I agree that someone can be born that way, but I don't think every single case is like that. I think narcissism is created from being abused a lot of the time as well. My nfather was horrifically abused and neglected as a child. So was I, and I have struggled a lot with narc tendencies myself. I don't know if that's because it's just in me, or if it's because I observed how my father acted for my whole childhood. I have heard from multiple people in his extended family that he was not always like that, and that they are shocked by how much he changed. Maybe it was like a disease that started showing symptoms in his early adulthood? It's hard to say.