Typically, the child comes to believe that they have a personality defect that makes them unvalued and unwanted; overindulgent, permissive parenting or insensitive and over-controlling parenting are risk factors towards the development of NPD in a child.In Gabbards Treatments of Psychiatric Disorders (2014), the following factors are identified as promoting the development of narcissistic personality disorder:
An oversensitive temperament (individual differences of behavior) at birth
Excessive admiration that is never balanced with realistic criticism
Excessive praise for good behaviors, or excessive criticism for bad behaviors in childhood
Overindulgence and overvaluation by family or peers
Being praised by adults for perceived exceptional physical appearance or abilities
Trauma caused by psychological abuse, physical abuse or sexual abuse in childhood
Unpredictable or unreliable parental caregiving
Learning the behaviors of psychological manipulation from parents or peersMoreover, the research reported in "Modernity and Narcissistic Personality Disorders" (2014) indicates that cultural elements also influence the prevalence of NPD, because narcissistic personality traits more commonly occur in modern societies than in traditionalist conservative societies. Pathophysiology
Studies of the occurrence of narcissistic personality disorder identified structural abnormalities in the brains of people with NPD, specifically, a lesser volume of gray matter in the left, anterior insular cortex. The results of a 2015 study associated the condition of NPD with a reduced volume of gray matter in the prefrontal cortex. The regions of the brain identified and studied – the insular cortex and the prefrontal cortex – are associated with the human emotions of empathy and compassion, and with the mental functions of cognition and emotional regulation.
It is only since the late 1800s that narcissism has been defined in psychological terms:
Havelock Ellis (1898) was the first psychologist to use the term when he linked the myth to the condition in one of his patients. Sigmund Freud (1905-1953) used the terms "narcissistic libido" in his Three Essays on the Theory of Sexuality. Ernest Jones (1913/1951) was the first to construe extreme narcissism as a character flaw. Robert Waelder (1925) published the first case study of narcissism. His patient was a successful scientist with an attitude of superiority, an obsession with fostering self-respect, and a lack of normal feelings of guilt. The patient was aloof and independent from others and had an inability to empathize with others situations, and was selfish sexuality. Waelders patient was also overly logical and analytical and valued abstract intellectual thought (thinking for thinkings sake) over the practical application of scientific knowledge.Narcissistic personality was first described by the psychoanalyst Robert Waelder in 1925. The term narcissistic personality disorder (NPD) was coined by Heinz Kohut in 1968. Waelders initial study has been influential in the way narcissism and the clinical disorder Narcissistic personality disorder are defined today

Freudianism and psychoanalysis
Much early history of narcissism and NPD originates from psychoanalysis. Regarding the adult neurotics sense of omnipotence, Sigmund Freud said that "this belief is a frank acknowledgement of a relic of the old megalomania of infancy"; and concluded that: "we can detect an element of megalomania in most other forms of paranoic disorder.