Genetic Risk Assessment Questionnaire: Fill & Download for Free

What if or can a narcissist have to have something happen to them when young or can they just become one on their own?This is a little complicated because while there is a lot of research on antisocial and borderline personality disorders, there’s a comparative lack of similar research on narcissistic personality disorder, specifically. The reason for this is that ASPD and BPD are associated with higher “social urgency”[1] than NPD and consequently receive a larger pool of funding for research.First of all I would like to thank Anna Clarke for bringing to my attention a very interesting study on genes and personality disorder development. I have long shared the opinion of the experts who study, diagnose, and treat this disorder that NPD likely has a genetic component. If Quora ever decides to reactivate my spaces I will add it to my list of helpful resources and studies.The genetic epidemiology of personality disordersThis study found an association between certain gene candidates and certain behavioral patterns. These include negative emotionality, impulsivity, low agreeableness, and introversion. This is similar to the views and statements of Dr. Elsa Ronningstam, a respected expert on NPD specifically, who cites an inherited predisposition to hypersensitivity, low frustration tolerance, and compromised emotional regulation.This particular study suggests genes linked to neurotransmitters (especially serotonin and dopamine) may play a role in PD development. That said, only a small number of these gene studies have been successfully replicated so for now we will have to take it with a grain of salt. Research suggests but does not yet conclusively prove a genetic component to personality disorders in general, let alone NPD specifically. No “narcissism gene” has been identified.For the sake of this discussion let’s assume that there is indeed a genetic component to NPD. The study does not stop there. It does not say “there might be a genetic component, let’s call it a day.” It goes on to more pointedly answer your question.Yes, something happened to us when we were young.The aforementioned genetic factors influence how a child reacts to and is impacted by environmental stressors. Decades of twin and adoption studies strongly back the conclusion that personality disorders have a strong gene-environment correlation.Gene-environment interaction was demonstrated in an adoption study as early as in 1974, when Crowe found that early institutional care was a risk factor for later antisocial behavior only when a genetic risk factor was present.In another adoption study, Cadoret et al found significant gene-environment interaction by showing that there was a negligible risk for antisocial behavior from a genetic risk alone (antisocial behavior in the biological parent), no effect of an adverse adoptive family environment alone, but a substantial effect when both were present.The finding was replicated in a later study with a larger number of adoptees, Jaffe et al, using a twin design, found significant gene-environment interaction with respect to childhood maltreatment and the development of antisocial behavior, and in a twin study Tuvblad et al demonstrated a significant gene-environment interaction by showing that the heritability for adolescent antisocial behavior is higher in socioeconomic advantaged environments.Using an advanced family design, Feinberg et al recently found an interaction of genotype and both parental negativity and low warmth predicting antisocial behavior.…In a community based twin study, Hicks et al demonstrated a significant gene-environment interaction with a number of environmental risk factors showing that greater environmental adversity was associated with increased genetic risk for antisocial PD and substance use disorders.AndBased on results from quantitative genetic studies showing gene-environment interaction for antisocial behavior, Caspi et al studied the association between childhood maltreatment, and a functional polymorphism in the promoter region of the MAOA gene on antisocial behavior assessed through a range of categorical and dimensional measures using questionnaire and interview data plus official records. The results showed no main effect of the gene, a main effect for maltreatment and a substantial and significant interaction between the gene and adversity. The maltreated children whose genotype conferred low levels of MAOA expression more often developed conduct disorder and antisocial personality than children with a high activity MAOA genotype.This finding came from a study of adults involving childhood maltreatment, MAOA gene variation, and ASPD risk. It was later replicated in another study[2] that also included 7 year old children who were or had suffered maltreatment. The finding suggests the MAOA gene “influences vulnerability to environmental stress, and that this biological process can be initiated early in life.”Lastly, people who study, diagnose, and treat NPD professionally have also found that environment factors into NPD development. Elinor Greenberg is an invaluable resource here on Quora if you want to learn more about this disorder from a realistic, clinical perspective. Other experts on NPD have also made the adverse environment connection to pathological narcissism—Heinz Kohut, Otto Kernberg, James Masterson, Elsa Ronningstam, and more. This connection has been recognized and well known for a very, very long time and really is not up for debate at this point.I know that some people have the impression that pathological narcissism springs forth from spoiling, doting on, and overindulging a child. I do not agree with this assessment. People frequently fail, for some reason, to understand that the “golden child” who was actively pitted against his siblings, played like a pawn and objectified by the parent(s), simply suffered a different form of abuse. Make no mistake—pitting your children against each other in a bid to earn your very conditional love and approval, or risk very real neglect, abuse, scorn, and contempt, is most assuredly abuse.I also want to point out that what you see on the outside looking in is not always a clear picture of what happens behind closed doors when you aren’t there. My family is an example of this. People thought I was a spoiled, ungrateful little princess with a doting Martha Stewart mom. My reality was very different. Behind closed doors I suffered abject neglect and abuse. Few people knew about it and fewer still knew the full extent. My friends thought my family was great. The handful of times I spoke up I was casually dismissed as a liar, including school staff and other people who had the power to help me but chose not to.Lastly, I want to add that while all of the above are reasons somebody might develop a personality disorder such as NPD, it does not excuse poor behavior. I firmly believe that as adults we must advocate for ourselves, since the people responsible for the maltreatment we experienced obviously did not and will not. It’s difficult, painful, and often feels degrading and re-victimizing, but it’s necessary to peel that bandaid off and get on with an improved quality of life for the sake of ourselves and those we care about, few though they may be.Footnotes[1] https://www.borderlinepersonalitydisorder.org/wp-content/uploads/2013/11/NPD-Basic-Second-Edition-In-Print-03-2016.pdf[2] MAOA, maltreatment, and gene–environment interaction predicting children's mental health: new evidence and a meta-analysis

