Signs of Narcissistic Personality Disorder (NPD) in Children

By Greg Baer M.D.

July 3, 2024

Learn more about Narcissistic Personality Disorder (NPD), what it is, signs of it in children, how it develops, and how to prevent it.

Watch the Video here.

Narcissism vs Selfishness: Which Is It?

To be narcissistic simply means to be selfish. We ALL demonstrate these qualities from time to time. 

Some people, however, can never stop being selfish. They’ve become so focused on self-serving behaviors that their personality is defined by them. They have narcissistic personality disorder, or NPD.

Pay close attention to this article. In the beginning, I will briefly describe this common and serious mental health problem.

But the real point—the potentially lifesaving point—is to help you avoid standing by while your child gradually develops this problem.

The individual steps toward this crippling disorder are insidious, often innocent-looking. They are so common as to be accepted as normal. Keep reading all the way to the end, and you will discover ample reward for your doing that.

Characteristics of Narcissistic Personality Disorder (NPD)

NPD is a condition in which there is an inflated sense of self-importance and an extreme preoccupation with one's self. The acronym NPD will be used in this article to refer either to the disorder or to the person who has it—only for the sake of brevity, not to dismiss the seriousness of the problem or the pain of the person affected.

Following are some of the criteria used for making the diagnosis of NPD.

People with this disorder:

  • Have an exaggerated sense of self-importance
  • Have a sense of entitlement and require constant, excessive admiration
  • Expect to be recognized as superior even without achievements that warrant it
  • Exaggerate achievements and talents
  • Are preoccupied with fantasies about success, power, brilliance, beauty, or the perfect mate
  • Believe they are superior and can only associate with equally special people
  • Monopolize conversations and belittle or look down on people they perceive as inferior
  • Expect special favors and unquestioning compliance with their expectations
  • Take advantage of others to get what they want
  • Have an inability or unwillingness to recognize the needs and feelings of others
  • Are envious of others and believe others envy them
  • Behave in an arrogant or haughty manner, coming across as conceited, boastful and pretentious
  • Insist on having the best of everything — for instance, the best car or office
  • Pursue primarily selfish goals

How Someone with NPD Handles Criticism

At the same time, people with narcissistic personality disorder (NPD) have trouble handling anything they perceive as criticism, and on such occasions they can:

  • Become impatient or angry when they don't receive special treatment
  • Have significant interpersonal problems and easily feel slighted
  • React with rage or contempt and try to belittle the other person to make themselves appear superior
  • Have difficulty regulating emotions and behavior
  • Experience major problems dealing with stress and adapting to change
  • Feel depressed and moody because they fall short of perfection
  • Have secret feelings of insecurity, shame, vulnerability and humiliation

To put it most briefly and pointedly, people with NPD are motivated only by one word, over and over: Me, Me, Me.

Why We Need to Understand Narcissistic Personality Disorder

So why is it important for us to understand NPD? Because the incidence is SO very high that we all know several people with it. Until we understand the disorder, these people are very confusing and can cause considerable stress to the people around them.

Narcissistic personality disorder causes problems in every area of life: personal happiness, relationships, work, school, financial affairs, and more. People with narcissistic personality disorder are often disappointed and unhappy when they're not given the special favors or the admiration they believe they deserve.

A fulfilling relationship with a spouse—or life partner—is quite impossible. The NPD makes everything about HIM or HER, which makes genuine and loving connection unattainable. Other people might be briefly entertained by a narcissist, but not for long. People begin to avoid them diligently.

NPD is Easy to Miss Before You Are Trapped

Ironically, many NPDs can be quite charming. They can be the “life of the party.” They can appear to be quite ingratiating.

But ALWAYS their motivation is to trade their favors, their charms, their time, and more for something THEY want.

This can be especially confusing to people who are dating an NPD, who can be creatively and abundantly giving.

But once the NPD has established a contract with their partner—marriage or moving in together, for example—the trap is snapped shut. The partner discovers that they’re in a prison, where they are nothing more than an object to serve the NPD.

Treatment for NPD

I have worked personally with a great number of people with NPD, and with their families. Once the disorder has matured, I have never seen anyone “cured” of the problem. They can learn to manage their demands somewhat, and their families can learn to respond differently to the selfishness of the narcissist.

However, true cures are virtually unheard of, as further confirmed by my numerous conversations with psychiatrists and psychologists.

Incidence of NPD

In a study of nearly 35,000 adults by the National Institutes of Health, published in the Journal of Clinical Psychiatry, 6.2% of adults were found to have NPD with an incidence of nearly 8% for men and almost 5% for women.

