Hello Bunny,
He's 18 and just started college. If I had to sum up my worries in one (long) sentence, I'd say it's a combination of: extreme obsession with his appearance (for example, it takes him 45 minutes to apply topical acne cream and he usually only has a few small blackheads to begin with); a history of manipulating friends in high school then ignoring them because they weren't "interesting"; rarely grasping consequences for irresponsible behavior and then choosing to lie rather than be upfront when reality hits; extreme rage in situations where he feels he has failed/not lived up to his own expectations or been rejected by peers (he always does apologize later and seems to feel genuine remorse). Otherwise, he's very intelligent though did not live up to his potential in HS and the jury's still out 1st semester into college; good looking though he doesn't believe this; and can be very funny, warm and charismatic when HE chooses.
What might have made him a narcissist, much as I don't want to believe he may be? Genetics, if that's a factor, but more likely something to do with a traumatic culture change in 6th grade moving from an fairly depressed industrial community to a wealthy suburban area (with all the judgmental peer behavior that goes with it); a father who was primary caregiver and while loving in many ways, overprotected and criticized him all his life; a mother (me) who often overcompensated as a result of being raised by a very destructive NPD parent and trying to balance out my husband's impatience and critical attacks
Right now my son appears to be doing ok in college but the insecurities actually seem to be getting worse. He recently told me he feels he has no self confidence and can't walk past anything that reflects his image without analyzing himself. If he doesn't look in public, he's nothing. He's also not handling rejection from the opposite sex well at all. It's probably good he's telling us these things, yet nothing we or his friends say seems to restore any belief in himself and he continues to see life as only about "looking good" and the power this represents. The one wonderful thing about college so far is that it appears he has formed many real friendships, unlike high school, and these mean alot to him. Also, he's never had a real girlfriend, so maybe some of the rejection reactions and anxieties are totally normal.
Still, I just don't know how to tell if some of the other traits are lingering adolescent narcissism or if there are real problems forming here. I would be very interested to hear your thoughts and appreciate your interest. My apologies for the long reply, but wanted to give as complete a picture as I could. --Sunflower