.1

There is also another type of narcissism known as vulnerable narcissism. Someone in this subtype will hold many of the same internal beliefs about themselves, but their external presentation is usually more subdued. Vulnerable narcissists are less vocal about these beliefs, because they hold more intense shame than other narcissists, struggle with criticism, and generally need more reassurance.

At What Age Does Narcissism Develop?

Click here to open the answer container. Click here to close the answer container.

Research shows that certain narcissistic traits may emerge as early as preschool. One large study among preschoolers found that poor impulse control, interpersonal antagonism, the need to be the center of attention, and histrionic tendencies correlate with themes of narcissism later in life.8 That said, it remains unclear if people are born predisposed to narcissism or if this trait potentially evolves in response to both genetic and environmental factors.

Can You Have a Good Relationship With Someone With NPD?

Click here to open the answer container. Click here to close the answer container.

Having a relationship with someone with NPD may be difficult, but it’s absolutely possible. Relational satisfaction will depend on many variables, including the severity of certain behaviors, insight, and the desire to continue working on the relationship. For example, if you and the other person are both willing to engage in honest communication- and hold each other accountable with love and care- the relationship can be healthy.

In other cases, having a good relationship may be impossible. This is especially true if there are undertones of abuse, coercion, gaslighting, or other forms of manipulation. A good relationship may not be feasible if the person with NPD is unwilling or unable to change certain behavioral patterns.

Is Narcissism Learned or Inherited?

Click here to open the answer container. Click here to close the answer container.

It’s likely a combination of both. For example, inherited genetic factors may make someone more susceptible to developing narcissistic traits. However, upbringing, culture, family influence, attachment patterns, and early childhood trauma also likely play a role in shaping personality. This complex interplay appears to be true for all mental illnesses, including personality disorders.

Is Narcissism Genetic? Infographics

Is Narcissistic Personality Disorder Genetic  Is Narcissism Learned or Inherited

Sources Update History

ChoosingTherapy.com strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • American Psychiatric Association, (2013). Diagnostic and statistical manual of mental disorders (5th ed.) Arlington VA: American Psychiatric Publishing.

  • Torgersen, S., et al. (2012). The heritability of cluster B personality disorders assessed both by personal interview and questionnaire. Journal of Personality Disorders, 26(6), 848–866. https://doi.org/10.1521/pedi.2012.26.6.848

  • Luo, Y. L., Cai, H., & Song, H. (2014). A behavioral genetic study of intrapersonal and interpersonal dimensions of narcissism. PLoS ONE, 9(4). https://doi.org/10.1371/journal.pone.0093403

  • Van Schie, C. C., et al. (2020). Narcissistic traits in young people: Understanding the role of parenting and maltreatment. Borderline Personality Disorder and Emotion Dysregulation, 7(1). https://doi.org/10.1186/s40479-020-00125-7

  • Putnam, A. L., et al. (2018). Collective narcissism: Americans exaggerate the role of their home state in appraising U.S. history. Psychological Science, 29(9), 1414–1422. https://doi.org/10.1177/0956797618772504

  • Konrath, S. & Bonadonna, J.P. (2014, in press) Narcissism. In Whitbourne, S. (Ed.), The Encyclopedia of Adulthood and Aging, Wiley Press.

  • George, F. R., & Short, D. (2018). The cognitive neuroscience of narcissism. Journal of Brain Behaviour and Cognitive Sciences, 1(1), 1-9.

  • Preschool Personality Antecedents of Narcissism in Adolescence and Emergent Adulthood: A 20-Year Longitudinal Study (2010, Aug). National Library of Medicine. Retrieved from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2811719/

Show more Click here to open the article sources container.

We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

April 4, 2025
Author: No Change
Reviewer: No Change
Primary Changes: Edited for readability and clarity. Added “At What Age Does Narcissism Develop?”, “Can You Have a Good Relationship With Someone With NPD?”, “Is Narcissism Learned or Inherited?” New material written by Nicole Arzt, LMFT and medically reviewed by Rajy Abulhosn, MD.
November 2, 2022
Author: Maggie Holland, MA, MHP, LMHC
Reviewer:Kristen Fuller, MD
Show more Click here to open the article update history container.

Your Voice Matters

Can't find what you're looking for?

Request an article! Tell ChoosingTherapy.com’s editorial team what questions you have about mental health, emotional wellness, relationships, and parenting. Our licensed therapists are just waiting to cover new topics you care about!

Request an Article

Leave your feedback for our editors.

Share your feedback on this article with our editors. If there’s something we missed or something we could improve on, we’d love to hear it.

Our writers and editors love compliments, too. :)

Leave Feedback

Additional Resources

To help our readers take the next step in their mental health journey, ChoosingTherapy.com has partnered with leaders in mental health and wellness. ChoosingTherapy.com is compensated for marketing by the companies included below.

Online Therapy

BetterHelp – Get support and guidance from a licensed therapist. BetterHelp has over 30,000 therapists who provide convenient and affordable online therapy. BetterHelp starts at $65 per week and is FSA/HSA eligible by most providers. Take a free online assessment and get matched with the right therapist for you. Free Assessment

Online-Therapy – Online-Therapy.com provides a weekly live video session, unlimited text messaging, and self-guided activities like journaling. Starting at $64 per week, this is one of the most affordable options for CBT therapy. Try Online-Therapy

Narcissist Recovery Support Group

Circles – Anytime, anonymous, and free. Never feel alone during life’s greatest challenges. Drop-in to live conversations and share thoughts, ask questions, or learn from others on the same journey. Join Circles Now

Narcissism Newsletter

A free newsletter from the experts at ChoosingTherapy.com for those recovering from narcissistic abuse. Get helpful tips and the latest information. Sign Up

ChoosingTherapy.com Directory 

Find local therapists that offer online and in-person therapy. Search for therapists by specialty, experience, insurance, and location. Find a therapist near you.

Best Online Therapy Services of 2025: Our Firsthand Experiences & Recommendations

Best Online Therapy Services

There are a number of factors to consider when trying to determine which online therapy platform is going to be the best fit for you. It’s important to be mindful of what each platform costs, the services they provide you with, their providers’ training and level of expertise, and several other important criteria.

Read more
ChoosingTherapy.com Logo White
  • About Us
  • Contact Us
  • Write for Us
  • Careers
  • Editorial Policy
  • Advertising Policy
  • Privacy Policy
  • Terms of Service

FOR IMMEDIATE HELP CALL:

Medical Emergency: 911

Suicide Hotline: 988

View More Crisis Hotlines
Choosing Therapy on Facebook
Choosing Therapy on Instagram
Choosing Therapy on X
Choosing Therapy on Linkedin
Choosing Therapy on Pinterest
Choosing Therapy on Tiktok
Choosing Therapy on Youtube

© 2025 Choosing Therapy, Inc. All rights reserved.

X