These are overwhelming numbers, especially since most clinicians I have spoken to estimate these numbers to be far too low. Why is NPD under-estimated? Because selfish behavior has become increasingly normalized in our culture. Me-me-me is normal and often even encouraged.

What would we do if the incidence of COVID were 6.2%? Or cancer of the lung? Or any medical condition? Eradication would become our Number One priority. Yet identification and management of NPD is virtually off the radar, despite the unspeakable cost of NPD to individuals, couples, families, businesses, and more.

The Contribution of PARENTS in Developing NPD

NPD is not an inherited disorder. It develops over years in response to some combination of circumstances and stimuli. I can state with categorical certainty that NPD is a response to PAIN, much as any addictive behavior.

Children who do not have sufficient and consistent Real Love are in constant emotional pain, which cannot be ignored. They WILL respond with whatever behaviors minimize or eliminate their pain in the short term. A child who becomes entirely focused on HIS pain, HIS needs, and HIS approaches to pain reduction and self-gratification is—by definition—narcissistic.

To be plain, NARCISSISTIC PERSONALITY DISORDER IS A RESPONSE TO THE PAIN OF LACKING REAL LOVE. Really.

NPD is usually diagnosed in adolescence or early adulthood. However, the diagnosis is delayed by years because no parent wants to admit their child is afflicted with such an emotionally terminal problem.

Nor is any child quick to admit that he or she is over-the-top selfish all the time. I’ve seen NPD fully developed by age 12, and I’ve seen the signs blooming exponentially in children much younger.

NPD is Like a Virus: Both Need to Be Recognized Early

With practice, a full-blown adult NPD can be spotted fairly easily. It is very common among politicians, CEOs, entertainers, and in other occupations where NPD is confused with confidence, drive, and passion.

If we really want to be serious about reducing the incidence and effect of NPD around us—especially in our own families—we have to recognize how it develops. It’s sneaky. It develops by repetition of behaviors that can appear to be so innocent individually.

But these behaviors are like the introduction of a fatal virus. One or two virus particles may be eradicated by the immune system without anybody knowing that it happened. Introduction of a sufficient “viral load,” however, may cause the beginning of serious symptoms.

The virus can be treated successfully if identified early and treated aggressively. But if we don’t recognize the early virus, and we allow it to multiply unhindered, the result can be serious illness and death. And now it’s a bit late to correctly identify the virus, isn’t it?

Recognizing the Signs of Narcissistic Personality Disorder in Children

Following are some examples of what NPD DOES look like in a child, and what the early symptoms look like in a child who is developing narcissistic tendencies. Pay close attention to them, because your child does exhibit some of them: 

