Two psychiatrists, believe they have discovered a new, YouTube generation, delusion: believing you are in a secret reality TV show.

The article describes cases of people who believe they are secretly being filmed. 

"I realized that I was and am the centre, the focus of attention by millions and millions of people," explained one patient, an army veteran who came from an upper-middle-class upbringing."My family and everyone I knew were and are actors in a script, a charade whose entire purpose is to make me the focus of the world's attention."

The belief that they are being filmed certainly gives the person a sense of importance, or worth independent of and beyond the mundane life he lives in.  In other words, it allows for an inflation of identity without actually having to do anything.   Call it grandiosity

The patient added that he planned to climb to the top of the Statue of Liberty, and if his true love were waiting for him, the puppeteer strings would be cut. If she failed to show up, he would jump to his death.

Grandiosity is one explanation, but I submit that the important part of this delusion isn't the filming, but the "puppeteer."  The delusion isn't about self-importance, but rather an explanation for powerlessness.  I am being manipulated by the outside.  There's nothing I can do.

Consider that a delusion which enhances your importance might not be one you'd want terminated; but these cases have the termination of the delusion built in.

In "reality" (ha!) such cases are cognitive metaphors for maturity.  Only when you gain sufficient self-awareness and autonomy can you break away from the artificial, manipulated reality of adolescence.

"But these guys are 30 years old!"  Exactly.  Real adolescents don't need a delusion to tell them they're powerless.  But a 30 year old should be dealing with intimacy vs. isolation, but instead they're stuck back at identity vs. role confusion.

The delusion is the protection, not the empowerment.  It says, "don't worry, you haven't accomplished anything because the producers haven't put that into the script yet."  Ultimately, this YouTube delusion is the result of a fleeting awareness that you cannot choose your identity unless you back it up with actions-- that actions are identity.

When a narcissist has this awareness, he has two choices.  He can retreat into a protective delusion, such as this one; or he can convince-- read: force-- someone else to accept his identity even in the absence of actions.  "I am a tough cop!  Well, maybe not actually a cop, but if something went down in this mall, I could be like a cop, and that's just as good!"

You do not want to be the person the narcissist tries to convince.