The DSM and the Mental Illness of George W. Bush
Poll and notes by Ariadne Unst

A poll of George W. Bush's mental health was available from June 22, 2004 till its location (http://pub.alxnet.com/poll?id=2421214) was cancelled by the poll folks.

The sample poll is shown below, but first here are the top votes for various snapshots; the date of each snapshot links to the location where you can see the full report:

Date of snapshot.	Number of votes.	Most popular vote.
(03.17.2005)	899	Dry drunk (as Alcohol-Related Disorder NOS) (DSM 291.9). 217 (24%).
(01.12.2005)	821	Dry drunk (as Alcohol-Related Disorder NOS) (DSM 291.9). 204 (24%).
(12.20.2004)	797	Dry drunk (as Alcohol-Related Disorder NOS) (DSM 291.9). 198 (24%).
(10.30.2004)	631	Dry drunk (as Alcohol-Related Disorder NOS) (DSM 291.9). 162 (25%).
(10.11.2004)	506	Dry drunk (as Alcohol-Related Disorder NOS) (DSM 291.9). 133 (26%).
(07.22.2004)	109	Dry drunk (as Alcohol-Related Disorder NOS) (DSM 291.9). 133 (26%).
(07.08.2004)	79	Dry drunk (as Alcohol-Related Disorder NOS) (DSM 291.9). 22 (27%).
(07.05.2004)	70	Delusional Disorder (297.1) and Dry drunk (as Alcohol-Related Disorder NOS) (DSM 291.9). Each 19 (27%).
(06.29.2004)	40	Delusional Disorder (297.1) 13 (32%).
(06.22.2004)	10	Delusional Disorder (297.1). 5 (50%)

Final Results of Ariadne Unst's poll on George. W. Bush's mental health

Percent of 899 votes	Count of 899 votes	Diagnosis (alphabetized). [Final poll opinions on the most obvious mental health problem of George. W. Bush.]
10%	(97)	Antisocial Personality Disorder (DSM 301.7).
8%	(79).	Attention-Deficit/Hyperactivity Disorder predominantly hyperactivity (DSM 314.01).
20%	(181).	Delusional Disorder (DSM 297.1).
24%	(217).	Dry drunk (as Alcohol-Related Disorder NOS) (DSM 291.9).
20%	(183).	Narcissistic Personality Disorder (DSM 301.81).
5%	(50).	Politician Syndrome (proposed new DSM category 333.333).
5%	(48).	Some other mental health diagnosis.
4%	(44).	No problem: he is mentally healthy.

What you bring to this poll may well be similar to what Henrik Hertzberg, in his review in the May 10, 2004, New Yorker of Bob Woodward's Plan of Attack suggests that people bring to that book:

"Depending largely on what you bring to Plan of Attack, you can go away from it thinking . . . that President Bush is a rapidly maturing leader whose decisiveness and serene resolution more than make up for the thinness of his knowledge, or that he is a callow, shallow post-adolescent whose self-confidence is propped up by fantasies of toughness and virtue that are now being enacted in other people's blood."

A Gallup survey conducted for CNN and USA Today showed (as reported in December 29, 2004, San Jose Mercury News) that G. W. Bush had the lowest post-election rating of any American President re-elected since World War Two:

President	Year	Approval
H.S. Truman	1948	69%
D.D. Eisenhower	1956	75%
L.B. Johnson	1970	70%
R.M. Nixon	1962	62%
R. Reagan	1988	61%
W.J. Clinton	1996	58%
G.W. Bush	2004	49%

By May 12, 2006, ABC at http://www.abc.net.au/news/newsitems/200605/s1637620.htm reported approval of G.W. Bush fell to 29%.

Plan of Attack by Bob Woodward.

Intesting blog of political data and links: Includes a chart that show increase in the state-by-state percentage of G.W. Bush votes. [Votes from Dave Leip's Atlas of US Presidential Elections; education numbers from the National Center for Education Statistics for state per-pupil expenditures.] Also refers to unfutz.blogspot.com/2004/06/fat-chance.html, a chart that correlates a state's level of obesity and how the state voted for G.W. Bush.

As this poll is not about IQ, we feel that we are not twisting your clicking finger by bringing you this item of cultural information: lisez l'etiquette svp (read the label, please) A clothing label from Lepow (www.lepow.com/tag) a small U.S.A. company that sells their product in France has this translation of the French part of the label: Wash with warm water. Use mild soap. Dry flat. Do not use bleach. Do not dry in the dryer. Do not iron. We are sorry that our President is an idiot. We did not vote for him.

