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Have other US presidents been publicly assessed for personality disorders by experts?
Executive Summary
Multiple public efforts by psychologists, historians and commentators have evaluated U.S. presidents’ personalities, and experts have publicly assessed at least one recent president for possible personality disorder traits, but the practice is uneven, controversial, and seldom results in formal clinical diagnoses. Broad, systematic expert ratings of presidents exist—such as peer‑reviewed studies using historians and biographers to score presidents on traits like narcissism and the Big Five—and high‑profile case compilations of clinicians assessing a sitting president have ignited ethics debates [1] [2] [3]. The evidence shows both precedent for public expert evaluations and strong professional constraints—like the Goldwater Rule—against offering formal diagnoses without direct examination, which keeps most historical assessments speculative rather than clinical [4] [5].
1. Why historians and psychologists rank presidents — and what they actually measure
Scholars and commentators have produced systematic rankings that treat presidents as subjects for personality assessment, often using structured instruments adapted for historical figures; one peer‑reviewed study asked 120 expert raters to score 42 presidents on grandiose narcissism, placing Lyndon B. Johnson, Theodore Roosevelt and Andrew Jackson at the top of that scale (published April 14, 2024) [1]. Other research using the Big Five personality framework similarly relies on expert biographers and historians who translate archival evidence, writings, and third‑party observations into trait scores; these studies seek correlations between personality profiles and measures of “presidential greatness,” not to produce clinical diagnoses [2]. Such methodological choices are explicit: these are expert‑rating exercises framed as historical or political science inquiry rather than psychiatric evaluations, and they produce comparative, probabilistic portraits rather than confirmed clinical conditions [6].
2. The one high‑profile psychiatric intervention and its fallout
A distinctive example of clinicians publicly assessing a sitting president occurred with Donald Trump, when a group of psychiatrists and mental‑health professionals compiled The Dangerous Case of Donald Trump and related publications asserting concern about his mental state; 27 psychiatrists contributed to that volume and associated commentary [7] [3]. That intervention crystallized a debate over professional duties versus ethical rules because many contributors invoked a “duty to warn” while critics cited the Goldwater Rule, which prohibits psychiatrists from diagnosing public figures without direct examination and proper authorization. The controversy highlighted how public psychiatric pronouncements can influence political discourse even when they remain non‑diagnostic and contested [4] [8].
3. What’s absent: formal clinical diagnoses of historical presidents
Despite multiple expert‑rating studies and media discussions of presidential mental health, there is little evidence of formal, publicly documented clinical diagnoses of personality disorders for past presidents identified through direct clinical assessment. Popular and scholarly surveys cover depression, anxiety, bipolar disorder, and substance issues among presidents across history, but these are often retrospective interpretations or literature reviews rather than contemporary psychiatric assessments performed on the patient [9]. Thoughtful overviews and historical essays note longstanding concerns about presidents’ physical and mental fitness—such as hidden illnesses or cognitive decline—but they stop short of reporting validated clinical records concluding personality disorder diagnoses for earlier presidents [5].
4. Two competing dynamics: scholarly assessment vs. professional ethics
The record shows a tension between two forces: historians and political psychologists increasingly apply standardized trait measures to presidents to understand leadership, while psychiatrists and professional associations emphasize ethical limits on diagnosing public figures without evaluation. Public expert‑rating studies expand scholarly understanding of personality correlates of leadership, but clinical professionals generally resist formal public diagnoses in order to preserve diagnostic validity and adhere to ethical rules like the Goldwater principle [2] [4]. This dual pathway explains why we see abundant comparative personality research and occasional clinician statements about risk, yet very few, if any, accepted clinical diagnoses of presidents for personality disorders based on direct clinical methods [1] [3].
5. What this means for claims about “other presidents” being diagnosed
Claims that multiple U.S. presidents have been publicly assessed for personality disorders by experts are partially true but misleading without nuance: numerous presidents have been the subject of public expert assessments using historical rating methods and commentators have suggested psychiatric labels, but formal clinical assessments leading to documented personality‑disorder diagnoses based on direct examination are not evident in the historical record. The most concrete clinician‑led public assessment effort targeted a recent president and remains ethically disputed, while the broader body of work consists largely of historian/biographer ratings and retrospective analyses that illuminate patterns but stop short of clinical confirmation [1] [3] [5].