Is Donald Trump a Psychopath?

Short answer: yes. Long answer: also yes.

Shortly after Trump was elected in 2016, I remember hearing a news story about a group of psychologists who broke some sort of code of silence to speak out about his diagnosable mental issues. I wanted to know more, but the news, busy jumping from one scandal to the next, never seemed to get back to this topic. The exception was that every time I saw George Conway on screen, he would refer to Trump as a malignant narcissist.¹ Here we are 8 years later, and I’m finally realizing the news won’t play this story. I’m creating this article to chase down the facts for myself and to improve public awareness of the dangerous situation we find ourselves in.

Definition of Psychopath

I went to college back in the 1990s and learned the terms psychopath and sociopath in my Psychology 101 and Abnormal Psychology classes. It turns out that the 90s were a long time ago, and those words are no longer used as modern diagnoses. However, they are still used colloquially, and there has been quite a bit of data collected over the past century related to the term psychopath, so they are still useful to define.

Psychopath: a mentally unstable person, especially a person having an egocentric and antisocial personality marked by a lack of remorse for one's actions, an absence of empathy for others, and often criminal tendencies

Sociopath is considered to be a synonym of psychopath, with no difference in definition.

How it applies to Trump

By the definition above, is Trump a psychopath? Let’s look at the elements in the definition:

1. Lack of remorse for one’s actions

   Trump is famous for his refusal to apologize, no matter how egregious his behavior. Who can forget when he insulted a Gold Star Family by claiming that Khizr Khan’s speech was written by Hilary Clinton’s campaign and by claiming that the fallen soldier’s mother didn't speak at the convention because she was forbidden from doing so? When asked to apologize for these remarks, Trump instead equated his own sacrifice of “working very, very hard” to that of the Gold Star parents.² This egocentric response is the kind of thing that could only make sense to a psychopath. More recently, when Trump was convicted on 34 charges related to illegal influence of the 2016 election, he certainly didn’t show remorse for those actions. Rather, he called the jury “rigged”, the judge “crooked”, and claimed the trial was politically motivated.³

2. Absence of empathy for others

   According to Mary Trump, Donald Trump did not develop the ability to feel empathy due to emotional neglect and abuse in his childhood. This led to problematic behaviors, including bullying, disrespect, and aggressiveness.⁴ We were able to witness this lack of empathy for ourselves under Trump’s leadership during the COVID pandemic, when he minimized the death toll and refused to mourn publicly.⁵ Trump’s infamous quote of “I like people who weren’t captured” in reference to the late senator and war hero, John McCain, is an example of lack of empathy that will be written in the annals of history.⁶

3. Criminal tendencies

   Trump has demonstrated a pattern of criminal behavior that spans decades. We are all aware of his 34 convictions for election interference, the $80 million in damages for sexual abuse and defemination, the $364 million fine for financial fraud, and the ongoing (at least for now) case concerning mishandling of classified documents. However, his pattern of criminality was established long before he became the president. For instance, Trump and his father were sued in 1973 for violating the Fair Housing Act, in 1988 he settled an antitrust suit with the FTC, and in 2015 he settled a suit related to charges of fraud related to Trump University. According to USA Today, Trump and his businesses have been involved in at least 3500 legal actions in the years before he became president.⁷

These facts seem to indicate that Trump is a psychopath. But if that’s the case, it only leads to more questions. Is there an official diagnosis? If so, why would psychologists and the media be quiet about this? What does this mean for us Americans who will be, once again, living under his rule?

The Hare Psychopathy Checklist

If Trump were to be officially diagnosed as a psychopath, it would be done using the Hare Psychopathy Checklist-Revised (PCL-R) which was developed in the 1970s to assess people accused of crimes, awaiting sentencing, or serving time in prison. This tool includes a list of 20 traits of a prototypical psychopath, such as glib and superficial charm, lack of empathy, sexual promiscuity, pathological lying, and egocentricity. Since its publication, the Hare checklist has been associated with tens of thousands of clinical studies.

