A mental health professional can't diagnose someone with narcissistic personality disorder until they're 18.
Before that, certain precursors like a child's environment and demeanor can increase their chance of developing NPD.
Genetics can also play a role, and it's usually a combination of factors.
Someone can't be officially diagnosed with narcissistic personality disorder (NPD), a condition where a person has an extremely heightened sense of self-importance as a defense mechanism, until age 18 when their personality fully develops.
But there are certain signs and precursors that could make a child more likely to become narcissistic and later receive a diagnosis, Craig Malkin, a psychologist and author of "Rethinking Narcissism," told Insider.
In one 20-year longitudinal study of preschoolers, researchers observed which children developed unhealthy narcissistic traits like extreme entitlement, exploitativeness, and aggression. They found a combination of factors, like an indulgent or permissive parenting styles, genetics, and early-in-life temperament, increased the likelihood of a child developing narcissism in their early twenties.
They're more melodramatic than their peers
If a preschooler's personality is steeped in lots of melodrama, it could be one potential sign of a future NPD diagnosis, according to Malkin.
He said most three- and four-year-olds have a dramatic flair and tendency towards selfishness, considering their young age. But if a child always wants to be the center of attention, needs to win, or has a tendency to bully others, it could suggest a proclivity towards unhealthy narcissism.
Their caregiver is neglectful or overindulgent
The parenting style of a child's caregiver could also potentially influence if they develop narcissism later in life, said Malkin.
In Cramer's study of preschoolers, children who experienced authoritative parenting, where the parent held firm boundaries but was also present and nurturing, were the most likely to develop safe and secure relationships as they grew up.
But children who were extremely melodramatic, and who also had parents that ignored or neglected them, spoiled them constantly, or insisted on perfection, were more likely to become narcissists in adulthood.
If a parent is neglectful or demands perfection as a requirement for their attention, a child may learn to internalize the message that they're not enough as they are. As adults, they might develop an overblown sense of self-importance as a defense mechanism for their underlying feelings of inadequacy.
If a child was spoiled or told they're more important or special than their peers, it could also lead to narcissism in adulthood, according to Malkin.
While it's normal for parents to nurture their children and boost their self-esteem, giving a child what they always want and suggesting they have entitlement could lead to an unhealthy sense of superiority.
They have a caregiver who's a narcissist
Not every neglectful or overindulgent parent is a narcissist themselves, but they can be. When narcissistic parent's sense of self influences how they raise their child, it can increase a child's risk of developing narcissism, according to Malkin.
For example, narcissists hold the often-unconscious belief that, "you're either the loudest or the most exceptional, or you're nothing," Malkin said. A child may pick up on this behavior and they'll start to believe that black-and-white thinking.
"So, there's either the victim or the aggressor, or there's the winner or the loser. A child raised that environment is going to identify with narcissism. Like, 'I want survive and I want to matter, so I gotta be like this person,'" Malkin said.
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