What would you say about a patient who had been depressed for several years, fulfilled all of your criteria for an adult who lacked illusory grandiosity, but who in response to SSRI treatment became able to do everything previously attributed to failure of parental enthusiasm? Since 1988, when Prozac came on the market, this has been our experience in one case after another. My own opinion is that what you describe as a lack of illusory grandiosity is often (not always, of course) secondary not to affect management scripts forged within inadequate parenting situations, but to a biological disorder of shame affect that leaves the individual mired in the experience of shame and therefore unable to risk any expansion of self-concept.
It makes a great deal of difference when we look at the affects expressed by the patient rather than yield to the temptation to scrunch people into terms like "narcissistic."