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Author Note
Lindsay Kastroll is a member of the University Honors Program and Department
of Psychology at California University of Pennsylvania. She would like to give special
thanks to her advisors: Dr. Emily Sweitzer and Dr. Sean Madden in the Department of
History, Politics, and Society, and Dr. Reuben Brock in the Department of Psychology.
She would also like to note that the results of the following study are limited by her lack
of clinical psychological training, and that replication studies are needed to judge their
accuracy.

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Abstract
The acerbic quality of the 2016 Presidential Election prompted several psychologists to
weigh in on the mental health of then-candidate Donald Trump, a trend that has
continued into his presidency. One of the many diagnoses given to the president is that of
sociopath, a label that is characterized by the absence of a conscience. This is a very
serious charge to level at a president, because without a conscience, what would keep
them from deliberately harming the American people? The present study seeks to analyze
a sample of 15 US presidents stratified over the past 45 presidencies for sociopathic traits
using the DSM-5 characteristics for antisocial personality disorder (APD) on biographies
of their lives. It uses the data collected to understand how often presidents are elected
with sociopathic traits and what historical contexts they were elected in, providing further
insight on when and why the United States ends up with a commander without a
conscience. Ultimately, it identifies that three out of the 15 presidents studied meet the
criteria for APD and hypothesizes that the elections of sociopathic individuals occur in
times of social uncertainty, a concept that will need to be analyzed in future research.
Keywords: sociopathy, psychopathy, antisocial personality disorder, American
presidents, Goldwater rule

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Commanding without Conscience:
Determining the Frequency of Sociopathic Presidents’ Elections
The Executive Office of the United States is one of the most powerful positions in
the world. The American president is Commander in Chief of the armed forces, leader in
foreign diplomacy, head of the legislature, symbol of the country, among other
substantial, powerful labels. With so much power invested in one person, one may
wonder what type of person is attracted to such a position. An optimistic view would
assert that presidential candidates are interested in the job because they believe they may
positively impact the country in some way; a more cynical attitude might note how
attractive the power, prestige, and dominance that the position comes with would be to a
corrupt mastermind.
This distinction between good versus evil intentions has dramatic implications for
the presidency, the United States, and the world. If the president is only striving for their
own self-interest and not that of their constituents, what is to stop them from disregarding
the needs and desires of the country, or even stop them from intentionally harming the
country? Some would argue that their conscience would effectively prevent them from
performing this kind of behavior, and for most people, it would. But this rule assumption
does not stand for those among the population that lack a conscience.
Sociopathy is an untreatable lack of conscience or guilt found in 1 out of every 25
people (Stout, 2006). This lack of conscience is often accompanied by other disagreeable
characteristics, such as egocentrism, lack of empathy, deceitfulness, or impulsivity
(Stout, 2006; Hare, 1993). Although commonly confused with psychosis, an individual
with this condition is not psychotic; they fully understand the world around them and the

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consequences of their actions. They simply do not care about the distinction between
right and wrong. In fact, the first time it was described in the early nineteenth century, it
was called mania sans délire, “insanity without delirium” (Pinel, as cited in Kiehl &
Lushing, 2014).
It is easy to imagine how someone free from the constraints of a conscience may
desire a high-status position as a tool to get what they want, and what position is higher
status than that of President of the United States? The present study seeks to examine
how frequently an individual exhibiting sociopathic traits is elected to this office by the
American people using the APA’s Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition (DSM-5) criteria for Antisocial Personality Disorder (APD). It
expects to find two out of the 45 presidents meet the criteria based on the 4% prevalence
rate. It also asks the research question, “In what historical contexts do these individuals
get elected, and what commonalities do these contexts share?”
Literature Review
Sociopathy, also known as psychopathy, refers to a pervasive set of behaviors and
personality traits that persist throughout an individual’s lifetime. Although the words are
often used interchangeably, Hare (1993) made a distinction between the two. The
difference is in the source of the disorder’s development rather than the content;
psychopathy can be attributed to biological sources while sociopathy can be attributed to
environmental experience. Psychopathy also carries a stigma due to its similarity to the
word “psychotic” (despite the differences between the conditions), while sociopathy fails
to carry this same stigma (Hare, 1993). Because of the lack of stigma and personal blame,
the preferred word of choice in the present study is sociopathy.

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Table 1
Items of the PCL-R by Factor
Interpersonal
Affective
Glibness
Lack of
and/or
remorse or
superficial
guilt
charm
Grandiose
sense of selfworth
Pathological
lying

Shallow affect

Callous and/or
lack of
empathy
Conning and/or Failure to
manipulative
accept
responsibility
for own actions

Lifestyle
Need for
stimulation
and/or
proneness to
boredom
Parasitic
lifestyle

Antisocial
Poor
behavioral
controls

Unrelated
Promiscuous
sexual
behavior

Early behavior
problems

Many shortterm marital
relationships

Lack of
realistic, longterm goals
Impulsivity

Juvenile
delinquency
Revocation of
conditional
release

Irresponsibility

Criminal
versatility
Note. Information obtained from Hare (as cited in Hare & Neumann, 2005).