To make a diagnosis, the psychologist is to use an interview and review of family and criminal history to rate the patient on a scale of 0, 1, or 2 for each of the 20 items. Thus, the Hare Checklist has a maximum score of 40. When this scale is applied to people with no criminal history, they score an average of 5. When it is applied to non-psychopathic criminal offenders, they average around 22. The cutoff to be diagnosed as a psychopath in the UK is 25 and in the US is 30.⁸ Donald Trump scores a 34.⁹

You don’t have to take my word for it. Vince Greenwood, PhD and Seth D. Norrholm, PhD, carefully and professionally used the Hare scale to evaluate Trump and published their results in The more dangerous case of Donald Trump: 40 psychiatrists and mental health experts warn anew (2024), which I highly recommend that you purchase and read for yourself. Here is what they found:

Hare Psychopathy Checklist-Revised (PCL-R)

1. Glibness / superficial charm - 2

2. Egocentricity / grandiose sense of self-worth - 2

3. Proneness to boredom / need to stimulation - 2

4. Pathological lying and deception / gaslighting - 2

5. Conning / lack of sincerity - 2

6. Lack of remorse or guilt - 2

7. Shallow affect - 2

8. Callous / lack of empathy - 2

9. Parasitic lifestyle - 1

10. Poor behavior controls - 2

11. Promiscuous sexual behavior - 2

12. Early behavior problems - 2

13. Lack of realistic long-term goals - 1

14. Impulsivity - 2

15. Irresponsibility - 2

16. Failure to accept responsibility for own actions - 2

17. Many short-term marital relationships - 1

18. Juvenile delinquency - 1

19. Revocation of parole - 0

20. Criminal versatility - 2

Total = 34

By all measures, Trump is a psychopath. This is not opinion or hyperbole. This is a fact that has been and will continue to affect the lives of all Americans.

Antisocial Personality Disorder

As mentioned earlier, the term psychopath has been updated in recent years to antisocial personality disorder (ASPD). The Diagnostic and Statistical Manual - 5 (DSM-5), also known as the psychiatrist’s bible, has defined the disorder as follows:

Antisocial personality disorder (ASPD) is defined as a pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years. To be diagnosed with ASPD, an individual must meet the following criteria:

1. Be at least 18 years old

2. Show evidence of conduct disorder with onset before age 15

3. Exhibit at least 3 of the following 7 traits:

• Failure to conform to social norms and laws, indicated by repeatedly engaging in illegal activities

• Deceitfulness, indicated by continuous lying, using aliases, or conning others for personal gain or pleasure

• Impulsivity or failure to plan ahead

• Irritability and aggressiveness, indicated by repeatedly getting into fights or physically assaulting others

• Reckless disregard for the safety of self or others

• Consistent irresponsibility, shown by repeated failure to sustain consistent work behavior or honor financial obligations

• Lack of remorse after hurting or mistreating another person¹⁰

There has already been more than enough evidence presented in this article that shows Donald Trump exhibits at least 3 of these traits and is thus diagnosable with ASPD. There is something new in this definition, however, which is the use of aliases. This trait was famously demonstrated by Trump during the 1980s when he called reporters and gave the name “John Barron” or sometimes “John Miller.”¹¹ Trump is also famous for his failure to honor financial obligations, with numerous reports of his refusal to pay contractors and employees. He likes to use the phrase “other people’s money” when referencing this trait.

Malignant Narcissism

In addition to ASPD, the DSM-5 includes narcissistic personality disorder (NPD) as a diagnosable condition, which is a pervasive pattern of grandiosity, need for admiration, and lack of empathy that begins by early adulthood and is present in a variety of contexts. According to an article in the Biomedical Journal of Scientific and Technical Research, ASPD and NPD are two faces of the same coin.

Individuals with [NPD] have a grandiose sense of self-importance. They routinely overestimate their abilities and inflate their accomplishments, often appearing boastful and pretentious… While individuals with this disorder generally require excessive admiration, their self-esteem is almost invariably very fragile. A sense of entitlement, combined with a lack of sensitivity to the wants and needs of others, may result in the conscious or unwitting exploitation of others… Vulnerability in self-esteem makes individuals with narcissistic personality disorder very sensitive to “injury” from criticism or defeat. They may react with disdain, rage, or defiant counterattack¹²

Trump’s grandiose sense of self-importance is almost too obvious to warrant further discussion, but in the spirit of providing evidence, here are some of Trump’s own words that illustrate this trait:

• Nobody knows the system better than me, which is why I alone can fix it.¹³

• I don’t need to consult my generals. I’m speaking with myself, number one, because I have a very good brain and I’ve said a lot of things.¹⁴

• I have Ivy League education, smart guy, good genes. I have great genes and all that stuff, which I’m a believer in.¹⁵

Malignant Narcissism is the term for a psychological syndrome that combines ASPD with NPD. Individuals with malignant narcissism are especially dangerous to those around them because of their tendency for manipulation, exploitation, and aggression. These individuals will do whatever it takes to achieve their goals and maintain their grandiose view of themselves, even if it means hurting others in the process.¹⁶ Since Trump displays the traits of both ASPD and NPD, George Conway is correct to call him a malignant narcissist.

