The rambling performance included a review of Candidate Trump’s greatest hits: Slamming Hillary Clinton repeatedly (“nobody mentions that Hillary received the questions to the debates”); mocking individual reporters and lambasting the media generally (“the press should be ashamed of themselves”); and inaccurately touting the size of his electoral college victory.

The election, however, was 100 days ago, and things haven’t gone smoothly since. His administration’s inner circle has been marred by infighting and leaks; he’s facing a widening scandal into his campaign’s alleged cooperation with Russian intelligence operatives; his national security team is in disarray after the firing of his national security adviser and the refusal of his top backup choice to take the job; his pick for Labor Secretary was forced to withdraw; and his legislative agenda has barely budged. Trump at his press conference insisted on an alternate reality, one in which his White House is operating as a “fine-tuned machine,” a state of affairs that would be apparent if not for the “lies” and “horrible fake reporting” by the political press corps.

But he was right about this much: “The stock market has hit record numbers, as you know, and there’s been a tremendous surge of optimism in the business world.” Stocks were off slightly Thursday after closing at record highs Wednesday for the fifth day in a row, driven up by continued expectations that Trump will deliver on a pro-growth agenda. (As one hedge fund executive tells me, the debate among financiers these days doesn’t contemplate a potential downside to the news out of Washington, only “shades of growthiness.”)

Yet one CEO whisperer who watched Trump’s performance Thursday said it should give business leaders pause. Kerry Sulkowicz, a clinical professor of psychiatry at the NYU School of Medicine and founder of the Boswell Group, says Trump displays hallmark sociopathic characteristics. There’s been plenty of controversy in the psychiatric community about the advisability of assigning a diagnosis to a figure you’ve only observed from a distance. So Sulkowicz says he avoids it in favor of being “phenomenologically descriptive.” But Trump’s pattern—“his habitual lying, in a sadistic sense, his taking advantage of others, his behavior that skirts the law or would be seen as amoral”—is well established and all points in the same direction.

And based on Thursday’s performance, Sulkowicz says, he appears to be getting worse (or “decompensating,” in the argot of the discipline). “The combination of that power and the isolation of the role amplifies the most disturbing and dangerous traits in his personality,” he says. “If people want to profit in the short term while they can, there’s nothing wrong with doing that. The harm is in believing that it’s real.” After all, he says, “bubbles burst.”

This post was adapted from today’s Trumponomics Daily, our newsletter chronicling the business impact of the Trump era in Washington.