Some researchers, such as psychologist Jean Twenge, say this new world where compliments are better than sex and pizza, in which the self-enhancing bias has been unchained and allowed to gorge unfettered, has led to a new normal in which the positive illusions of several generations have now mutated into full-blown narcissism. In her book The Narcissism Epidemic, Twenge says her research shows that since the mid-1980s, clinically defined narcissism rates in the United States have increased in the population at the same rate as obesity. She used the same test used by psychiatrists to test for narcissism in patients and found that, in 2006, one in four U.S. college students tested positive. That's real narcissism, the kind that leads to diagnoses of personality disorders. In her estimation, this is a dangerous trend, and it shows signs of acceleration. Narcissistic overconfidence crosses a line, says Twenge, and taints those things improved by a skosh of confidence. Over that line, you become less concerned with the well-being of others, more materialistic, and obsessed with status in addition to losing all the restraint normally preventing you from tragically overestimating your ability to manage or even survive risky situations. In her book, Twenge connects this trend to the housing market crash of the mid-2000s and the stark increase in reality programming during that same decade. According to Twenge, the drive to be famous for nothing went from being strange to predictable thanks to a generation or two of people raised by parents who artificially boosted self-esteem to 'roidtastic levels and then released them into a culture filled with new technologies that emerged right when those people needed them most to prop up their self-enhancement biases. By the time Twenge's research was published, reality programming had spent twenty years perfecting itself, and the modern stars of those shows represent a tiny portion of the population who not only want to be on those shows, but who also know what they are getting into and still want to participate. Producers with the experience to know who will provide the best television entertainment to millions then cull that small group. The result is a new generation of celebrities with positive illusions so robust and potent that the narcissistic overconfidence of the modern American teenager by comparison is now much easier to see as normal.