What are the implications for the American people?

Looking back at his first term, Vince Greenwood highlights two incidents where Trump’s psychopathy led to significant suffering, including deaths, for the American people. Greenwood’s point was that these incidents were not based on political strategy but three fundamental traits common to psychopaths: impulsivity, remorselessness, and drive to dominate.¹⁷

The first is in Trump’s handling of the COVID-19 crisis, where an estimated 40% of American deaths could have been avoided had we had more competent and empathetic leadership.¹⁸ During the crisis, Trump’s impulsivity showed itself with poor decision making, including the choice not to attend coronavirus task force meetings. Trump’s remorselessness meant that he made decisions, such as the decision to hide critical information, based on what would make him look good rather than on the devistating consequences to the American people. The drive to dominate explains why Trump did not collaborate with public health officials, such as Dr. Anthony Fauci.

The second is in Trump’s handling of his loss to Biden in the 2020 presidential election. Trump’s grandiose sense of self-importance would not allow him to understand he had been defeated, and instead, he created an alternate reality in which he actually won the election “by a landslide” except that the other side cheated. This happened quickly, because before 3:00 am on the night of the election, Trump impulsively announced that he had already won. He did not and could not consider the harm this accusation might cause to the American society, and harm us it did. Rather, he ignored all presidential duties for the remainder of his term and focused on manipulating and dominating his way to the failed and deadly coup that happened on January 6.

Greenwood pointed out that these drives are not choices or strategies but hardwired traits associated with psychopathy. It would be unreasonable to expect them to disappear and for Trump to do a better job of leading us through the next crisis. What we can expect that the wellbeing of the American people will continue to be of no concern for any domestic issues that arise during Trump’s next presidency. Humanitarian concerns, including the extreme suffering of people in Ukraine and Gaza, will have no bearing on his decision making.

During his next presidency, Trump will quite literally make decisions for his own benefit rather than for the benefit of the people who are depending on him. That’s not hyperbole. That’s what makes a psychopath a psychopath. The American voters have put their trust in someone who is completely and predictably untrustworthy. It would be naive to hope this won’t lead to hardship, death, and suffering, including for those who voted for him.

Why didn’t psychologists speak out?

Actually, they did. At first, psychologists faced an ethical roadblock to discussing their opinions and diagnoses of a political figure, called the Goldwater Rule. As the situation became more dire, several were able to justify breaking the rule because of a superseding ethical mandate called Duty to Warn. The Goldwater Rule is based on the fallout after Barry Goldwater, Republican nomination for the 1964 presidential race, successfully sued for defamation after being labeled as “mentally unfit” by psychologists.¹⁹ Duty to Warn is the ethical obligation for a psychologist to breach client confidentiality when there is a need to protect potential victims from violent acts.

Because the threat of harm to the American people, and to all of humanity, was so great, many psychologists did speak out. They published books such as The Dangerous Case of Donald Trump: 27 Psychiatrists

and Mental Health Experts Assess a President, 233 of them published an open letter²⁰ in the New York Times, and they teamed up with George Conway to form the Anit-Psychopath PAC to help spread their warning. You can see a commercial from that PAC below.

The 233 psychologists ended their open letter with the following:

Without question, malignant narcissists have been history’s most grandiose, paranoid, and murderous leaders. Inevitably, they escalate until they are completely out of control, ultimately destroying themselves and the nations they lead.

As mental health professionals we feel a desperate duty to warn our fellow citizens of this imminent catastrophic public danger before it’s too late.

Why doesn’t the media cover this?

This is a much better question. It’s clear that right wing propaganda media channels, such as Fox News, wouldn’t have spread the word to the public about the danger of Trump’s psychopathy. However, why wasn’t the topic spread more widely in the mainstream media? George Conway has called discussion of mental disorders in the media as “the last taboo” and has called out various channels for the double standard of scrutinizing Biden’s mental fitness but not Trump’s.

Since Trump “came down the golden escalator” and entered the political arena, journalists have struggled to find an ethical and professional way to cover his antics. I believe this is due to the fact that Trump is a literal psychopath. His actions are not understandable to those of us who only score in the single digits on the Hare Psychopathy Checklist. Up until the publication of The Dangerous Case of Donald Trump in 2017, journalists are to be forgiven for not understanding that the firehose of lies and scandals from the Trump campaign could not be covered in the way that other campaigns are covered.

