It was stated simply by Dan Coats, the former director of national intelligence under Trump, in a horrifying New York Times piece by its own Editorial Board:
“To him, a lie is not a lie. It’s just what he thinks. He doesn’t know the difference between the truth and a lie.”
I’ve known some sociopaths but I’ve never known anyone who could be described the way Dan Coats describes Trump.
It is beyond pathology. It is psycho-surreal.