One popular measure of sociopathy is the Psychopathy Checklist – Revised (PCLR) by Robert Hare, which is a clinician-rated measure of 20 characteristics determined to
be related to the presence of sociopathy (Hare & Neumann, 2005). Four factors have been
found to represent 18 of these characteristics (see Table 1; Hare, as cited in Hare &
Neumann, 2005). Neumann, Hare, and Newman (2007) built off of these four factors to
make a definition of the condition.
[…] psychopathy is essentially a personality disorder involving a failure to: (a)
adopt the common interpersonal conventions of honesty, modesty, and
trustworthiness, (b) experience full-fledged emotions concerning one's relation to
others (e.g., love, empathy, guilt), (c) adopt widely shared sociocultural norms

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pertaining to financial responsibility and safe conduct, and (d) obey the laws of
society. (Neumann, Hare, & Newman, 2007)
It is important to note that the presence of one or a few of these characteristics does not
immediately make a person sociopathic. What matters is the number and degree of these
characteristics, not just their occasional presence. Accidentally sleeping through a class
might constitute a lack of responsibility, but if it only happens once, then it certainly
could not be considered evidence of a personality defect.
Although sociopathy is commonly equated with criminals, especially serial
killers, it may also be adaptive for certain careers. Kiehl and Lushing (2014) describe this
idea as controversial, because “it is an oxymoron to suggest that someone is a ‘successful’
psychopath because by definition, to be afflicted with a personality disorder (e.g.
psychopathy) one must have pathological symptoms that cause impairment in multiple
domains of one’s life.” However Lilienfeld, Watts, and Smith (2015) argue that “[…]

successful psychopathy is not an oxymoron; it may instead be a variant of psychopathy in
which the adaptive traits (e.g., superficial charm, social poise) […] are especially
prominent.” In a study of employees at several companies located in the United States,
researchers found that high PCL-R scores were positively correlated with high ratings on
communication, strategic thinking, and creativity/innovation and low ratings on
management style, ability to act as a team player, and performance (Babiak, Neumann, &
Hare, 2010).
Another concept related to sociopathy is Antisocial Personality Disorder, or
APD, which only focuses on criminal and antisocial behaviors (leaving out the
personality traits associated with sociopathy; Hare, 1993) According to the DSM-5, APD
is the “pervasive pattern of disregard for, and violation of, the rights of others” (American

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Psychiatric Association, 2013a). Again, individuals with this disorder are not psychotic,
which makes APD extremely different from other mental disorders: it does not cause the
individual any distress. For this reason, some argue that it should not be classified as a
mental disorder at all (Stout, 2006). However, it is still included in the DSM-5, and its
criteria are as follows:
A. A pervasive pattern of disregard for and violation of the rights of others, occurring
since age 15 years, as indicated by three (or more) of the following:
1. Failure to conform to social norms with respect to lawful behaviors, as
indicated by repeatedly performing acts that are grounds for arrest.
2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning
others for personal profit or pleasure.
3. Impulsivity or failure to plan ahead.
4. Irritability and aggressiveness, as indicated by repeated physical fights or
assaults.
5. Reckless disregard for safety of self or others.
6. Consistent irresponsibility, as indicated by repeated failure to sustain
consistent work behavior or honor financial obligations.
7. Lack of remorse, as indicated by being indifferent to or rationalizing
having hurt, mistreated, or stolen from another.
B. The individual is at least age 18 years.
C. There is evidence of conduct disorder with onset before age 15 years.
D. The occurrence of antisocial behavior is not exclusively during the course of
schizophrenia or bipolar disorder. (American Psychiatric Association, 2013a)

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Criterion C, evidence of conduct disorder, can be further described as the presence of
“aggression to people and animals,” “destruction of property,” “deceitfulness or theft,” or
“serious violations of rules” (American Psychiatric Association, 2013a).
Mental Health of Presidents
Dutton (2016) acknowledges that some occupations benefit from the presence of
certain sociopathic traits. A politician would make good use of these traits: ideal
politicians are “charming, persuasive, self-confident individual[s] who can be ruthless
when necessary and who is also heat resistant: he or she can maintain focus, keep a cool
head and perform under fire” (Dutton, 2016). In his research, Dutton (2016) had
biographers of historical figures complete an abbreviated form of another measurement
tool for sociopathic traits called the Psychopathic Personality Inventory – Revised. The
PPI-R has three different factors built out of its eight subscales: Fearless Dominance
(Stress Immunity, Social Potency, and Fearlessness), Impulsive Antisociality (Impulsive
Nonconformity, Blame Externalization, Machiavellian Egocentricity, and Carefree
Nonplanfulness), and Coldheartedness (Benning, Patrick, Hicks, Blonigen, & Krueger,
2003; Benning, Patrick, Blonigen, Hicks, & Iacono, 2005). For politicians, high levels of
Fearless Dominance and low levels of Impulsive Antisociality would make the “ideal”
candidate (Dutton, 2016).
Dutton’s (2016) study organized the 42 U.S. presidents at the time of the study by
overall PPI-R score and then also determined the top ten in Fearless Dominance and
Impulsive Antisociality. The highest-scoring overall five were 1) John F. Kennedy, 2)
Bill Clinton, 3) Andrew Jackson, 4) Teddy Roosevelt, and 5) Lyndon B. Johnson, while
the lowest five were 38) William Howard Taft, 39) Rutherford B. Hayes, 40) James