Even after there was clear evidence of a dangerous personality disorder, the media, for the most part, failed in its duty to give sufficient warning to the American people. This may be because they were uncertain if the Goldwater Rule applied to them. Maybe it was because of the understandable desire to avoid contributing to a stigma concerning the vast majority of people with mental disorders, who pose no threat to anyone. Journalists went to such lengths to avoid discussing Trump’s psychosis that they inspired a new word: sanewashing. The point is that if you consistently report on a the activities of a psychopath as if he were not a psychopath, then your reporting will be inaccurate.

One thing most journalists did do was cover the numerous court cases against Donald Trump and the existential threat he poses to our democracy. If they didn’t cover the diagnosis, they certainly covered the symptoms. The media gave the Amercian voters more than enough information to understand that Trump was unequivocally unqualified and disqualified to hold office.

Why didn’t the voters care?

I’ve addressed a lot of questions in this article, but this is the one I grapple with the most. Since I personally was uncertain as to whether Trump had a diagnosable mental disorder until doing the research for this article, I think it’s safe to assume most Americans were simply unaware that Trump is indeed a psychopath. Even if they did hear a mention of it on the news, as I did, our media environment has been so polluted with misinformation, that it’s understandable they would be skeptical when hearing such an unusual and inflammatory report.

On the other hand, every American voter should have been aware that Trump is a lying, manipulative criminal who has already attempted to overthrow our democratic system of government and will certainly try again given the chance. They might not know the word for this is psychopath or malignant narcissist, but they absolutely should have had the common sense to understand that he is dangerous. I have no answer for why so many American voters didn’t care about safety, sanity, or decency.

Is there any hope?

In this time shortly after the 2024 election, it seems that each new development takes away a little more hope. Not only is Trump president-elect, but the Senate and House are both in Republican hands, and there is little reason to believe that the Republican leadership will do anything other than continue to enable Trump’s worst instincts. We also can not count on the conservative members of the Supreme Court to defend democracy after making a mockery of our Constitution with the Trump v. United States immunity decision. Each announcement of a new cabinet pick, such as Matt Gaetz for Attorney General, reminds us that the institutions we have always taken for granted may not survive this onslaught.

I have a slim hope that the upper echelons in our military will place barriers that may come between a potential order of a nuclear attack and the carrying out of that attack. Bob Woodward reported in his book, War, that General Mattis “was so worried that former President Trump would order a nuclear strike against North Korea that he slept in gym clothes in case of an emergency overnight call.” It was mentioned in the 2024 version of The more dangerous case of Donald Trump, that John Kelly, retired 4-star Marine general, was seen holding the 2017 version of the same book while he was serving as Trump’s chief of staff. Perhaps I am still too naive, but it is comforting to tell myself that perhaps the military takes this threat more seriously than the general public does. Maybe they won’t follow Trump’s most catastrophic and illegal orders.

I also have some hope that a new coalition of democratic governors, calling themselves Governors Safeguarding Democracy, will provide resistance to the implementation of Trump’s cruelest policies, especially with respect to mass deportations. Massachusetts governor Maura Healey is reported by CNN to have said the state police would “absolutely not” support Trump’s deportation efforts and “every tool in the toolbox is going to be used to protect our citizens, to protect our residents and protect our states, and certainly to hold the line on democracy and the rule of law as a basic principle.”²¹

Personally, I believe the best long-term strategy to address the fact that so many American voters were duped into voting for a psychopath lies with our institution of public education. We need to redouble our efforts to teach civics and critical thinking in our K-12 schools. Math teachers like me can do more to help our students understand why absolute statements such as “I am 100% sure” are less reliable than statements presented with an honest assessment of uncertainty. Even as an inveterate church lady, I understand that we must keep religion out of our school and the scientific method in. We need to increase opportunities for our students to attend 2- and 4-year colleges, not just for career readiness, but for the sake of developing an informed populace. Afterall, 56% of the voters without a college degree supported Trump in this disastrous election, but 55% of voters with a degree voted for Harris.²²

I must be on to something because one of Trump’s first priorities once he takes over in January is to dismantle the Department of Education.²³ His running mate, JD Vance, has introduced legislation attacking elite universities and has called Harvard’s endowment “a cancer on American society.”²⁴ It is a trademark of malignant narcissists to seek power through manipulation and attack anything that gets in their way, so it is reasonable to conclude that he must see education as something separates him from power. Since we have arrived at the very sad state of affairs where even a church lady like me needs to join the resistance, education is one way in which I will do my part. This blog seems to be a pretty good start.

