So in order: Both, yes, but not always, and it depends.
Narcissistic personality disorder is believed to have some combination of genetic and environmental factors. It is a chronic condition with no real cure.
Straight ass narcissists on the other hand, if it’s not actually NPD and just someone super stuck up, that can often be an environmental thing. The nurture part of Nature Vs. Nurture. A lot of that stuff is often learned behavior from parents or other role models, whether from being spoiled or something, or direct observation and such.
As far as that goes there can really be any number of causes and fixes as well. You can find tons of stories of people who because huge pains on the ass after coming into some major money or something. You can also find a number of stories of people like that who change after some kind of traumatic event for instance. It doesn’t ALWAYS or even frequently happen, but it can.
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