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Monroe, 41) Millard Fillmore, and 42) William McKinley. The top five in Fearless
Dominance were 1) Theodore Roosevelt, 2) John F. Kennedy, 3) Franklin Delano
Roosevelt, 4) Ronald Reagan, and 5) Rutherford B. Hayes. The top five in Impulsive
Antisociality were 1) Bill Clinton, 2) Lyndon B. Johnson, 3) Andrew Johnson, 4) Andrew
Jackson, and 5) Chester A. Arthur.
Other studies have investigated issues of presidential mental health other than
sociopathy. Watts et al. (2013) investigated the presence of grandiose narcissism
(flamboyance and dominance), vulnerable narcissism (emotional fragility and social
withdrawal), and Narcissistic Personality Disorder (NPD; a blend of the two) in the 42
American presidents at the time. Presidents were higher on average than the population in
grandiose narcissism and NPD but equal to the population in vulnerable narcissism. The
highest scoring presidents on grandiose narcissism were 1) Lyndon B. Johnson, 2) Teddy
Roosevelt, 3) Andrew Jackson, 4) Franklin D. Roosevelt, and 5) John F. Kennedy, while
the lowest were 38) Millard Fillmore, 39) James Monroe, 40) Grover Cleveland, 41)
Ulysses S. Grant, and 42) Calvin Coolidge. In the end, “this analysis revealed that
grandiose narcissism, but not vulnerable narcissism or NPD, has increased significantly
over time across the presidents” (Watts et al., 2003).
Instead of measuring exclusively one disorder, Davidson, Connor, and Swartz
(2006) reviewed biographies, narrative accounts, and journals to compare all American
presidents prior to 1974 to the disorders listed in the DSM-IV. They found that 49% of
their sample had symptoms of DSM-IV disorders. Out of the 37 presidents reviewed, “the
most common disorder was unipolar depression (N = 9), followed by anxiety (N = 3),
alcohol abuse or dependence (N = 3), somatoform disorder (N = 1), bipolar I disorder (N

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= 2), bipolar II disorder (N = 1), paranoia secondary to cerebrovascular accident (N = 1),
and breathing-related sleep disorder (N = 1)” (Davidson et al., 2006). None of the time
periods saw greater or lesser presence of disorders.
The Goldwater Rule
No discussion of public figures’ mental health would be complete without
addressing the Goldwater Rule. The Goldwater Rule is an ethical standard that was
created following a muckracking campaign against Senator Barry Goldwater during the
1964 presidential election that sought psychiatric evaluations of his fitness (Ginzburg,
1964). Also known as Section 7.3 of the American Psychiatric Association’s (2013b)
Principles of Medical Ethics, this rule states that when a psychiatrist is called upon to
give their professional opinion on the mental health or behavior of a public figure, it
would be unethical to do so without having personally examined them and received
permission first. It only allows for the psychiatrist to discuss “psychiatric issues in
general.” The American Psychological Association does not have a direct equivalent to
the Goldwater Rule; Sections 5.04 and 9.01 provide the closest approximation
(Lilienfeld, Miller, & Lynam, 2017). Section 5.04 directs psychologists publicly sharing
their expertise to do so in accordance with their professional experience and with the
Ethics Code, and with acknowledgement that no therapeutic relationship exists between
themselves and the subject (American Psychological Association, 2017). Section 9.01
states that psychologists must base their opinions on sufficient evidence, and must either
attempt to personally examine the individual in question or, when an examination is not
necessary, “conduct a record review or provide consultation or supervision,” making sure
to explain the limits of their conclusion (American Psychological Association, 2017).

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Due to the particularly acerbic quality of the 2016 presidential election, several
psychologists and psychologists have felt the need to speak up about the mental health of
now-president Donald Trump, calling into question the appropriateness of the Goldwater
Rule. While there are many arguments in defense of the Goldwater Rule – a psychiatrist’s
rule is to educate instead of comment (Friedman, 2014), a diagnosis cannot be done
without a psychiatrist-patient relationship (Park, 2018), or an inaccurate or unsolicited
diagnosis could damage the individual in question (Appelbaum, 2017) – there are just as
many strong attacks against the rule. Kroll and Pouncey (2016) argue that the Goldwater
Rule, as an ethic, only serves to protect the American Psychiatric Association’s image
and does not actually protect individuals. As they eloquently put, “We believe that the
Goldwater Rule is itself unethical if it suppresses public discussion of potentially
dangerous public figures […] Psychiatry should encourage scrutiny of the behaviors of
public figures, not squelch it” (Kroll & Pouncy, 2016).
Lilienfeld, Miller, and Lynam (2017) provide a different, though equally as
compelling argument on the ethics of speaking out. They call into question whether
psychologists it is indeed ethical to follow a Goldwater-type rule when their expertise
could potentially inform voters’ decisions. They call for a replacement of the Goldwater
Rule which would allow professionals to give their professional opinions on the mental
health of “individuals [who] hold positions of substantial power over others, as is the case
for most high-profile politicians” but not on said individuals’ fitness for office
(Lilienfeld, Miller, & Lynam, 2017). This viewpoint still emphasizes the role of educator
advocated by Friedman (2014), while also granting psychologists more freedom to
accomplish that education.

