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Psychiatrists seldom diagnose narcissism in children due in large part to the fact that most symptoms are believed to set in during adolescence and adulthood. Children normally have fantasies of limitless power and ability — a key characteristic of narcissism outlined by the Diagnostic Statistical Manual of Mental Disorders IV (DSM-IV) — but they also have personalities still in the process of formation. There is a chance that children will eventually grow out of their narcissistic behavior. Studies have found, however, that narcissism could conceivably manifest as a disorder regardless of age. Possible signs of narcissism in children include throwing tantrums when criticized, a lack of responsibility for an action's consequences, and resistance to attitude adjustment.
A number of the identified symptoms of narcissism in the DSM-IV are related to having an abnormally-inflated sense of grandeur, both in the patient's perceived importance and in his abilities. In children, this can manifest as seeing other children being beneath them. The narcissistic child believes he is superior to his peers, and will not hesitate to express this. He will exclude other children from his playgroup on the basis of lower material wealth, poorer social status, and the inability to perform the same tasks with a suitable skill level. This also creates an inability to properly deal with criticism; the child believes he is infallible and will react violently when told otherwise.
On the other side, narcissism in children tends to magnify feelings of envy. Since the child's perceived self-importance is greater than average, he will take it as an affront to his value if he sees others being better than him at some skills, or having better things. This is often paired with antisocial behavior, and so the narcissistic child will often get into fights with children he sees as better than him in order to establish his own superiority. In some children, this can manifest as a tendency to steal the toys of others.
Narcissism in children can also inflate a child's sense of entitlement to unrealistic levels. A child with narcissism might resent being told what to do; he chooses not to recognize another person's authority simply because he thinks the other person is not as important as he. In return for his perceived superiority, the narcissistic child will expect to be admired by the people around him, creating a pathological need to be the center of attention. These unrealistic expectations can lead to withdrawal from individuals that do not reinforce them, a key trait of narcissism in general.