You hear a lot of people being called narcissists these days — movie stars, ex-girlfriends, presidential candidates, millennials. The word just seems to come up a lot more than it used to, Rebecca Webber writes in a thoughtful and timely cover story in Psychology Today.

But is narcissism really more prevalent than before? Psychologists’ consensus, she says, is no. The condition called narcissistic personality disorder, or NPD, affects only about 1 per cent of the population, a figure that has remained about the same since the term was established in 1968.

“Most (but not all) putative narcissists today are innocent victims of an overused label,” she writes. “They are normal individuals with healthy egos who may also happen to indulge in the occasional selfie and talk about their accomplishments. They may even be a bit vain. But while we’re diagnosing friends, relatives, and our kids’ classmates, true pathological narcissists may be evading detection.”

And that’s a problem, she writes, because these are people whose social dysfunction and unstable sense of self-identity could be treated if it were identified.

For example, some true narcissists are obsessed with helping other people — kind of self-aggrandisement through martyrdom. We’ve all met people like this, Craig Malkin, author of ‘Rethinking Narcissism’, tells Webber — “self-sacrificing to the point where you can’t stand to be in the room with them”. Other narcissists might have so damaged a sense of self that they cannot handle criticism and become highly introverted.

When faced with a setback such as job loss or divorce, the true narcissist — rather than being buoyed by a strong ego — is often devastated by fear of being weak and vulnerable. This can lead to profound melancholy or defensive rage, which might lead the sufferer to seek professional help.

But such people rarely understand the root of their problem. “I’ve never heard anyone say, ‘I think I’m a narcissistic personality,’” Steven Huprich, president-elect of the International Society for the Study of Personality Disorders, is quoted as saying.

Are narcissists made or born? Both, Webber’s experts say. Narcissism begins in the genes but it is developed — or controlled — by influences including parenting styles and formative relationships.

The general culture is also part of the mix. Lifetime rates of NPD are four times as high in famously competitive New York than in Iowa. Parents should not be afraid to help their kids develop a healthy sense of self-esteem, but rather than encouraging them to be “the best,” it’s preferable that they be “the best that they can be.”

And what about those supposedly narcissistic millennials? Nah. People are always more narcissistic when they’re young: “It’s a self-absorbed stage of life,” says Emily Bianchi, a professor at Emory University. Her research indicates that people who face difficult issues during their youth develop a healthy sense of their limitations that fends off narcissism later in life. Which would mean that millennials, “still struggling to establish themselves during a slowly recovering economy,” might end up less narcissistic than their elders in the long run.

Finally, what about that narcissistic ex-boyfriend? Don’t be so quick to use the label. “Whenever couples are in high conflict, they become more self-centred,” Malkin says. “Rage makes narcissists of us all.”