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Still others believe that it would be futile to change the Goldwater Rule; McNally
(2018) argues that suspending the Goldwater Rule and allowing psychologists and
psychiatrists to offer diagnoses would not provide voters with any more information than
they already have, because said diagnoses would be based on readily observable
behavior. And if a voter supports a candidate despite the behavior, a diagnostic label
would not likely change their minds. This study is of the opinion that allowing
professionals to offer their expertise, though theoretically futile, is the right thing to do,
and while it does not go so far as to officially diagnose any of its subjects with APD, it
investigates with the purpose to inform future researchers and voters.
Methods
To answer the research questions, the researcher selected a stratified random
sample of 15 U.S. presidents to study. This was achieved by splitting the 45 presidents,
from Washington to current sitting president Donald Trump, into three groups (first 15,
middle 15, and most recent 15) and selecting 5 names from each out of a hat. A stratified
sample was selected because it would account for the most diverse set of historical
circumstances to analyze. The 15 presidents selected were as follows: James Madison,
James Monroe, Martin Van Buren, James Polk, Franklin Pierce, Abraham Lincoln, James
Garfield, William McKinley, Woodrow Wilson, Calvin Coolidge, Herbert Hoover,
Richard Nixon, Jimmy Carter, Barack Obama, and Donald Trump.
For each president selected (except for President Trump, who was judged as too
recent for various options of comprehensive biographies to be available), the researcher
chose a biography to read and rate using the DSM-5 criteria for APD. The criteria for
APD were preferred over the PCL-R because, although they are less related to

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sociopathy, they rely more on observable behaviors and will therefore act as a more
objective rating tool. Biographer bias and personal bias could confound any
interpretations about personality or motivations, making decisions on Psychopathy
Checklist items like “Egocentric” or “Need for excitement” particularly difficult to be
objective (Hare, 1993). A president’s actions are more often hard facts, less subject to
interpretation (though, they certainly could be subject to omission).
It is important to note that this type of design does not utilize proper
historiographic or history analysis methods because it is not a historical study. A historian
would be interested in gathering all relevant historical facts for understanding a particular
event, using mostly primary sources; this study is more interested in gathering
psychological data, and it is not within the scope of the present study to consult primary
sources in a search for that data because of limited access and time. Instead, it uses
psychological methods to analyze historical data collected by other people: biographers,
who undeniably have more expertise on their subjects than the researcher.
The standards for the biographies selected largely rested on two premises: that
they had to be biographies and not autobiographies, and that they had to cover the
president’s entire lifespan. Autobiographies were excluded because of the potential for
manipulation of facts to make oneself appear better. The biographies needed to cover
their entire lifespan for two reasons. First, criterion C of APD requires the presence of
conduct disorder when the individual was under the age of 15. For some presidents,
though, information on their childhoods did not always survive, meaning that the
presence of conduct disorder could not always be supported or contradicted. The second
reason is that the diagnosis of APD requires an analysis of long-term functioning (Lyons

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& Martin, 2014); any biographies that only focused on a certain time in the president’s
life, especially their term as president, were immediately excluded.
Other information that was used in selecting biographies was length, rating, and
availability. Books under 300 pages were excluded, because it was assumed that the
longer ones would have more content (but books over 1,000 pages were also excluded
due to time limitations). Also, ratings and reviews on Amazon.com were taken into
consideration because they provide valuable insight into the contents of book options that
summaries might leave out. An example of a positive comment in a review would be
attention to detail in all aspects of life, not just politics, while a negative might be a
tendency to gloss over prejudices. Availability, though very important, was of least
concern, because the researcher’s university is part of the Pennsylvania Academic
Library Consortium, Inc. and can borrow books from other universities’ libraries when
needed.
During reading, any behavior that may have met the DSM-5 criteria for APD
were recorded on a sheet with the page number it could be found on. After reading, any
criterion that saw repeated instances over the lifetime were recorded and tallied. Any
president that met three or more criteria was judged to exhibit a concerning amount of
sociopathic behaviors.
Results
Of the 15 American presidents studied, only three met the level A criteria for
APD: James Garfield, Richard Nixon, and Donald Trump. Of those three, only Garfield
and Trump had evidence of conduct disorder (APD criterion C) before the age of 15
(three other presidents also met this criterion: Pierce, Wilson, and Hoover, bringing the

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total to five). The three out of 15 presidents showing a concerning number of sociopathic
behaviors – 20% – can be extrapolated to 9 out of 45, presuming the observed trend
would continue for the total number of presidents. Details about the 15 presidents studied
follows.

Number of APD Criteria Displayed
8
7
6
5
4
3
2
1
0

James Madison, fourth President of the United States, was a remarkably
responsible man, who had the best attendance record of the Continental Congress,
supported his estranged brother’s children as if they were his own, and “weighed matters
carefully […] [suspending] judgements as long as possible” in order to make the best
decision possible (Ketcham, 1992). James Monroe, his friend and successor, was
described as equally as thoughtful (Ammon, 1990). These two early presidents both
exhibited the same characteristic of APD: “Deceitfulness, as indicated by repeated lying,
use of aliases, or conning others for personal profit or pleasure” (American Psychiatric

