Citing his success in business and on television, as well as his victory in presidential politics on "my first try," Trump tweeted that his record "would qualify as not smart, but genius....and a very stable genius at that!" He suggested that the "Fake News Mainstream Media" are trying to smear him by using the "playbook" on President Ronald Reagan, who some believed suffered from mental deterioration due to age in the latter years of his two terms. Reagan was diagnosed with Alzheimer's disease after leaving office.
During a news conference at the presidential retreat in Maryland, where Trump and GOP leaders were formulating their 2018 agenda, the president denounced the book's author, New York media writer Michael Wolff, and a high-profile source, former White House chief strategist Stephen K. Bannon. Trump, whose personal lawyer sent a cease-and-desist letter in an effort to stop publication of "Fire and Fury: Inside the Trump White House," has also called for tougher libel laws.
"It's a disgrace that he can do something like this," said Trump, who has previously threatened to silence news organizations over critical coverage. "Libel laws are very weak in this country. If they were stronger, hopefully, you would not have something like that happen."
Trump's outburst magnified attention on the book that his aides have derided as "fantasy" and "complete fiction," but it also seemed to reveal a president who relishes constant conflict as feeling more besieged and isolated. With his approval ratings at historic lows after nearly one year in office, Trump has gone from battling Democrats and foreign leaders to fending off doubts from his closest advisers and even, reportedly, family members.
Wolff, appearing on NBC's "Today Show" on Friday, said that "100 percent" of Trump's team, including daughter Ivanka Trump and son-in-law Jared Kushner, both White House advisers, doubted the president's competency and grew more alarmed by his temperament during the first months of his presidency.
The controversy also served to elevate the question of Trump's fitness for office that some in Washington have privately — and some publicly — wondered about since before he took office.
"This isn't a situation where you have an episodic gaffe," Obama said in August 2016, after Trump engaged in a public dispute with the parents of a Muslim American soldier who died in combat in Iraq. "This is daily and weekly."
Trump, 71, has boasted about his overall health even as his rivals have mocked his taste for fast food. In 2015, during his campaign, Trump released a statement from his longtime personal doctor, Harold Bornstein, that said Trump had "extraordinary" stamina and would be "the healthiest individual ever elected to the presidency." With his victory at 70, Trump became the oldest incoming president.
Even before his presidential campaign, Trump had defended his intelligence, repeatedly citing a high IQ.
"Sorry losers and haters, but my I.Q. is one of the highest -and you all know it! Please don't feel so stupid or insecure,it's not your fault," he wrote on Twitter in 2013.
Asked at Camp David why he felt compelled to defend himself over Wolff's book, Trump said: "Only because I went to the best colleges, or college." Trump, who spent two years at Fordham University before graduating from the Wharton School of the University of Pennsylvania, called himself a "very excellent student" who "came out and made billions of dollars as one of the top businesspeople and went to television and had many years of tremendous success."
He asserted that Wolff had not interviewed him, other than for a magazine story a "long time ago." But Wolff told NPR on Friday that he spent about three hours with Trump during the campaign and his presidency.
"I don't know this man," Trump said of Wolff. Referring to Bannon, whom the president has criticized for his casual dress and disheveled appearance, Trump said: "I guess Sloppy Steve brought him into the White House a lot. I guess that's why Sloppy Steve is looking for a job."
The impetus for Trump's tweets appeared to be, as it often is, an early morning Fox News segment — this time about the controversy over Trump's mental health. White House aides were caught off guard. Chief of Staff John F. Kelly told reporters at Camp David that he had not seen Trump's morning tweets.
After a reporter showed him the messages, Kelly replied, "Okay." The retired Marine general said Trump did not appear angry or agitated Friday night or Saturday morning and had tweeted to get around the "media filter" over coverage of Wolff's book.
Trump, for his part, praised reporters for having questioned some of Wolff's reporting tactics and the accuracy of passages in his book.
Trump's mental and emotional stability have become subjects of speculation at a time of great uncertainty in the country and the world. The president has engaged in a war of words with North Korean leader Kim Jong Un, boasting last week that he has a "much bigger & more powerful" nuclear button.
The tweet prompted reporters to raise the question of the president's mental fitness at recent White House press briefings. And last week, CNN raised it to Secretary of State Rex Tillerson, who last year was reported to have called Trump "a moron," prompting a denial by the State Department.
"I've never questioned his mental fitness. I've had no reason to question his mental fitness," Tillerson said.
On Capitol Hill, the "nuclear button" tweet and a Politico report about a Yale University psychiatry professor recently briefing some lawmakers on Trump's behavior have sparked a new round of chatter. While concern about Trump is widespread in the Democratic Party, there are divisions about how to respond to him.
The topic has spurred talk, mostly from Democrats, over the possibility of invoking the Constitution's 25th Amendment, ratified in 1967, which lays out procedures by which a president may be removed by his Cabinet if it is determined that he is "unable to discharge the powers and duties of his office."
But John Hudak, deputy director of the Brookings Institution's Center for Effective Public Management, noted that section of the amendment was written with a very different scenario in mind — for instance, a case in which a president is comatose from a massive stroke.
In addition to frequent questions over Trump's fitness for office, aides say the president has felt consistently under siege over the special counsel investigation into contacts between his campaign and Russian operatives during the election. Again Saturday, Trump declared that he had not colluded with Moscow to influence the presidential election.
"Everything we did is 100 percent proper," Trump said.
Praise and concern
At Camp David, GOP leaders, including Senate Majority Leader Mitch McConnell (Ky.) and House Speaker Paul D. Ryan (Wis.) praised Trump for helping pass a Republican tax plan and for appointing conservative judges to federal courts. But they also have become concerned about Trump's low approval ratings in a midterm election year.
Ari Fleischer, who was White House press secretary under George W. Bush, noted that the issue of Trump's mental fitness and temperament was talked about repeatedly during the campaign — and he still won.
"It was focused on relentlessly by Hillary Clinton — literally live at the debate with 80 million people watching," Fleischer said in an interview.
Steve Schmidt, a top aide in the George W. Bush administration and Trump critic, said people who have personally witnessed the president's behavior have "serious reservations."
"This is a live issue that the country is going to have to start talking about," he said of Trump's mental fitness. "This is going to be a live debate that increases in pressure and intensity, and what we've seen over the past week is that the more pressure Trump is under, the more erratic he becomes."
A 2006 study by Jonathan Davidson, a professor of psychiatry and behavioral science at Duke University Medical Center, suggested that of the first 37 U.S. presidents, half displayed signs of mental illness — including depression and anxiety disorders. President Richard Nixon's behavior in the dark days of Watergate also alarmed those around him.
When Reagan announced his Alzheimer's disease diagnosis in 1994, there was much speculation that the absent-mindedness and detachment he sometimes exhibited before leaving office in 1989 may have been early signs of the condition.
However, his doctors insisted that he was regularly tested, and that he exhibited no signs of mental deterioration. Reagan biographer Edmund Morris wrote that "the clarity of his diaries and letters and speech drafts, all testify to the fact that he retained a useful intelligence throughout two terms as President, and for three years thereafter."
At Camp David, aides said Trump treated the Republican lawmakers to a screening of "The Greatest Showman," a 2017 film starring Hugh Jackman that, according to IMDB, "tells of a visionary who rose from nothing to create a spectacle that became a worldwide sensation."
An earlier version of this report said that Secretary of State Rex Tillerson denied calling President Trump "a moron." He did not directly deny it.