I think it's a little far-reaching to apply a pretty serious psychiatric evaluation (i.e. something meant to diagnose a significant mental deviation from the norm) to a pattern of behaviour that's incredibly common. Because it is so common, it becomes the norm. It is therefore more reasonable to assume it really is childish behaviour.

Narcissism isn't just a medical diagnosis. It's also just a character trait used to describe extreme selfishness outside of psychiatric circles.

Certain personality disorders become much more prevalent in certain jobs. CEOs are much more likely to be sociopaths than the general population, for example. Is it a stretch to assume that NPD might be similarly more common in high status positions?

Common misconception about sociopathic ceos: https://www.spsp.org/news-center/blog/landay-harms-psychopat...

I find this very unpersuasive. Especially where it is arguing against claims not commonly made by such studies:

> We also found that leaders with psychopathic tendencies were slightly less effective at their jobs in terms of fostering productivity.

Usually the argument is that sociopaths rise to this level of power and eventually flame out. I’ve never seen any argument that sociopathy tends to make you a good CEO, but rather than it makes you more likely to rise to that level.