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Association, 2013a). As was the political fad of the time, Madison and Monroe both
participated in publishing newspaper essays under pseudonyms, often attacking political
enemies. Madison famously participated in the writing of The Federalist papers under the
pseudonym Publius with Alexander Hamilton and John Jay in order to encourage
ratification of the Constitution (Ketcham, 1992).
The analysis of Martin Van Buren, eighth President of the United States, was
limited by the fact that most of the information about his life, particularly personal
correspondences, have been destroyed (Widmer, 2005). Any conclusions about traits that
he may have or may have not shown are based on inadequate information compared to
those of other presidents. That being said, no evidence of any APD traits was discovered
for the “Sly Fox of Kinderhook.” It may be noted, however, that he was particularly
grandiose in his dress and event-planning, and also quite glib (he could say “everything
and nothing at once;” Widmer, 2005). The eleventh president, James K. Polk, displayed a
single trait out of the criteria: “Reckless disregard of safety of self or others” (American
Psychiatric Association, 2013a). This was particularly noticeable in the fact that he did
nothing to avoid the possibility of going to war with Mexico (over the Republic of Texas)
and with Great Britain (over the Oregon Territory) at the same time, a disastrous prospect
due to the amount of resources simultaneous wars would require (Borneman, 2009).
As a child, fourteenth president Franklin Pierce roughhoused and destroyed
furniture for fun, and one day decided he was tired of school and returned home (Nichols,
1998). These instances of physical fighting, destruction of property, and truancy provide
enough information to support criterion C, evidence of conduct disorder (American
Psychiatric Association, 2013a). As an adult, he could be irritable and of “mercurial

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mood,” but not to the extent that he got into repeated fights (Nichols, 1998). He did,
however, meet the criterion “Deceitfulness, as indicated by repeated lying, use of aliases,
or conning others for personal profit or gain” when he and his fellow Democrats
attempted to use a congressional investigation for party purposes (American Psychiatric
Association, 2013a; Nichols, 1998).
Abraham Lincoln, sixteenth President of the United States, is widely regarded as
one of the greatest for his management of the most divisive time in American history –
the Civil War. Despite his hallowed historical position, Lincoln displayed two criterion
for APD. First, he showed a “Failure to conform to social norms with respect to lawful
behaviors, as indicated by repeatedly performing acts that are grounds for arrest” in
participating in a duel, illegal in Illinois, across state lines and in his repeated suspensions
of habeas corpus (American Psychiatric Association, 2013a; Donald, 1995). He also
showed “Deceitfulness, as indicated by repeated lying, use of aliases, or conning others
for personal profit or pleasure” by writing newspaper articles attacking enemies under a
pseudonym (American Psychiatric Association, 2013a; Donald, 1995).
James Garfield, America’s twentieth president, was an interesting man due to his
seemingly indecisive, constantly shifting, and strongly held opinions. Examples of this
are his sudden, fervent zeal for his Disciple faith (which he eventually questioned and
neglected), his disgust at politics, which he swore he would never join, and his shift from
ardent militarism to passionate pacifism (Peskin, 1999). As a child, he picked fights with
other boys who he felt had crossed him, giving evidence for conduct disorder under the
age of 15 (Peskin, 1999). As an adult, Garfield showed three criteria for APD, making
him the first president studied to meet the minimum criteria. The first was “Failure to

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conform to social norms with respect to lawful behaviors” (American Psychiatric
Association, 2013a), which he exemplified in advocating for total war despite the
military’s preference for chivalry and in breaking the rule prohibiting congressional votes
on personal financial interests (Peskin, 1999). He also displayed “Deceitfulness, as
indicated by repeated lying, use of aliases, or conning others for personal profit or
pleasure” (American Psychiatric Association, 2013a). There were several accounts of his
lying in Peskin (1999), including his accusation that two opponent congressmen were
corresponding with the enemy and his deceitful defense in the Crédit Mobilier scandal.
The third trait was a “Lack of remorse, as indicated by being indifferent to or
rationalizing having hurt, mistreated, or stolen from another” which was shown in
flirtations with other girls and even an infidelity during his marriage (American
Psychiatric Association, 2013a; Peskin, 1999).
In contrast to Garfield and his infidelity, twenty-fifth president William McKinley
was remarkably devoted to his wife, whose health was often failing (Merry, 2017). Merry
(2017) overall portrayed him as a responsible, caring, and humble man, the complete
antithesis to a sociopath. The study found no evidence to contradict this wholesome view.
Woodrow Wilson, who served as twenty-eighth President of the United States, did cheat
on his wife, but was fraught with guilt over the fact and realized his own selfishness
(Heckscher, 1991). The only criterion supported by the text was criterion C, evidence of
conduct disorder: as a child, Wilson enjoyed attacking unsuspecting neighborhood
children with bows and arrows (Hecksher, 1991). This almost-unmarred record may have
been due to biographer bias – the biographer completely omitted Wilson’s history of
racism (Matthews, 2015). It is hard to tell, without reading another biography, what else

