Skip to content

How to Recognize Narcissistic Personality Disorder

Reading Time: 7 minutes

Are teenagers naturally narcissistic? Adolescents are in the midst of forming their identities and learning how to navigate their inner and outer worlds. Therefore, they are often oversensitive, self-obsessed, and unaware of others’ needs.

These traits are also symptoms of a serious mental health disorder called narcissistic personality disorder (NPD). Narcissistic personality disorder is believed to affect around 6 percent of people nationwide, but is more prevalent in younger people.

Narcissistic personality disorder affects more males than females, and it often begins in the teens or early adulthood. Consequently, a major National Institute of Health study found that 9.4 percent of Americans in their early twenties experienced episodes of narcissistic personality disorder.

However, narcissism isn’t the same thing as NPD. Raising a narcissistic teenager is quite different than dealing with narcissistic personality disorder in teens. While some children and teens may show traits of narcissism, this may simply be typical of their age and doesn’t mean that they have or will develop NPD.

Increasing Narcissism Among College Students 

According to a study in the Journal of Personality, college students have become increasingly narcissistic over the past 30 years. Researchers analyzed data from 85 samples of American college students who completed the 40-question Narcissistic Personality Inventory (NPI).

As a result, they found that, between 1982 and 2006, college students’ NPI scores significantly increased by about two narcissistic answers. A follow-up study added 22 new studies to the meta-analysis and found further increases in narcissism among college students through 2008. Subsequently, the researchers proposed two reasons for this increase:

  1. A greater focus in recent years on building self-esteem in teens and young adults
  2. The internet and social media, which encourage young people to focus obsessively on themselves and their public image.
Newport Academy Mental Health Resources: How to Recognize Narcissistic Personality Disorder

A Conflicting Study of Narcissism in High School Students

However, another group of researchers analyzed adolescent narcissism via the National Institute on Drug Abuse’s “Monitoring the Future” survey, which tracks the attitudes, behavior, and values of America’s youth. While the survey didn’t measure narcissism directly, it investigated related factors, including egotism, self-esteem, individualism, and the importance of social status.

Subsequently, researchers found that, on all of those measures, high school seniors in 1976 were no different than those who graduated 30 years later, in 2006. Therefore, these results contradicted the studies on narcissism in college students. (Interestingly, the researchers from the first study challenged the results of the study on high school students.)

In conclusion, opinions about narcissism in young people differ. Some experts believe that teens are very much like they have always been when it comes to narcissistic behavior. For example, the ancient philosopher Socrates, who lived between 469 and 399 BC, wrote, “Children today are tyrants. They contradict their parents, gobble their food, and tyrannize their teachers.”

However, other mental health professionals are concerned about the impact of social media, in particular, on teen narcissism.

Narcissism and the Myth of Narcissus

A little background on the origin of the term “narcissistic”: In Greek mythology, Narcissus was a hunter, the son of a river god and a nymph, and was known for his beauty. As a result, he was so proud that he disdained those who loved him.

Subsequently, the myth relates, Narcissus saw his own reflection in a pool of water and fell in love with it, not realizing it was only an image. Thereafter, he became obsessed with the beauty of his reflection and lost his will to live. In fact, he stared at his reflection until he died.

Therefore, narcissism is the word used to describe a fixation with oneself and one’s physical appearance or public image.

Newport Academy Mental Health Resources: How to Recognize Narcissistic Personality Disorder

What Is Narcissistic Personality Disorder?

Narcissistic personality disorder is an extreme version of narcissism. Moreover, it is one of the more difficult personality disorders to diagnose, because the symptomology can be mistaken for other mental health conditions or simply difficult personality traits.

What is a narcissist? Narcissistic tendencies include having grandiose ideas about oneself and one’s achievements. Therefore, narcissists seek excessive admiration from other people and society as a whole. Furthermore, they become fixated on external success and control.

Additionally, narcissists lack empathy. Thus, they do not feel compassion for or identify with other people. Narcissists tend to have denigrating, dismissive attitudes toward other people. Consequently, the symptoms of narcissistic personality disorder often disrupt personal or professional relationships. However, such narcissistic behaviors tend to hide feelings of low self-esteem and fear of personal inadequacy.

Narcissistic personality disorder was originally identified to describe personality disorders that could not be classified as either neurotic or psychotic. Moreover, narcissistic personality disorder is more widespread in males than females.

Symptoms of Narcissistic Personality Disorder

In order for a person to be diagnosed with narcissistic personality disorder (NPD), they must meet five or more of the following symptoms:

  • Maintains a grandiose sense of self-importance; exaggerates achievements and talents
  • Preoccupied with fantasies of success, power, brilliance, beauty, or the perfect mate
  • Believes that they are “special,” superior, and unique, and can only be understood by other special or high-status people
  • Requires constant, excessive admiration
  • Has a very strong sense of entitlement—for example, unreasonable expectations of favorable treatment
  • Takes advantage of others to get what they want
  • Lacks empathy, is unwilling to recognize or identify with the feelings and needs of others
  • Is often envious of others or believes that others are envious of them
  • Regularly shows arrogant, haughty behaviors or attitudes; boastful and pretentious
  • Monopolizes conversations and belittles or looks down on people they perceive as inferior
  • Insist on having the best of everything—for instance, the best car or office.
Newport Academy Mental Health Resources: How to Recognize Narcissistic Personality Disorder

Traits and Complications of NPD

Furthermore, people with narcissistic personality disorder may experience any of the following narcissistic traits, all of which interfere with interpersonal relationships and the ability to function well in daily life.

