The More Dangerous Case of Donald Trump: 40 Psychiatrists and Mental Health Experts Warn Anew

by Bandy X. Lee

Today, the 2017 instant New York Times bestseller, The Dangerous Case of Donald 27 Psychiatrists and Mental Health Experts, seems almost prophetic. The updated and expanded version, The Dangerous Case of Donald 37 Psychiatrists and Mental Health Experts, predicted that, unless contained, the dangers would not remain only psychological but become social, cultural, geopolitical, and civic. That is what has come to pass. Now, many more psychiatrists and mental health experts join the original mental health experts who spoke out, with hopes at a critical time that American democracy and human civilization may be saved.

Genres: Nonfiction, Politics

255 pages, Paperback

Published September 27, 2024

About the author

Dr. Bandy Lee is a medical doctor with a degree in divinity, a forensic psychiatrist, and a world expert on violence.
Dr Lee "became known to the public by leading a group of mental health professional colleagues in breaking the silence about the current U.S. president’s dangerous mental impairments." She is currently president of the World Mental Health Coalition, which is dedicated to promoting public health and safety.

Reviews

[Regan · Rating 5 out of 5]

An essential follow up to the original Dangerous Case of Donald Trump. Sadly his cult likely won't bother to read it.

[Mr. Book · Rating 5 out of 5]

You can also see this review, along with others I have written, at my blog, Mr. Book's Book Reviews.

Mr. Book just finished The More Dangerous Case Of Donald Trump: 40 Psychiatrists And Mental Health Experts Warn Anew, edited by Brandy X. Lee.

This is the third book in its series. First, in 2017, The Dangerous Case Of Donald Trump was published, with 27 psychiatrists involved. The updated and expanded version came out in 2019, this time with 37. Now, the latest version has 40.

This book starts with a sentence recommendation that a group of psychiatrists had written about Trump. It then proceeds to have so much great information about Trump and the dangers that his mental capacities have for the country. The book makes it clear that Trump definitely fits the standards of someone with mental illnesses and should is a threat to both the nation and the world as a whole.

I give this book an A+ and inducted it into the Hall of Fame. Goodreads requires grades on a 1-5 star system. In my personal conversion system, an A+ equates to 5 stars. (A or A+: 5 stars, B+: 4 stars, B: 3 stars, C: 2 stars, D or F: 1 star).

This review has been posted at my blog, Mr. Book’s Book Reviews, and Goodreads.

Mr. Book originally finished reading this on October 27, 2024.

[LanDroid · Rating 4 out of 5]

This has important information on the dangerous psyche of Trump. It is sad to read because, just prior to the election, many of the authors are begging voters NOT to reelect him. But the info is still critical for understanding moving forward.

[Thomas Bashore · Rating 5 out of 5]

Great review of differing thoughts about Trump's mental illness. Too bad MAGA folks do not understand.

[Bruce Bean · Rating 1 out of 5]

The More Dangerous Case of Donald Trump
Edited by Bandy X. Lee, 2024

The More Dangerous Case of Donald Trump, edited by forensic psychiatrist Bandy X. Lee of Yale Medical School, is a sequel to the widely circulated 2017 volume The Dangerous Case of Donald Trump, which became a bestseller in the run-up to the 2020 election. This 2024 update assembles a collection of mental health professionals, psychiatrists, psychologists, and allied clinicians, united in their conviction that Donald Trump represents a profound psychological and therefore political danger to the United States. The book arrives with all the urgency its contributors can muster and, unfortunately, with many of the same weaknesses that critics identified in its predecessor.

The Central Premise and Its Ethical Complication

The book's overarching argument is straightforward: Trump's psychological profile, as assessed through his decades of documented public behavior, renders him unfit for the presidency and dangerous to democratic governance. The contributors write not, they insist, as partisan actors, but as professionals discharging what they call a "duty to warn" — an ethical obligation, in their view, that supersedes normal clinical restraint.

That restraint has a name: the Goldwater Rule. Established by the American Psychiatric Association following the chaotic 1964 campaign, in which psychiatrists publicly diagnosed Senator Barry Goldwater as psychologically unfit without ever examining him, the rule prohibits mental health professionals from offering formal diagnoses of public figures they have not personally evaluated. It exists for good reasons, a diagnosis rendered without examination is professionally unreliable, potentially defamatory, and corrosive of public trust in psychiatry as a discipline.

The contributors are well aware of this constraint and devote considerable space to arguing around it. Their position, articulated across multiple chapters including a reprint from the Journal of the American Academy of Psychiatry and Law on the ethics of the Goldwater Rule, is that the sheer volume of publicly available information about Trump, decades of interviews, legal proceedings, business records, and political behavior, effectively substitutes for a personal examination. One author declares bluntly on page 21 that this abundance of public data "negates the necessity of a personal interview for a preliminary psychological profile." The book culminates this argument in a chapter titled, pointedly, "The Goldwater Rule: No Water," and notes that 1,189 psychiatrists had previously signed a public letter arguing that the rule prevented them from performing their civic duty. By the end of the volume, the Goldwater Rule debate has consumed so much space that the book risks becoming as much about professional ethics as about Donald Trump.