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may have been omitted.
“Silent Cal” Calvin Coolidge, thirtieth President of the United States, is famous
for his successful management of the Police Strike of 1919 and his efforts to cut back
government spending in order to reduce the national debt (Shlaes, 2014). Coolidge was
notably less racist than Wilson, but still exhibited more APD traits than said predecessor.
First, Cal showed “Consistent irresponsibility, as indicated by repeated failure to sustain
consistent work behavior or honor financial obligations” (American Psychiatric
Association, 2013a). His attempts to start a fundraiser for charity while vice president
may have seemed like a good idea, but it raised considerable concerns about bribery,
making it a very poor decision (Shlaes, 2014). He also foresaw the Great Depression on
the horizon, but “believed it was wrong to do anything about it” (Shlaes, 2014). Along
with irresponsibility, he also displayed a “Lack of remorse, as indicated by being
indifferent to or rationalizing having hurt, mistreated, or stolen from another” (American
Psychiatric Association, 2013a), which came to the forefront when the nation was
plagued by catastrophic floods and he stubbornly refused to give government aid to the
areas affected, even after he was accused of being inhumane (Shlaes, 2014).
As a child, businessman-turned-president Herbert Hoover had a penchant for
drowning squirrels in a local stream and once set his father’s workshop on fire, running
away before he could be caught (Whyte, 2017). This behavior gives evidence in support
of APD criterion C, conduct disorder before the age of 15 (American Psychiatric
Association, 2013a). Once he entered the workforce as a mining engineer in Australia,
Hoover’s dark side showed; he ran his employees like a “slave driver” and compared
himself to the “devil” with no remorse, which provides evidence of “Lack of remorse, as

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indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from
another” (Whyte, 2017; American Psychiatric Association, 2013a). He also portrayed
considerable “Deceitfulness, as indicated by repeated lying, use of aliases, or conning
others for personal profit or pleasure” by backdating agreements, writing articles under
pseudonyms, spying on competitors, and giving false explanations of statements under
oath (American Psychiatric Association, 2013a; Whyte, 2017). However, almost all of
Hoover’s sociopathic behaviors disappeared at the outbreak of World War I, when he
suddenly became a humanitarian hero (Whyte, 2017).
There was no data to support the existence of conduct disorder in young Richard
Nixon, but in adulthood he did exhibit many characteristics of APD. He exhibited
“Failure to conform to social norms with respect to lawful behaviors, as indicated by
repeatedly performing acts that are grounds for arrest” by breaking into a friend’s estate
for a place to spend the night, conspiring with the South Vietnamese during his campaign
to prevent his opponent from getting the upper hand, ordering a break-in in an attempt to
find incriminating evidence against Lyndon B. Johnson, and paying hush money to the
Watergate burglars, among other examples (American Psychiatric Association, 2013a;
Thomas, 2015). He also displayed “Deceitfulness, as indicated by repeated lying, use of
aliases, or conning others for personal profit or pleasure” in his lies about his life history,
manipulations of reporters, and his anonymous release of false rumors to embarrass an
enemy and his subsequent refutations of his own rumors to make himself seem like the
good guy (American Psychiatric Association, 2013a; Thomas, 2015). Thomas (2015) also
noted several examples of kicking, punching, pushing, and shoving his employees, which
support the presence of “Irritability and aggressiveness, as indicated by repeated physical

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fights or assaults” (American Psychiatric Association, 2013a). Nixon also showed
“Reckless disregard for safety of self or others” (American Psychiatric Association,
2013a), which could be seen in his egging on violent protesters, advocating for
intervention in and invasion of other countries, and refusal to visit the hospital for
dangerous phlebitis (Thomas, 2015). Lastly, he exhibited an astonishing “Lack of
remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or
stolen from another” (American Psychiatric Association, 2013a). As a young man, Nixon
had a stormy relationship with his then-girlfriend and started seeing other girls while they
were still together, and later marginalized his wife from his political life, banishing her
from the room or only allowing her to watch ceremonies while hidden behind a pillar
(Thomas, 2015).
In complete contrast to Nixon, Jimmy Carter was portrayed as a caring and
responsible man who resigned from a promising Navy career in order to run his family
farm after his father died (Padgett, 2016). No evidence was found to support any of the
APD criteria, but this could have been due to poor biography selection. Instead of
describing Carter’s journey to the White House and what he did to get there, Padgett
(2016) instead told the story of the people who campaigned for him, herself included,
making it a partial autobiography that was likely biased in its descriptions of Carter. The
biography on forty-fourth president Barack Obama, in comparison, was also written by
someone who knew him, but as a reporter, not a friend (Mendell, 2007). This biography
did provide evidence of two APD criteria: “Failure to conform to social norms with
respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds
for arrest” and “Lack of remorse, as indicated by being indifferent to or rationalizing

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having hurt, mistreated, or stolen from another” (American Psychiatric Association,
2013a). As a young man, Obama often used alcohol (even underage) and marijuana and
even tried cocaine, which is, of course, illegal (Mendell, 2007). He also got an incumbent
disqualified to run for their own seat because they failed to properly gather signatures,
devoted time to writing a memoir at 33 despite the strain on his wife, and after ran for
senate despite the stress on his family, all without remorse (Mendell, 2007).
Current president Donald Trump is fascinating because there is evidence to
support every criterion of APD. Due to the recent nature of his election, the researcher
elected to study news articles instead of biographies because sufficient book options were
not available yet. As a child, Trump allegedly punched a teacher in the face, threw rocks
at his neighbors, attacked teammates for getting outs in baseball, and tried to push his
roommate out a window (Schwartzman & Miller, 2016). As an adult, he has shown a
remarkable pattern of behavior in line with all of the antisocial traits.
•