  • Whining. A certain amount of this is relatively unavoidable as a child makes the transition from pre-verbal crying to speaking. But as quickly as a child can speak, he or she must be REQUIRED to speak. For more about this, see the Ridiculously Effective Parenting Training, Chapter Zero, on RealLoveParents.com.
  • Your child hits a sibling. You carefully explain to the “hitter” how this behavior is not loving, and the child might apologize. But the child’s goal is to get out of trouble—for HIMSELF—not to recognize any pain caused to the sibling. And if the “hitter” is pushed to state that what he did was wrong or selfish, he tends to become resistant, defiant, and even belligerent.
  • Your child fails to keep the rules of the home, which are clear to everyone. You say something to the child, who shrugs his shoulders. After being very specific, the child might correct the errant behavior, but it soon repeats itself—especially if you’re not consistent in loving and teaching. Eventually, words are not enough to change the lack of responsibility, so you apply a consequence. The child often ignores the consequence. Or—most commonly and most insidiously—completes just barely enough of the consequence (additional work, for example) to avoid further consequence FOR HIM. But there is no expression of remorse, and no expression of “I was irresponsible,” or “I was wrong.”
  • Your child makes a mistake. You point it out. The IMMEDIATE response of the child—before there is even time to genuinely think—is to defend himself. He might do this by denying the mistake entirely. Or he carefully explains how it wasn’t his fault, or how the “right” way was impossible, and on and on.
  • Your child engages in a team sport. He is clearly not one of the best players on the team. So he  either (1) quits the team, expressing his disinterest in the sport or disgust toward the coach or others. Or (2) he makes exaggerated claims about his successes, especially if you are not in attendance at the events.
  • Your child is inconvenienced in some way. Perhaps his chair is minimally bumped during a meal as someone navigates the path between his chair and the wall. Immediately he lets out a sigh of disgust, or an insult, indicating the real message: “How dare you inconvenience ME, the center of the universe.”  
  • Your child has to have the best and newest of everything: top-brand clothing, the latest iPhone, the latest shoes, the latest version of a video game, and more. And he is insulted at any discussion that would even hint that he doesn’t “need” these things.
  • Your child requires constant attention and praise for every drawing made, song sung, point scored, and so on. All children enjoy positive feedback, but budding narcissists persist and interrupt you until they get what they want. And what you give them is never enough. The next demand for attention is seconds to minutes away.
  • Your child demands something he sees in the store. He might say he “wants” it, but the tone is unmistakably demanding, and the demand is proven if you dare to say “no.” Your refusal is followed by insistent pleading, anger, sulking, and demanding with an entitlement that can easily become scary.
  • Your child compares himself to a sibling, consistently pointing out how HIS performance, skill, or intelligence was superior.
  • Your child talks a lot about how he’s going to be rich and famous. He’ll talk about being in the NBA, for example, even though he couldn’t qualify for the basketball team at his middle school. This isn’t some brief fantasy but a genuine belief in rewards that are vastly disproportionate to his abilities and accomplishments.
  • Your child consistently belittles the efforts or performances of people he perceives as inferior—which includes almost anyone they would talk about.
  • Your child expresses a desire for a particular meal for dinner, even though dinner preparation is finished, or nearly so. He is incensed if the answer is no, and will continue to express that irritation and disgust before, during, and after the meal.
  • Your child takes the larger piece of cake, or cuts in line for the use of a piece of playground equipment, with no regard whatever for what they’ve taken from anyone else.
  • Your child offends a sibling or other child. You ask your child if he can see the effect on the other person. He shrugs his shoulders and says, “I guess,” obviously missing the point entirely. No empathy.
  • Your child doesn’t hesitate to ask someone to get him a drink or something to eat if that person gets up to get something for themselves. But your child NEVER offers to do the same for others.
  • Your child is irritated by the success of others, or dismisses it entirely.
  • Repetition. Your child asks for a thing. You refuse, for whatever reason. He asks again, over and over. He simply can’t believe that not getting what he demands is even an option.
  • Your child is in a hurry, and as he rushes down the hall he crushes the toy of a sibling, or he knocks a sibling down. He simply continues on his way, with little or no evidence that he even noticed, and certainly did not care. If he is confronted with his disregard for the feelings or well-being of the sibling, he exhibits one or more of the following responses:  
    • He denies that it happened.
    • He blames it on the sibling, who he claims was in the way.
    • He shrugs his shoulders, sighs, and says something like, “Okay, I’m sorry,” but the feeling of regret is noticeably absent.
    • He argues that he couldn’t help it.
    • He argues that he was in a big hurry and didn’t see the object or child.

Any ONE of the above behaviors might be innocent, or the result of building stresses elsewhere.

But we MUST pay attention to them, because they all can easily become patterns. Those are very difficult to change—even crippling.

What Parents Can Do to Stop the Development of NPD in their Child

YOU, the parents, are most responsible for the existence and growth of narcissistic personality disorder, a condition at least as harmful as any medical disease. What can we do?

  1. You can consistently identify selfish behaviors in our children. You must be very aware, or the problem will grow unchecked.
  2. You must love your children unconditionally and teach them. Such a child simply has no REASON to behave selfishly in an attempt to diminish his pain. You can learn to do this by going to RealLoveParents.com, where you can view the Ridiculously Effective Parenting Training.
  3. You must act quickly and consistently. Every second that a child is being selfish without that behavior being addressed, registers as permission for the child to continue that behavior. I can’t count how many parents have said to me that when they have attempted to correct a selfish behavior, their child has said, “But you let me do it before.” Children view uncorrected behavior as RIGHT behavior.

Eliminating Selfishness is Paramount in Combating NPD

Selfishness is a response to pain, and if it is allowed to continue, selfishness becomes one of the greatest CAUSES of pain. As parents we must recognize these patterns and do whatever is required to love and teach our children.

Sometimes we have to increase the consequences of selfishness to the point that the child unmistakably recognizes that selfishness is just too expensive to continue.

In the Ridiculously Effective Parenting Training I’ve described in detail the process of increasing consequences.

Some children require the elimination of every privilege before they recognize that they don’t want to continue their selfishness.

The longer we wait—in terms of the moment, as well as the age of the child—the more difficult it becomes to reverse patterns of selfishness.

We can address this problem, which is worsening world-wide. We must.

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About the author 

Greg Baer, M.D.

I am the founder of The Real Love® Company, Inc, a non-profit organization. Following the sale of my successful ophthalmology practice I have dedicated the past 25 years to teaching people a remarkable process that replaces all of life's "crazy" with peace, confidence and meaning in various aspects of their personal lives, including parenting, marriages, the workplace and more.

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