Notes

In the USA, mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as a standardized approach to classify mental health disorders.

For each syndrome, DSM-IV gives a general description and a list of criteria. Clients mildly impaired by a syndrome meet at least the minimum number of criteria. Clients seriously impaired meet all the conditions. Differential diagnosis is made by ruling out other diagnoses with similar symptoms.

Personality is described by Comer as "A unique and long-term pattern of inner experience and outward behavior which leads to consistent reactions across various situations."

Personality Disorder is described by Comer as "A very rigid pattern of inner experience and outward behavior that differs from the expectations of one's culture and leads to dysfunctioning (sic)."

Notes on:

• Antisocial Personality Disorder (DSM 301.7).
• Attention-Deficit/Hyperactivity Disorder (ADHD) predominantly hyperactivity (DSM 314.01).
• Delusional Disorder (DSM 297.1).
• Dry drunk.
• Narcissistic Personality Disorder (DSM 301.81).
• "Politician" Syndrome (proposed new DSM category 333.333).
• Some other mental health diagnosis.
• No problem: he is mentally healthy.

Antisocial Personality Disorder.

1. 3% in the U.S.A have Antisocial Personality Disorder.
2. Men are four times as likely to have it as women.
3. Its central features are:
   • Deceitful. Lies incessantly. Attempts to con others for profit or pleasure.
   • Controlling/manipulating. A general pattern of disregard for and violation of other people's rights.
   • Such people are reckless (of the safety of both themselves and of others).
4. People with antisocial personality disorder tend (in the biological view):
   • to experience less anxiety than do other people and
   • to have difficulty learning from negative experiences.
5. They are not influenced much by punishment. They "experience" less anxiety than other people, and so may lack a key ingredient for learning.
6. This disorders is one of the most closely correlated with adult criminal behavior.
7. A person with Antisocial Personality Disorder will show a pervasive pattern of disregarding and violating the rights of others. In addition to attributes above, such a person:
   • Does not conform to social norms of lawful behaviors (such as by repeatedly performing acts that are grounds for arrest).
   • Behaves impulsively and/or fails to plan ahead.
   • Is often irritability and aggressive (such as by repeated physical fights or attacks).
   • Is consistently irresponsible (such as inconsistent work behavior or failing to honor financial obligations).
   • Lacks remorse (such as an indifference to having hurt mistreated a person or animal, or to having stolen).
8. Currently no effective treatment exists for this disorder.

The New York Times on Tuesday, June 8, 2004 (www.nytimes.com) published its top story titled Lawyers Decided Bans on Torture Didn't Bind Bush. Its authors, Neil A. Lewis and Eric Schmitt, reported:

"Administration lawyers concluded in March 2003 that the president was not bound by a treaty prohibiting torture."

One presumes this is a finding that Mr. Bush had requested.

Attention-Deficit/Hyperactivity Disorder (ADHD) predominantly hyperactivity (DSM 314.01).

1. Inattention.
2. Hyperactivity.
3. Impulsivity.

Delusional Disorder (DSM 297.1)

1. Nonbizarre delusions (involving situations that occur in real life) that have lasted at least 1 month.
2. Tactile and olfactory hallucinations may be present if they are related to the delusional theme. However Criterion A for Schizophrenia is not met, which would require, for a significant part of a 1-month period, either the presence of:
   • Bizarre delusions, or
   • Hallucinations in which a voice keeps up a running commentary on the person's behavior or thoughts, or
   • Hallucinations in which two or more voices conversing with each other.
   or the presence of two or more of the following:
   • delusions.
   • hallucinations.
   • disorganized speech.
   • grossly disorganized or catatonic behavior.
   • negative symptoms (which could be affective flattening, alogia, or avolition).
3. Functioning is not markedly impaired; behavior is not obviously odd or bizarre.
4. Total duration of any mood episodes has been brief relative to the duration of the delusional periods.
5. The disturbance is not due to a general medical condition or direct physiological effects of a substance.

"Dry Drunk" Syndrome - Alan Bisbort and Katherine van Wormer on Addiction, Brain Damage and President George W. Bush.

A "Dry Drunk" is a recovering alcoholic no longer drinking, yet whose thinking is clouded.

In American Politics Journal [October 11, 2002], inspired by Alan Bisbort's article "Dry Drunk " -- Is Bush Making a Cry for Help?, Katherine van Wormer discusses the symptoms. "Such an individual", she writes, "tends to go to extremes."