“Failure to conform to social norms with respect to lawful behaviors, as
indicated by repeatedly performing acts that are grounds for arrest” (American
Psychiatric Association, 2013a): Took an illegal loan to keep Trump Castle
casino open, ran the fraudulent Trump University, and possibly participated in
Russian collusion (Buettner & Bagli, 2016; Hamburger, Helderman, & Crites,
2016; Hemel & Posner, 2017)

•

“Deceitfulness, as indicated by repeated lying, use of aliases, or conning
others for personal profit or pleasure” (American Psychiatric Association,
2013a): claimed grievances against business partner while partner was
incommunicado in Nepal and could not respond, ending the deal and turning

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all benefits over to Trump, and contacted news stations using a pseudonym
“John Barron, Trump’s spokesman” to talk about himself (Brenner, 1990;
Borchers, 2016)
•

“Impulsivity or failure to plan ahead” (American Psychiatric Association,
2013a): Donald J. Trump Twitter account, where he often posts claims with
no supporting evidence and also frequently posts insults to his enemies despite
advice that he should stop (https://twitter.com/realDonaldTrump)

•

“Irritability and aggressiveness, as indicated by repeated physical fights or
assaults” (American Psychiatric Association, 2013a): allegedly raped his exwife Ivana, although she has since changed the story (Gerstein, 2016)

•

“Reckless disregard for safety of self or others” (American Psychiatric
Association, 2013a): made comments suggesting a Clinton assassination
during the 2016 presidential campaign (Cummings, 2016)

•

“Consistent irresponsibility, as indicated by repeated failure to sustain
consistent work behavior or honor financial obligations” (American
Psychiatric Association, 2013a): hired and exploited illegal immigrants,
delayed payments on debts, failed to pay contractors and suppliers for their
casino work, used casino money to invest in real estate instead of to pay off
casino debt, put personal debt under the casino names and then gave
responsibility to shareholders, and experienced four bankruptcies at the
casinos (Brenner, 1990; Buettner & Bagli, 2016)

•

“Lack of remorse, as indicated by being indifferent to or rationalizing having
hurt, mistreated, or stolen from another” (American Psychiatric Association,

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2013a): intimidated Ivana into a prenuptial agreement, refused to change said
prenuptial agreement, pressured her to sign a new agreement later, and
threatened her with divorce if she failed to “act like his wife” and take care of
“her” kids (Brenner, 1990)
Discussion
After identifying which presidents exhibit a high number of sociopathic traits and
calculating the frequency in which their elections occur, the logical next step would be to
examine the historical circumstances in which they occur. Although a complete analysis
of the historical circumstances that influenced the elections of James Garfield (1880),
Richard Nixon (1968), and Donald Trump (2016) is outside of the scope of the present
study, some brief notes on the events happening during those times can be collected from
the biographies read and the personal experience of the researcher.
The election of 1880 took place in the Post-Reconstruction era, a time when many
states had only just been readmitted to the Union and African Americans were exploring
new but still limited rights. This was also a time of concern over Chinese immigration,
with many Americans advocating for new restrictions or even bans on immigration from
China due to competition over jobs. Of primary concern in the election, however, was the
tariff and the gold standard (Peskin, 1999). Garfield, as a Republican, was in favor of a
high tariff and the gold standard. The previous president, Rutherford B. Hays, was also a
Republican, meaning there was no shift in party power with this election.
The election of 1968 was plagued by the Vietnam War and protests against it,
along with Martin Luther King’s assassination and the resulting race riots (Thomas,
2015). Richard Nixon ran on a platform of “law and order,” promising to provide stability

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to the social situation. He also made a campaign promise to end the draft. His
predecessor, Lyndon B. Johnson (who succeeded John F. Kennedy after he was
assassinated) was a Democrat who had increased US involvement in the Vietnam
conflict; the shift from him to Nixon was not just significant because of party differences,
but also because of the differences in the way they publicly handled the war.
The election of 2016 continued certain themes from the two just described. Illegal
immigration from Mexico was highlighted in President Trump’s push for a border wall.
The unpopular war in Afghanistan continued, as did concern about terrorism. Racial
tensions were high due to televised cases of police brutality, and the social justice
movement advocated for increased respect for and fair treatment of minorities. Donald
Trump inherited all these issues from Democratic president Barack Obama, so during this
time of social unrest the nation also had to cope with the changing of parties.
The common thread between all of these elections is social unrest, typically in
race relations. This unrest and instability can shake up people’s lives, creating a lot of
uncertainty about safety, economic security, and especially, group membership or
identity. According to the social identity theory of leadership from the field of social
psychology, this uncertainty of group and individual identity can explain why citizens
would elect someone who does not represent their group. Social identity theory of
leadership posits that group leaders with high prototypicality (how stereotypical they are
of a group) are viewed as more effective and receive more support from group members
than leaders with low prototypicality (Hogg, 2001). However, in times of uncertainty,
people seek ways to reduce that uncertainty because it is an unpleasant experience; so,
people are more likely to support a non-prototypical leader because “any leader who can

