I think the issue with the DSM was mostly that the definition -- in terms of language -- now covered routinely accepted behaviour. That is, it wasn't useful to

I think the issue with the DSM was mostly that the definition -- in terms of language -- now covered routinely accepted behaviour. That is, it wasn't useful to use those terms to describe a disorder. What ultimately happened, as I recall, is a reworking of the definition to focus more on the core behaviour that Narcissistic Personality Disorder really means, though I guess functionally this might be much the same as saying "things we used to think were evidence of a diseased mind are now commonplace behaviours". I assure you that outside of the USA we've always admired the individualism and those aspects of the American Dream etc., and I don't think that is what the DSM debate was about. There's always been unfair tropes about Americans abroad but the change we would notice in the last 40 years is the whining/demands to be accommodated, the babying of language, and the growth of infantilism generally. The "Karen" trope is a consequence of cultural narcissism. You guys have changed. I'm sure the Brits have too (and in a few holiday destinations we are the worst tourists on earth, no question, though that's not narcissism, it's cheap booze) but I don't know if our core character has changed (for better or worse!) and I would say the world misses the cool self-assuredness it used to associate with the USA. "What's in it for me?" is selfishness, not narcissism.