I think we should all be concerned because the slope we're on is pretty slippery.Wellness programs have dubious value (something I wrote about here: RAND Corporation (Briefly) Publishes Sobering Report On Workplace Wellness Programs) but often "require" something called a "Health Risk Assessment."Most of the questions are fairly innocuous - and the programs themselves are designed (in theory) to lower the cost of healthcare insurance for both the employer and their employees.That slippery slope? The HRA's (exactly like the one you're describing) can be administered anytime (new hire, open enrollment) and there's no real limit to the type of personal questions - or screening tests that are often required.The University of Pennsylvania found itself in hot water over this exact issue earlier this year - as reported in the NYT: On Campus, a Faculty Uprising Over Personal DataThe plan requires nonunion employees, like professors and clerical staff members, to visit their doctors for a checkup, undergo several biometric tests and submit to an extensive online health risk questionnaire that asks, among other questions, whether they have recently had problems with a co-worker, a supervisor or a divorce.If they don’t fill out the form, $100 a month will be deducted from their pay for noncompliance. Employees who do participate will receive detailed feedback on how to address their health issues.At a university where some employees earn less than $50,000 annually, the faculty members contended that an $1,200 annual surcharge for nonparticipation — or $2,400 if the employee has a spouse or domestic partner on the school’s plan when that person has the option of coverage from his or her own employer — amounted to a strong-arm tactic.Their motive is simple. The employer rate can be lowered with the data from these HRA's.Every employee will need to decide for themselves how comfortable they are with employers having very detailed information about not just their medical history (which they've always had access to through claims data) but their future as well. One HRA asked female employees if they were planning to have children that year. Refusal to answer was $200 per month assessment. With genetic testing getting ever cheaper - there's really no end in sight.The countervailing argument is that employers never see the results of the HRA - only the insurance carrier - but it's hard to imagine some employers won't push that with vendors that they are paying.We do need to end the historic accident of employer-based health coverage. This is a great example of why.In the end - the relevant question for all of us (regardless of where insurance is provided) is this one:"I'm comfortable providing detailed health information to my doctor - but why should I be financially penalized for not providing personal health information to an insurance company?"

The most important thing to consider is whether you feel comfortable with the doctor. Does he take the time to answer your questions. Is the hospital he’s affiliated with convenient? What is his temperament like? Does he listen? How many years has he been in practice? EctThe first OBGYN I saw when I was pregnant was “odd”. I waited two hours past my appointment. I asked his staff at two hours if he has an emergency come up. They told me no, he was always that late. I could see the old fashion appointment book on the counter. He was way overbooked. I was seen. He asked me questions about my religious background- on the genetic risk questionnaire I had filled out, I noted I’m from an Ashkenazi background. My husband isn’t. The risk of Tay Sachs was not elevated. The questions were not just risk assessment. I decided to switch doctors. I was uncomfortable with him and I wasn’t going to wait 2.5 hours for every appointment. Emergency fine. A little late, ok, but triple booking. Nope.I got a new referral from my internist. He was a little less convenient to get to his office, maybe 10 minutes further. He was in a large group practice. One of the things the second doctor told me was that he liked to deliver his patients babies. He said that if could he would, but that if he was on vacation, not feeling well or had had even one drink, he wouldn’t. I thought that was awesome. He was honest and reasonable. He delivered both my children, including in the middle of the night. But honestly at the end, I didn’t give a _____ who caught the babies. My pregnancies were uneventful. He’d still be my OBGYN if I hadn’t been forced to change insurance - I’d make the drive once a year 35 miles - because I liked him. That’s an intangible.