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reduce uncertainty is more appealing than no leader” (Rast, Gaffney, Hogg, & Crisp,
2012). Winter (1987) contributes to this concept by identifying that “the greatest
presidents were those who were least congruent with the followers of their society.”
According to his research, George Washington, Teddy Roosevelt, Harry S. Truman, and
John F. Kennedy are all highly rated and highly incongruent, while James Buchanan,
Ulysses S. Grant, Warren G. Harding, and Calvin Coolidge are lowly rated and
congruent.
This study does not present enough research to establish a relationship between
historical circumstances, uncertainty, and sociopathic presidents, but it does present an
interesting hypothesis: When societal events occur that generate more uncertainty in
citizens’ lives, there is more support for sociopathic candidates than in relatively stable
times. This hypothesis would be important to investigate because it could help in
predicting presidential elections due to an increased understanding of voters’ decisionmaking processes. Future researchers pursuing this hypothesis would need to identify
which presidents are and are not sociopathic, investigate the social climates at the time of
their campaigns to measure uncertainty and prototypicality, and determine which
candidate in each campaign was more prototypical. This design would require a great
deal more historical analysis than was performed in the present study, and would
therefore be even more labor intensive.
Implications on the Goldwater Rule
After hypothesizing about voter motivation, it is once again important to return to
the Goldwater Rule. In light of the information covered in the literature review and the
results of the present study, the researcher argues that the Goldwater Rule should be

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removed or replaced in accordance to the recommendations of Lilienfeld, Miller, and
Lynam (2017). Information relevant to the mental status of a political figure, especially
when it concerns repeated and pervasive patterns of behavior that are not likely to go
away, would be vital for informing not just voters, but also other political figures. In the
case of the President of the United States, the 25th Amendment of the United States
Constitution provides circumstances for the removal of the president due to an inability to
perform the duties of their office (U. S. Const. amend. XXV). An inability to perform the
duties of a president does not have to be due to a physical handicap, but could also be due
to a mental condition as well; would it be unethical to withhold psychological expertise
about the abilities of the president from the Vice President and other principle officers of
government in their decisions regarding Amendment 25? Because of the wide-ranging
effects on society of this decision, the researcher argues that yes, to deny any information
about the mental functioning of the president in such a circumstance would be unethical.
Although providing this information without the permission of the individual (the
president) may seem like an ethical infraction and invasion of privacy, one must
remember that in becoming president, the individual relinquishes some privacy due to the
scrutiny and needs of the entire country.
There is another alternative to removing the Goldwater Rule that hasn’t been
discussed: perhaps the Commander in Chief could be required to complete routine
psychiatric evaluations while in office. This seems like a commonsense answer to the
problem, but there are several major issues that could limit the effectiveness of such a
plan. First, what conditions would exclude a president from holding office? Some mental
disorders are more easily treatable, more temporary, or more docile than others – where

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would the cutoff need to be placed? This determination is outside the scope of the present
study, and would need to be addressed in future research. A second concern is the impact
such a policy would have on mental health stigma. While exposing Americans to the fact
that even their president can be susceptible to mental disorders may have the positive
effect of normalizing mental disorders, it may have the opposite effect of increasing
stigma due to fear of what a powerful person with a mental illness could do to the
country. Third, if the president is aware that their career hinges on their responses in the
evaluation, they may be inclined to lie or withhold potentially damaging information
(Lilienfeld, Miller, & Lynam, 2017).
Limitations
This study had several limitations that may have affected its results which should
be addressed in future studies. The first limitation is that plenty of valuable information
may be lost to history. Unfortunately, save for miraculous discoveries of missing data,
nothing can be done about this limitation. Letters burn, memories die with people, and
there is nothing that can be done to recover that information. However, biographer bias
may be something that can be counteracted. Biographer bias, such as intentionally
omitting relevant facts that may improve/ damage the image of the biography subject, can
dramatically impair the researcher’s ability to be objective in their analysis. One way of
circumventing this limitation would be consulting multiple different biographies to get
multiple different viewpoints on the subject; another would be to study primary resources
only. Due to time and resource constraints, these methods may not be feasible and the
future researcher must develop their own method to avoid this limitation.
Another limitation of this study is the incomplete education of the researcher; she

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is completing her Bachelor’s level degree and does not have the same level of clinical
expertise that a researcher with a PhD in the field would bring to a study. This unfinished
educational training may have affected the decisions and conclusions described in this
paper, and future replications are needed in order to validate the results. The final and
most salient limitation for this researcher and potentially any researcher studying political
figures is personal bias. The researcher of the present study identifies as a liberal
democrat, who does not agree with President Trump’s policies. This outlook may have
negatively affected the analysis of Trump, and positively affected recent Democratic
presidents. The danger of biased analysis of earlier or less well-known presidents is not
as high, because preconceived opinions are less likely to exist on them. However,
precautions must be taken in the future to prevent personal bias from affecting results.
This may be done by using multiple raters of varying political opinions and creating an
average response.
Conclusion
Due to sociopaths’ potentially dangerous lack of consciences, it is important to
analyze the American presidents for sociopathic traits because of the large amount of
power they yield. This study provided some brief insight into the frequency rates of APD
in American presidents compared to the general population, which raises important
concerns about the ethics of the American Psychiatric Association’s Goldwater Rule. In
order to better inform voters, the Goldwater Rule should be revised or retired to allow
psychiatrists the opportunity to give the public their professional opinions. This study
also provides a jumping-off point for future research, in suggesting research on what
historical contexts presidents with sociopathic traits are elected in. Further research on

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the mental health of presidents is necessary not only for informing voters but also
predicting their future voting patterns, giving this line of work far-reaching applications.

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