The aim of this study was to demonstrate a correlation between the clinical assessment of narcissistic personality disorder in children and underlying self and object relationships. D. Westen's Social Cognition and Object Relations Scale for the Thematic Apperception Test (1995; D. Westen, N. Lohr, K. Silk, K. Kerber, & S. Goodrich, 1985) was used to compare the object representations of two groups of referred latency-aged children, one for whom narcissistic issues were thought to be primary. Support for the clinical literature, which describes these children as lacking in empathy, struggling with self-esteem regulation, and in poor control of their impulses or aggression, was found. Additionally, a tendency to have a vulnerable sense of identity and to be preoccupied with seeking out and developing relationships with others was found to differentiate these children from peers with similar behavioral and diagnostic profiles. Results obtained have potential implications for the assessment and treatment of narcissistically disturbed children.