Narcissists tend to

  • Become impatient or angry when they don’t receive special treatment
  • Be extremely sensitive to criticism; very easily insulted
  • React with rage or contempt and try to belittle the other person
  • Have difficulty regulating emotions and behavior
  • Handle stress and change poorly
  • Suffer from depression or mood swings due to underlying insecurity
  • Feel secret shame, vulnerability, and humiliation.

Moreover, complications of narcissistic personality disorder, and other conditions that can occur along with it, include the following:

  • Relationship difficulties
  • Problems at work or school
  • Depression and anxiety
  • Physical health problems
  • Drug or alcohol misuse
  • Suicidal thoughts or behavior.
Newport Academy Mental Health Resources: How to Recognize Narcissistic Personality Disorder

The Causes of Narcissistic Personality Disorder

Researchers do not know for certain what causes NPD. However, most experts believe that narcissistic personality disorder emerges from a combination of these factors:

Genetic: Inherited characteristics may influence NPD. If a person has narcissistic personality disorder, research suggests that there is a slightly increased risk that their children will also suffer from NPD.

Neurobiological: Some experts believe that narcissistic personality disorder is a result of miscommunication between the brain and behavior and thinking.

Social and environmental: This refers to how a person is influenced by their early relationships with family, friends, and peers. Specifically, some experts theorize that parent-child relationships characterized by excessive adoration and overprotection, excessive criticism, or severe neglect or abuse may trigger NPD.

Psychological: This refers to the individual’s overall personality and temperament, which may be more or less vulnerable to NPD.

Therefore, narcissistic personality disorder appears to be the result of several interdependent and intertwined factors.

Newport Academy Mental Health Resources: How to Recognize Narcissistic Personality Disorder

Treatment for Narcissistic Personality Disorder in Teens

Therapy for narcissistic personality disorder is typically long-term psychotherapy with a mental health professional who has experience in treating NPD. On the other hand, people with NPD may seek short-term therapy to help them manage during especially stressful periods.

Psychotherapy for NPD seeks to help individuals learn to

  • Relate better to others in order to develop more intimate, enjoyable, and rewarding relationships
  • Understand and regulate emotions and how they influence behavior
  • Recognize and accept their actual level of achievement, competence, and potential
  • Tolerate criticisms or failures
  • Release the desire for unattainable goals and begin to accept the reality of what is attainable.

However, teens with narcissistic personality disorder are typically resistant to treatment. Therefore, family therapy and group therapy can be more effective. In addition, holistic approaches, such as yoga, meditation, sleep management, nutrition, and somatic experiencing, may be useful in supporting talk therapy. Additionally, teens with NPD benefit from exercises designed to assist them in developing empathy for others.

Sometimes, medications are prescribed to help with specific symptoms that prevent a person with NPD from functioning in daily life. However, medication is typically not part of the treatment plan for teens.

In conclusion, with NPD, seeking help at the first sign of trouble is key. A mental health professional can recommend the appropriate level of care, which many include weekly therapy or care at a residential or outpatient treatment center. As with all mental health disorders, early detection and diagnosis result in more favorable outcomes.

Therefore, parents need to maintain strong relationships with their children, and remain attentive and present. As a result, they can identify and address any issues immediately. Moreover, they benefit by building a lasting parent-child connection.

Key Takeaways

  • Narcissistic personality disorder affects only a small percentage of young people. However, teens may display narcissistic behaviors that are typical of their age and do not indicate they have NPD.
  • NPD is characterized by having grandiose ideas about oneself and one’s achievements, and lacking empathy for others.
  • In order for a person to be diagnosed with narcissistic personality disorder, they must meet five or more specific criteria. People with NPD also display a set of specific traits that typically interfere with interpersonal relationships and the ability to function well in daily life.
  • While some research shows that young people have become more narcissistic in recent years, other studies indicate levels of narcissism are not significantly higher than 30 years ago.
  • Treatment for NPD focuses on building better relationships skills and regulating emotions.

Frequently Asked Questions About Narcissism and NPD

What are the signs of a narcissistic teenager?

Being self-absorbed, not thinking about others’ feelings (especially parents’ feelings), and focusing intensely on their physical appearance and how they appear to others are all signs of a narcissistic teen.

How do you deal with a narcissistic teenager?

Scolding, criticism, and punishment are not helpful for shifting narcissistic traits in teens. Instead, role-model what caring and empathetic behavior looks like. And find opportunities to gently remind your teen how their behavior impacts others.

At what age does narcissistic personality disorder develop?

Like many other mental heath conditions, NPD typically begins in late adolescence or young adulthood.

Can narcissism be misdiagnosed as ADHD?

Inability to focus on others’ feelings could be a common symptom of ADHD and NPD. However, in general these conditions have a specific set of dissimilar symptoms. Only a mental health professional can accurately diagnose NPD or ADHD.

Images courtesy of unsplash


J Clin Psychiatry. 2008 Jul;69(7):1033-45.

J Personality. 2008 Aug;76(4):875–902.

J Personality. 2008 Aug;76(4):903–918.

Perspectives on Psychological Science; 5(1): 58–75

Am J Psychother. 1994 Winter;48(1):30-51.