[Personality disorders are] pervasive, maladaptive, and chronic patterns of behavior, thinking, and feeling, ultimately leading to distress and dysfunction. Patients with personality disorders suffer from distorted perceptions of reality and abnormal affective behavior, manifesting in maladaptive coping mechanisms and distress. 2The psychiatric profession groups personality disorders into three clusters, unimaginatively called A, B, and C. Cluster-B, which is particularly relevant to Trump, is sometimes labeled the "dramatic/emotional/erratic" cluster and includes antisocial, narcissistic, histrionic, and "borderline" personality disorders 3. Commonly, patients will have more than one diagnosed disorder from within a cluster.
Narcissistic personality disorder: I have no problem calling Donald a narcissist -- he meets all nine criteria [listed in the DSM-5 book] 4b... [But] this is far beyond garden-variety narcissism; Donald is not simply weak; his ego is a fragile thing that must be bolstered every moment because he knows deep down that he is nothing of what he claims to be. 4c Antisocial personality disorder: A case could be made that he also meets the criteria for antisocial personality disorder, which in its most severe form is generally considered a sociopathy but can also refer to chronic criminality, arrogance, and disregard for the rights of others. 4d Dependent personality disorder: [from Cluster-C] Donald may also meet some of the criteria for dependent personality disorder, the hallmarks of which include an inability to make decisions or take resposibility, discomfort with being alone, and going to excessive lengths to obtain support from others. 4e Other: Dr. Trump entertains the possibility of "a long undiagnosed learning disability that for decades has interfered with his ability to process information" 4e, as well as a co-morbid sleep disorder 4e.She summarizes:
Donald's pathologies are so complex and his behaviors so often inexplicable that coming up with an accurate and comprehensive diagnosis would require a full battery of psychological and neuropsychological tests that he'll never sit for. 4dTestifying to the accuracy of this statement is the large number of relatively minor, but still unfathomable, behaviors noted elsewhere on this page: his caffeine hyper-consumption, his multiple personal fears, his germaphobia, his sexual bravado as expiation for the cowardice of his illegal draft evasion, his sensitivity about his hand size, his laughable hair style, his overabundant skin make-up, and so on.
Delusions are fixed beliefs that are not amenable to change in light of conflicting evidence. Their content may include a variety of themes (e.g., persecutory, referential, somatic, religious, grandiose).The last sentence of the definition is of special interest, as it may explain why so large a fraction of the American population could adhere to Trump's delusions.
[[ Elided: definition of "bizarre delusions" and its examples ]] The distinction between a delusion and a strongly held idea is sometimes difficult to make and depends in part on the degree of conviction with which the belief is held despite clear or reasonable contradictory evidence regarding its veracity.
- Persecutory delusions (i.e., the belief that one is going to be harmed, harassed, and so forth by an individual, organization, or other group) are most common.
- Referential delusions (i.e., belief that certain gestures, comments, environmental cues, and so forth are directed at oneself) are also common.
- Grandiose delusions (i.e., when an individual believes that he or she has exceptional abilities, wealth, or fame) and erotomanic delusions (i.e., when an individual believes falsely that another person is in love with him or her) are also seen.
- Nihilistic delusions involve the conviction that a major catastrophe will occur, and
- somatic delusions focus on preoccupations regarding health and organ function.
a pp.12-14 b p.12 c p.198 d pp.12-13 e pp.13Comment: This Trump, niece of Donald Trump, is an experienced and well-trained Ph.D. psychologist (see p12).