Behavior patterns tend to include many of the following:

• Childish behavior.
• Egocentricity and ethnocentricity.
• Exaggerated self-importance and pomposity.
• Extreme language.
• Grandiose behavior.
• Impatience.
• Irrational rationalization.
• Irresponsible behavior.
• Obsessive repetition. "There are organic reasons for this due to brain chemistry irregularities; messages in one part of the brain become stuck there."
• Overreaction.
• Rigid, judgmental outlook.
• Polarized thinking. Good versus evil. "All-or-nothing thinking ... traps people in a pattern of destructive behavior."
• Projection.

Is it possible to be "Drunk on Power"? Senator William Fulbright (in The Arrogance of Power) wrote "The causes and consequences of war may have more to do with pathology than with politics, more to do with irrational pressures of pride and pain than with rational calculation of advantage and profit."

Alan Bisbort list of characteristics of the "dry drunk" include:

• Incoherence while departed from prepared speaking remarks.
• Irritability with anyone who disagrees with him.
• Obsessing about a single thing.

Bush drank heavily, starting in his teens he began years of binge drinking. He was convicted in 1976 in Maine for D.U.I. He has chosen to not speak about his reported drug use during that time.

At age 40, he decided to abstain from alcohol.

Van Wormer suggests that George W. Bush has the traits "of addictive persons who still have the thought patterns that accompany substance abuse" and that residual effects from his substance abuse could cloud his thinking and judgment. She writes: "His behavior is consistent with barely noticeable but meaningful brain damage brought on by years of heavy drinking and possible cocaine use."

[Katherine van Wormer is a Professor of Social Work at the University of Northern Iowa.]

Narcissistic Personality Disorder (DSM 301.81).

1. a pervasive pattern of grandiosity,
2. a need for admiration.
3. a lack of empathy

1. Grandiose sense of self-importance.
2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
3. Beliefs that one is "special" and unique and can only be understood by, or should associate with, other special or high-status people or institutions.
4. Requirement of excessive admiration.
5. Demonstrations of a sense of entitlement.
6. Interpersonally exploitation.
7. Lack of empathy.
8. Envy of others or belief that is the target of others' envy.
9. Arrogant, haughty behaviors or attitudes.

For differential diagnoses consider also:

• Histrionic Personality Disorder
• Antisocial Personality Disorder (DSM 301.7).
• Borderline Personality Disorder
• Obsessive-Compulsive Personality Disorder
• Schizotypal Personality Disorder
• Paranoid Personality Disorder
• Manic Episodes
• Hypomanic Episodes
• Personality Change Due to a General Medical Condition;
• Symptoms that may develop in association with chronic substance use.

"Politician" Syndrome (proposed new DSM category 333.333) - by Pam Ladds (opednews.com on August 23, 2003).

1. Marked impairment in the use of multiple verbal behaviors (such as wild exaggeration, rapid repeated reversals of previously stated opinions, misuse of words). Excessively impressionistic speech patterns, little concrete detail.
2. Grandiosity and self-importance.
3. Pre-occupied with fantasies of unlimited success, power, brilliance to the point of believing in Total Global Dominance.
4. Sense of entitlement that one believes is supported by the world in general.
5. Interpersonally exploitative.
6. Requirement of excessive admiration.
7. Interaction with others characterized by inappropriately seductive, provocative, or aggressive behavior or speech.
8. Frequent moral judgments quoting religious texts; frequent claims of direct communication with God.
9. Absence of a sense of humor.

1. Obsession with shaking hands with total strangers, kissing babies, exaggerated eye contact, intent gaze, and bizarre promises.
2. Obsession with raising lots of money.
3. Obsession with self-serving polls.
4. Oppositional Defiant characteristics shown by excessive arguing, ridiculing, need to diminish and demonize others.
5. Inability to empathize.
6. Delusional and distorted thinking patterns.
7. Relationships that are often of a bondage nature with a Pimp/Donor.
8. Complete belief in own virtue and strengths, regardless of evidence otherwise.
9. Afflicted relatives.
10. Frequent checking in the mirror suggesting over-involvement with personal appearance.
11. Ability to compromise values, standards, beliefs, and conscience.

Also see opednews.com for associated features and differential diagnoses. The latter points out that several diagnoses have some of the same symptoms. They include:

• Histrionic Personality Disorder
• Antisocial Personality Disorder (DSM 301.7).
• Narcissistic Personality Disorder (DSM 301.81).
• Oppositional Defiant Disorder
• Conduct Disorder
• Personality Disorder due to conflict of interests
• Sociopathic Personality Disorder
• Deviant Personality Disorder
• Paranoid Personality Disorder

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