1. Feinberg, A. (2024, July 22). George Conway launches “Anti-psychopath pac” focused on Trump’s mental health. The Independent. https://www.the-independent.com/news/world/americas/us-politics/trump-mental-health-antipsychopath-pac-b2581622.html

2. ABC News. (2016, July 30). Donald Trump to father of fallen soldier: 'I've made a lot of sacrifices'. ABC News. https://abcnews.go.com/Politics/donald-trump-father-fallen-soldier-ive-made-lot/story?id=41015051

3. CBC News. (2024, April 26). Trump lashes out at 'crooked' judge, trial after historic conviction. CBC. https://www.cbc.ca/news/world/trump-reaction-ny-conviction-1.7220470

4. Trump, M. L. (2020). Too much and never enough: How my family created the world's most dangerous man. Simon & Schuster.

5. Megerian, C. (2020, May 4). Trump rarely shows empathy in coronavirus crisis. Los Angeles Times. https://www.latimes.com/world-nation/story/2020-05-04/trump-rarely-shows-empathy-in-coronavirus-crisis

6. Collinson, S. (2019, March 20). Trump's relentless assault on John McCain is truly deplorable. CNN. https://edition.cnn.com/2019/03/19/politics/donald-trump-john-mccain-dead/index.html

7. Cummings, W., Schnaars, C., & Kelly, E. (2016, June 1). Exclusive: Trump's 3,500 lawsuits unprecedented for a presidential nominee. USA TODAY. https://www.usatoday.com/story/news/politics/elections/2016/06/01/donald-trump-lawsuits-legal-battles/84995854/

8. Haycock, D. (n.d.). Hare Psychopathy Checklist. Encyclopedia of Mental Disorders. http://www.minddisorders.com/Flu-Inv/Hare-Psychopathy-Checklist.html

9. Lee, B. X. (2024). The more dangerous case of Donald Trump: 40 psychiatrists and mental health experts warn anew. St. Martin's Press.

10. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

11. Digg. (2018). Listen to newly released recordings of Trump pretending to be 'John Barron' in 1980s phone interviews. https://digg.com/2018/trump-john-barron-recordings

12. Shoja, S. (2020). Narcissistic personality disorder and antisocial personality disorder: Two faces of the same coin. Biomedical Journal of Scientific & Technical Research, 26(1), 19650-19656. https://biomedres.us/fulltexts/BJSTR.MS.ID.003686.php

13. USA Today. (2016, July 21). Donald Trump accepts GOP nomination, says 'I alone can fix' system. https://www.usatoday.com/story/news/politics/elections/2016/07/21/donald-trump-republican-convention-acceptance-speech/87385658/

14. ABC News. (2016, April 26). President Trump has called himself smart six times before. https://abcnews.go.com/Politics/president-trump-called-smart-six-times-before/story?id=52209712

15. CNN. (2020, September 22). The dark subtext of Trump's 'good genes' compliment. https://www.cnn.com/2020/09/22/politics/donald-trump-genes-historical-context-eugenics/index.html

16. Charlie Health Editorial Team. (2023, September 11). What is a malignant narcissist? Definition, signs & traits to know. Charlie Health. https://www.charliehealth.com/post/malignant-narcissism

17. Greenwood, V. (2024, August 8.). The science behind Donald Trump's dangerous personality disorder. Medium. https://drvincentgreenwood-89455.medium.com/the-science-behind-donald-trumps-dangerous-personality-disorder-49b3f8e416de

18. Holpuch, A. (2021, February 11). US could have averted 40% of Covid deaths, says panel examining Trump’s policies. The Guardian. https://www.theguardian.com/us-news/2021/feb/10/us-coronavirus-response-donald-trump-health-policy?CMP=share_btn_url

19. Goldwater v. Ginzburg, 414 F.2d 324 (2d Cir. 1969).

20. Gartner, J., Segal, H., Greenwood, V., et al. (2024, October 18). A letter from mental health professionals on Trump's dangerous psychopathology. Anti-Psychopath PAC. https://web.archive.org/web/20241106002301/https://www.psychopac.org/open-letter/

21. Reston, M. (2024, November 9). Democratic governors and attorneys general prepare to be the first line of defense against Trump. CNN. https://www.cnn.com/2024/11/09/politics/democratic-governors-attorneys-general-trump/index.html

22. Wheeler, M. (2024, November 7). America's diploma divide: States with fewer grads went for Trump. Axios. https://www.axios.com/2024/11/07/college-degree-voters-split-harris-trump

23. Associated Press. (2024, November 20). Trump says he wants to dismantle the Education Department. Here's what that would mean. Fortune. https://fortune.com/2024/11/20/trump-dismantle-education-department-what-that-would-mean/

24. The Editors. (2024, November 20). Vance called Harvard endowment "cancer on American society".