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Narcissistic Personality Disorder

Teen girl looking at herself in the mirror due to her narcissistic personality disorder  

The teenage years are commonly characterized by self-centeredness and a lack of awareness for others. This is a typical phase as adolescents begin to seek independence from their parents and form their identities. For most, this phase eventually resolves itself, as adolescents become less self-absorbed, are able to comprehend the viewpoints of others and develop empathy for others’ misfortunes. However, for some teenagers, these traits are not part of a fleeting phase and can signify an early onset of teenage narcissistic personality disorder.

Personality disorders in teens are comprised of unhealthy thought and behavior patterns and significantly impact their relationships with others. Personality disorders are not formally diagnosed until the age of 18, but signs and symptoms may become evident during the adolescent years. Although some degree of narcissism is characteristic of adolescent development, narcissistic personality disorder in children goes beyond what is expected and symptoms do not resolve themselves as adolescents mature.

What Is Narcissistic Personality Disorder?

A narcissistic personality disorder is a mental health condition where an individual has an exaggerated sense of self-importance, a constant need for affection and admiration from others and a lack of empathy. Individuals with narcissistic personality disorder are incapable of empathy or sympathizing with others. They have an inflated sense of self-importance and feel that they are superior to others. People with narcissistic personality disorder are extremely attention-seeking and are constantly looking for approval and praise from others, largely stemming from self-doubt, fear and very low self-esteem.

The cause of narcissistic personality disorder can result from genetic and environmental factors. Developmental factors that can lead to teen narcissistic personality disorder can result from emotional abuse, unpredictable or overindulgent caregivers or extreme admiration without accurate feedback.

Narcissism in teens is different than a clinical, diagnosable personality disorder, as narcissism can be used to generally describe common adolescent qualities of arrogance, egocentrism and selfishness. However, a teenage narcissistic personality disorder is a clinical condition that is defined by fixed and rigid patterns of behavior.

Narcissistic Personality Disorder Statistics

According to the Diagnostic and Statistical Manual of Mental Disorders, about 1% of teenagers have Narcissistic Personality Disorder. Narcissistic personality disorder statistics show that the majority of teen narcissists are male, as 50-75% of men are estimated to have the condition. Teenage boys are much more likely to have the disorder than girls are.

An epidemiological study published in the Journal of Clinical Psychiatry studied narcissistic teenagers and found that young people are more likely than adults to have experienced symptoms of Narcissistic Personality Disorder.

Another study used the Narcissistic Personality Inventory and Interpersonal Reactivity Index to study narcissism and empathy and found that 70% of students scored higher on narcissism and lower on empathy than students from 30 years ago.

Types of Narcissistic Personality Disorder

Research has recently focused on categorizing different types of narcissistic personality disorder. The subtypes of narcissistic personality disorder can show how the disorder can present on a spectrum and vary across individuals. Identifying subtypes of narcissistic personality disorder would likely help practitioners to increase understanding of the condition and improve methods of treatment.

Although an individual cannot be formally diagnosed with narcissistic personality disorder until the age of 18, behaviors and symptoms of the various subtypes can appear in adolescents before that time. Narcissistic teenagers can fall into one of three categories, which reflect different types of severity and long-term outlooks.

Types of narcissistic personality disorders include:

  • High-Functioning Exhibitionist Type/Exhibitionist Narcissist: The exhibitionist narcissist is entitled and self-centered, which can lead to a lack of empathy and peer issues. An adolescent exhibitionist narcissist will believe that they are always right, is a poor listener, and will exaggerate their own skills and talents.
  • Fragile-Vulnerable “Covert” Type/Closet Narcissist: Teenagers with a closet narcissistic personality disorder do not present with the type of grandiosity as the other subtypes. Closet narcissistic traits can include a high vulnerability to critique and an expectation that others recognize their superiority. Teenage closet narcissists believe that everyone envies them, covertly expects peers to treat them with special regard and spend time fantasizing about their successes.
  • Grandiose “Overt” Type/Toxic Narcissist: Toxic narcissistic personality disorder represents the highest level of severity and is the most disordered amongst all the subtypes. The toxic narcissist displays a higher level of anger and aggression and is least likely to participate in treatment. The adolescent toxic narcissist is highly vulnerable to criticism, can be quick to anger, and believe that no rules apply to them.

Recognizing Teenage Narcissistic Behavior

Teenage narcissistic behavior can result in relationship issues, difficulties in school, depression, and anxiety or substance misuse. A teenage narcissist can show a lack of empathy and can manipulate people to get what they want. Their actions indicate their exaggerated beliefs of superiority and they can become aggressive with those who do not give them the respect and admiration that they seek.

Some characteristics of teenage narcissists can include:

  • Impatience and anger when they are not recognized or highlighted
  • High sensitivity to criticism and critique
  • Quick to anger and easily insulted
  • Difficulty with emotional regulation
  • Poor stress management skills
  • Mood swings that result from insecurities
  • Vulnerable to humiliation

Narcissistic personality disorder symptoms and causes can result from a combination of factors. Genetics and heredity can play a role in inherited characteristics and a slightly increased risk of having the disorder if a family member also has it. Psychological factors can contribute to personality, temperament, and vulnerability to symptoms of narcissistic personality disorder.  Social and environmental factors can also play a role, as child-caregiver relationships, other interpersonal relationships or past history of abuse can contribute to the disorder.

Teenage NPD and Substance Abuse

Narcissistic personality disorder in adolescence and an increased sense of entitlement has coincided with an increased rate of teen substance abuse. High levels of narcissism have been associated with increased impulsivity and sensation seeking, which can lead to drug and alcohol use.

Narcissistic personality disorder and alcoholism are related, as teenagers may use alcohol or drugs to promote their grandiose sense of self or self-medicate if they are not getting the type of admiration and gratification that they are seeking.

Teen Narcissistic Personality Disorder Treatment

Teen narcissistic personality disorder treatment entails psychotherapy and can include medication if there is a co-occurring condition. It is commonly difficult to get a teenager to agree to narcissistic personality disorder treatment due to their faulty perceptions of self. Adolescents often feel that treatment is a waste of time and are resistant to forming a therapeutic relationship with a practitioner. Teenagers also have strained relationships with family members and peers, which results in a strained support system that cannot encourage an adolescent to enter and stay in treatment.

Psychotherapy seeks to help a teenager to alter their thinking so that they can gain a more realistic perception of their abilities and sense of self. A teenager is also taught how to develop empathy for other people in individual and group therapy modalities.

Medication can be prescribed if an adolescent has a co-occurring condition such as depression or anxiety. Medication can also be used if depression or anxiety result from the teenager’s new sense of self.

If an adolescent has a co-occurring substance abuse disorder, residential treatment centers for teens like Next Generation Village can help. Reach out today to explore treatment options available to you and your family. Find the help you deserve.

Medical Disclaimer: Next Generation Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.


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