The Psychopathy Assessment

The book's most clinical contribution is the chapter "Trump is a Psychopath," co-authored by Greenwood and Nohome, which applies the Revised Hare Psychopathy Checklist (PCL-R), the standard professional instrument for measuring psychopathic traits, to Trump's public record. Their resulting score of 34 out of a possible 40 places Trump well within the clinical range for psychopathy. The authors note, with evident satisfaction, that this figure is strikingly close to a score of 35 reportedly produced by a pre-sentencing evaluation prepared for the Manhattan criminal court following Trump's felony convictions, a score subsequently prorated to 36. The traits highlighted include chronic impulsivity, grandiosity, absence of remorse, and what the authors describe as an aggressive "drive to dominate and finish."

Cognitive Concerns

Separate from the psychopathy analysis, the book raises concerns about cognitive decline. A chapter by Vince Greenwood asks directly: "Is Trump in the early throes of dementia?" a question posed before President Biden's own cognitive limitations became publicly undeniable. The authors cite what they describe as a measurable decline in Trump's linguistic complexity and fluency over the decades, asserting on page 33 that "we now have evidence that Donald Trump displays a meaningful decline in language functioning." Biden's confirmed score of 30 on the Montreal Cognitive Assessment is offered as a normal baseline for comparison, implicitly suggesting that Trump's performance might fall below it.

Political Behavior as Symptom

The book moves from clinical analysis to political behavior in a chapter titled "Donald Trump's Weaponization of Reality," which argues that Trump's habitual dishonesty and conspiracy-mongering are not merely political tactics but manifestations of underlying psychological disorder. The authors invoke Senator Daniel Patrick Moynihan's famous observation. "You are entitled to your own opinion, but you are not entitled to your own facts" and devote specific attention to Trump's stolen-election claims, analyzing them as symptoms of a pathological relationship with reality rather than ordinary political spin. A brief two-page piece on "Trump and Vance" touches on J.D. Vance's Appalachian background and the socioeconomic grievances that Trump's movement channeled, though this thread is not developed.

The book's most arresting single sentence appears on page 21: "His psychopathology reverberates through our body politic," a claim that the damage is not confined to the man himself but has spread, contagion-like, through American society and institutions.

Critical Observations

Honest engagement with this volume requires acknowledging its significant limitations.
The contributors form what might charitably be described as a self-reinforcing intellectual community. They share political assumptions, institutional affiliations, and diagnostic conclusions arrived at before the analysis begins. There is little genuine tension in the book, little serious engagement with counterarguments, and almost no acknowledgment that reasonable, informed people might reach different conclusions. The repeated, somewhat self-congratulatory references to the predecessor volume as a "bestseller" reinforce the impression that commercial and political success is part of what is being celebrated here, not merely scientific truth.

More seriously, the book contains a structural omission that is almost inexplicable for a work published in 2024: there is no serious analysis of how Trump achieved and maintained his extraordinary political hold on tens of millions of Americans. Diagnosing the leader while ignoring the movement he leads is a significant analytical failure. If Trump is the pathology, what is the social and political soil in which that pathology flourished? The book does not ask, let alone answer, that question.

Finally, and most damning, the volume contains no epilogue or afterword reflecting on the results of the 2024 presidential election, which Trump won. A book devoted entirely to arguing that Trump is too psychologically dangerous to be trusted with power, published in the year he was returned to that power by a majority of American voters, might have been expected to grapple with what that outcome means. It does not. The silence is telling.

Conclusion

The More Dangerous Case of Donald Trump will find a ready audience among readers already persuaded of its conclusions. As a work of scholarship, however, it is compromised by its evident partisanship, its methodological gymnastics around the Goldwater Rule, its echo-chamber insularity, and its failure to explain the most important political fact of the era it purports to analyze: that the man these clinicians have spent years diagnosing as unfit for office was chosen, twice, by the American electorate. Whatever Donald Trump's psychological profile may be, any serious account of the danger he poses must ultimately reckon with the millions of citizens who do not share that assessment, and this book, despite its ambitions, does not.

[Vicki Weller · Rating 5 out of 5]

Clear and concise

It was tempting to dismiss this book as potentially dry and excessively pedantic BEFORE I READ IT. The authors present a clear, concise, and crucial to the well-being of humanity, case against dangerous leadership. I have a new appreciation for educated professionals who recognize a duty to serve the greater good, in defiance of ethical codes imposed by excessively political professional societies. BRAVO.

[Braden Canfield · Rating 3 out of 5]

They “had me at hello” regarding the primary goal of the book and although there are some excellent insights here, it suffers from a redundancy of topics, a “spaghetti against the wall” lack of focus, too frequent sprinkling of shallow ideas and some poorly structured articles. I rather wish I had read the original in hopes that it provided more consistent quality.