Narcissism And Heart Disease

Toadstool admiring himself from artes at Frog Forum.

I stumbled upon this article yesterday:
Health Risk Higher for Guys Who Think They're 'All That'

And wondered how they measured narcissism. Here's the actual study:
Expensive Egos: Narcissistic Males Have Higher Cortisol, PLoS ONE, January 2012

Narcissism was assessed using the "Narcissistic Personality Inventory." They used a 40-point Narcissism Personality Inventory tool, which appears to be this:
Narcissistic Personality Quiz

I know, I know, not another quiz. But questionnaires have to be validated before they can be used in a study. That is, studies have to be conducted ahead of time to determine that the questionnaire really does indicate presence of the trait they are measuring, in this case narcissism (another phrase the authors used was "extreme self-focus.") So, this quiz isn't something you'd find in the back of Men's Health or Glamor Magazine. Well, maybe not.

Here was one such validation:
A Principal-Components Analysis Of The Narcissistic Personality Inventory And Further Evidence Of Its Construct Validity

Note this validation study accounted for both objective and subjective measures. So, your results on the quiz should presumably correlate well with both how you see yourself and how others see you.
________
The original study up top, by the way, found that men with higher scores in what they called "unhealthy" narcissism¹ had a higher activation of the hypothalamic-pituitary-adrenal (HPA) axis, which resulted in higher basal levels (basal, so all-the-time levels, as opposed to, say, a reaction to a stressful event) of the stress hormone cortisol. High levels of cortisol increase the risk for heart disease. The cortisol effect was still strong after controlling for related variables such as mood, general stress, social support, and relationship status.

Narcissism was related to the stress hormone cortisol in men, but not in women.

Also:

"Males tend to score higher on narcissism, and males also have larger increases in cortisol concentrations after stressors."

This was interesting:

"Given societal definitions of masculinity that overlap with narcissism (i.e. they include arrogance and dominance), we hypothesize that these difficulties in maintaining an inflated sense of the self are at least in part related to the extent to which males endorse stereotypically male gender roles. Threats to male gender roles and masculinity are constant, and provide a source of stress that make these roles difficult to maintain. Narcissism is also stressful and difficult to maintain. In addition, both high masculinity and narcissism advocate for high independence and agency, and emphasize individualism over an acceptance of social support. Because high narcissists report experiencing a greater number of daily hassles compared to low narcissists, low social support is especially likely to be toxic."

They said there may be pressure upon men in this society from endorsement of "stereotypically male gender roles." So ... men are pressured to act manly?

They concluded:

"[O]ur findings highlight the possibility that for males, narcissism may have an especially negative physiological effect. Considering the rising narcissism among both men and women in American culture, there may be potential long-term public health consequences if these trends continue. Given research finding that chronic HPA activation is associated with cardiovascular problems, and other work finding that an increased use of first-person singular pronouns is also associated with poor cardiovascular health, future work might examine high narcissism in earlier life predicts poor health outcomes in later life. We also recommend that future research attempt to better understand why male narcissists have higher basal cortisol concentrations, and in doing so, help to pinpoint potential windows of intervention."

They say narcissism is rising among Americans.

And this ... "increased use of first-person singular pronouns is also associated with poor cardiovascular health." Future studies will have a lot more adjustments to make for confounders!
________¹ If you take the quiz, you'll find that your score was broken down into 7 categories: Authority, Self-Sufficiency, Superiority, Exhibitionism, Exploitativeness, Vanity, and Entitlement. An "unhealthy" narcissism score was created using the Entitlement and Exploitativeness values. "Healthy" narcissism scores were derived by summing the Leadership/Authority, Self-Sufficiency, Superiority, and Vanity values. While "unhealthy" narcissism was linked to high cortisol, "healthy" narcissism was not.