EXCLUSIVE Democrats in Congress to explore creating an expert panel on Trump's mental health

[pat_k]

28. DT is mentally ill: Antisocial Personality Disorder and Narcissistic Personality Disorder

DT is mentally ill. He meets the criteria for Antisocial and Narcissistic Personality Disorders. And based on public conduct, I have no doubt that an evaluation would put him way up on the Psychopathy Checklist.

Lying and "distorting reality" are hallmarks. He breaks every rule in the book in pursuit of his own ends. He lies and distorts reality to rationalize and justify his wrongful conduct. To puff up his over-inflated ego he stereotypes and denigrates those he sees as out-groups. His callous disregard for others and sense of entitlement appear to know no bounds. He weaves grandiose tales of his fearsome power, omnipotence, and unequaled brilliance. He is proudly abrasive and offensive. He clearly enjoys humiliating and embarrassing others, but reacts to any perceived slight to his own person, appearance, or accomplishments aggressively and vindictively.

I'm sure there have been U.S. presidential candidates, and presidents, who could be diagnosed with a personality disorder of some sort, but I can't think any of who exhibited this level of psychopathy. I can't think of any who met as many diagnostic criteria for Antisocial Personality Disorder, or who met as many criteria for Narcissistic Personality Disorder.

Regarding Personality Disorders in general

There are four defining features of personality disorders. These are:

1) Distorted thinking patterns,
2) Problematic emotional responses,
3) Over- or under-regulated impulse control, and
4) Interpersonal difficulties.

I think it is pretty clear that DT exhibits these defining features.

Antisocial Personality Disorder DSM-5 301.7 (F60.2)

{Lengthy discussion that proceeds diagnostic criteria omitted}

There are four diagnostic criterion, of which Criterion A has seven sub-features
.
A. Disregard for and violation of others rights since age 15, as indicated by three of the seven sub features:

1. Failure to obey laws and norms by engaging in behavior which results in criminal arrest, or would warrant criminal arrest
2. Lying, deception, and manipulation, for profit tor self-amusement,
3. Impulsive behavior
4. Irritability and aggression, assaults others, or engages in fighting
5. Blatantly disregards safety of self and others,
6. A pattern of irresponsibility and
7. Lack of remorse for actions (American Psychiatric Association, 2013)

The other diagnostic Criterion are:
B. The person is at least age 18,
C. Conduct disorder was present by history before age 15
D. and the antisocial behavior does not occur in the context of schizophrenia or bipolar disorder

(American Psychiatric Association, 2013)

DT meets A. He shows "Disregard for and violation of the rights of others." He exhibits at least four of the seven "sub-features."
Specifically 1 (sexual assault clearly warrants arrest), 2, 3, and 7 (I don't think there would be any argument on these three). Arguably he exhibits some of the remaining features. For example, he probably meets 3. He is clearly "irritable and aggressive," but I don't know of any reports of physical assaults in adulthood.

He only needs three of the sub-features to meet the criteria for A "Disregard for and violation of the rights of others"

He is certainly over 18, and from descriptions of him as a kid in [link:http://www.pbs.org/wgbh/frontline/film/the-choice-2016/transcript/"Frontline: The Choice 2016]" he exhibited the same characteristics (plus physical aggression) from a young age.

Narcissistic Personality Disorder DSM-5 301.81 (F60.81)

The definition of NPD states that it is comprised of a persistent manner of grandiosity, a continuous desire for admiration, along with a lack of empathy. It starts by early adulthood and occurs in a range of situations, as signified by the existence of any 5 of the next 9 standards (American Psychiatric Association, 2013):
-- A grandiose logic of self-importance
-- A fixation with fantasies of infinite success, control, brilliance, beauty, or idyllic love
-- A credence that he or she is extraordinary and exceptional and can only be understood by, or should connect with, other extraordinary or important people or institutions
-- A desire for unwarranted admiration
-- sense of entitlement
-- Interpersonally oppressive behavior
-- No form of empathy
-- Resentment of others or a conviction that others are resentful of him or her
-- A display of egotistical and conceited behaviors or attitudes

On this one I'd say he's nine for nine (and only needs five for diagnosis).

The "Psychopathy Checklist" is highly correlated with the criteria for Antisocial Personality Disorder and Narcissistic Personality Disorder. Scoring is based on a structured interview, but, given the degree to which DT meets the criteria for Antisocial Personality Disorder and Narcissistic Personality Disorder, I have no doubt that DT's psychopathy score is very high.