Typically, the child comes to believe that they have a personality defect that makes them unvalued and unwanted; overindulgent, permissive parenting or insensitive and over-controlling parenting are risk factors towards the development of NPD in a child.In Gabbards 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
Excessive praise for good behaviors, or excessive criticism for bad behaviors in childhood
Overindulgence and overvaluation by family or peers
Being praised by adults for perceived exceptional physical appearance or abilities
Trauma caused by psychological abuse, physical abuse or sexual abuse in childhood
Unpredictable or unreliable parental caregiving
Learning the behaviors of psychological manipulation from parents or peersMoreover, 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 traditionalist conservative societies. Pathophysiology
Studies of the occurrence of narcissistic personality disorder identified structural abnormalities in the brains of people with NPD, specifically, a lesser volume of gray matter in the left, anterior insular cortex. The results of a 2015 study 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.
In medicine, bilirubinuria is an abnormality in which conjugated bilirubin is detected in the urine.The term "biliuria" is very similar, but more general. It refers to the presence of any bile pigment in the urine. Conjugated bilirubin is detected in urine at bilirubinemia of approximately 30-34 mmol/L or 2 mg/dL. In this concentration of conjugated bilirubin in the blood appears as yellowness of the mucous membranes and sclera. Causes
The most common cause of bilirubinuria is hepatocellular disease. More rare causes include inherited disorders, such as Dubin–Johnson syndrome and Rotor syndrome.Although Gilberts syndrome and Crigler–Najjar syndrome are characterized by increased bilirubin in the serum, the bilirubin in these inherited disorders is not conjugated and thus not excreted in the urine. The increase of stercobilin (urobilin) in the feces and urine is caused by the enhanced intracellular hemolysis of erythrocytes. Formed an unconjugated bilirubin entering the intestine, gives a large number of stercobilinogen (urobilinogen). Last absorbed into the blood and passes into the urine. Diagnosis
in order To properly

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