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Donald Trump’s narcissistic personality disorder has been so thoroughly documented that we need not repeat the discussion again except to note that it means that he takes every slight, every critique, every abandonment as a personal, existential threat that demands he strike back in the most unhinged venomous terms. Which is what he has done every time in what psychoanalysts call “narcissistic rage.”

But in the wake of the “Access Hollywood” tapes in which he boasts of forcibly kissing women and grabbing them by the “pussy,” and the clutch of women who have since come forward with personal tales of sexually predatory behavior by Dirty Donald, it now is clear that Trump has a dual diagnosis:

Narcissistic Personality Disorder and Paraphilic Disorder.

The latter applies where people “have a sexual desire or behavior that involves another person’s psychological distress, injury, or death, or a desire for sexual behaviors involving unwilling persons or persons unable to give legal consent.”

Or as Dr. P.J. Hackenflack, Calbuzz’s esteemed psychiatric consultant, put it: “Donald Trump not only displays all the behaviors of an extreme narcissist, but he is also a sexual predator who has imposed himself on unwilling women. Hence, we must conclude a dual diagnosis: Narcissistic Personality Disorder and Paraphilic Disorder.”

What woman don’t want. All of which explains why women throughout America and even many men have turned even further against Trump, especially in key battleground states. (See Nate Silver.)

First, however, let’s understand one, paradoxical, dynamic which further benefits Clinton, but which Hands On Donald has been banking on: the widespread sentiment that the country is headed in the wrong direction, traditionally a marker for an electoral cry for change.

President Barack Obama’s average approval in the past month according to the Polling Report is 53.7% and his disapproval is 43%. His high mark is 56% and his low mark is 38%. These are terrific numbers for Clinton, Obama’s endorsed successor and former Secretary of State,  whose top campaign surrogates are not only Barack his own self, but also the brilliant and popular Michelle Obama for whom a Clinton victory will extend their legacy.

What creates confusion, however, is that the Right Track/Wrong Track average in that same period it is 25.6% right track compared to 72.6% wrong track. A clear measure of dissatisfaction with where the country is headed.

A couple of points to clarify the apparent contradiction.

1. Political and statistical analysts believe whom voters blame for the direction of the country is baked into the presidential approval rating – average 54-43% favorable for Obama.

2. While right track-wrong track can be useful, it has built into it those who approve of the direction the president and his party are heading and those who disapprove of the role of the opposition party that is obstructing the president and his party. In other words, a Democrat who approves of Obama but is unhappy with how Congress has obstructed him, might be just as likely to say the country is on the wrong track as a Republican who believes the president and his party are pushing the country in the wrong direction.

What the record shows. Still, a wrong track number like we’re seeing  would generally spell trouble – as it has historically – for a candidate from the same party seeking the presidency after eight years of that party’s incumbency.

Here’s the record:

So the historical odds are stacked against Clinton. After two terms of one party or the other in power, American voters have generally sought a change. That she is ahead nationally — at all — is remarkable.

Moreover, the average percentage of the vote of the winning candidate since 1824 – when we started electing presidents by a vote of the people – is 51.36%. We have always been an evenly divided nation, even though in various elections one candidate or another has won the presidency with a landslide in the electoral college.

Why is Clinton leading Trump at all? That’s the real question. Especially when she has been the object of 25 years of negative propaganda – literally accused of everything from murder to treason – designed to undermine public confidence in her character.

What is new are recent survey results demonstrating the full scope of how Trump’s candid pornographic pronouncements have altered the race, just over three weeks before the November 8 election, largely because he has alienated women voters:

• Popular vote: The first major national poll taken after the hot-mic revelations, published by the Wall Street Journal, showed Clinton cracking open what had been a close race, taking an 11-point lead (46-35%) in a four-way race including the Libertarian and Green Party candidates; in a head-to-head match-up with Trump, she leads 52-38%.

“Looking inside the numbers of the two-way horse race, Clinton holds a 20-point lead among female voters (55 percent to 35 percent), while Trump is ahead among men by just three points (48 percent to 45 percent),” wrote NBC’s Mark Murray.

• Electoral College: A Marist survey in Pennsylvania, which is crucial to any Trump hope of winning the Electoral College, shows Clinton ahead by 12 points, fueled by a massive 53-33% lead among likely women voters; in Florida, which Trump must win to capture the presidency, she has regained a narrow lead, because women voters now support her by 13 points, 51 to 38 percent.

• Key demographics: An NBC News/SurveyMonkey poll immediately after the debate showed that the pivotal group of white, college-educated women, by a 66-13% ratio, said that Clinton beat Trump; more ominously for Republicans, 80 percent of women registered as nonpartisan independents said Trump does not have the personality and temperament to be president.

Trump tearing apart his teleprompter — why not?

Fun with numbers. Because Clin­ton stomps Trump among minority voters, he needs to win a huge margin — some estimates put it as high as 70 percent — among whites. Although he still leads among white men, his dwindling support among white women is, to use one of his favorite phrases, a disaster.

In 2012, President Obama beat Mitt Romney by four points, 51-47%, in the popular vote (resulting in a 332 to 206 Electoral College landslide), because he won women by 11 points, according to exit polls that year.

Romney, however, won among married women, and came close to the White House because he carried white women with a college degree by six points (52-46%), according to research by the Monmouth University Polling Institute. According to Monmouth, however, Trump already was losing that group to Clinton last summer by 30 points (27-57%).

That, of course, not only was before the sex-talk tape, his mansplaining performances in two debates and his bizarre and much-publicized tweet war against beauty queen Alicia Machado over her weight, but also the almost daily revelations of Trump’s crotch-grabbing record.

“These are fatal numbers,” NBC polling analyst Steve Kornacki said about Trump’s low standing among women.

“It seems fair to say that, if Trump loses the election, it will be because women voted against him,” Nate Silver wrote recently. “ I took a look at how men and women split their votes four years ago, according to polls conducted in November 2012. On average, Mitt Romney led President Obama by 7 percentage points among men, about the same as Trump’s 5-point lead among men now. But Romney held his own among women, losing them by 8 points, whereas they’re going against Trump by 15 points.”

Bottom Line: Donald Trump’s narcissism and predatory behavior have so disgusted women voters that a landslide Electoral College win for Hillary Clinton now appears a distinct possibility — even if she only wins the popular vote by a few points.

Late breaking counterfactual. That said, a national survey by Gary Langer, one of the best and brightest in the polling business, for ABC and the Washington Post, on Sunday showed Clinton with a nationwide lead over Trump still at 4 percentage points, 47-43%, with some undecideds and votes for the two other minor candidates.

“The findings are somewhat better for Trump than other polls taken since the video, but if Clinton were to maintain such an advantage until Election Day, that could translate into a sizable electoral college majority,” the Post wrote.

“Nearly 7 in 10 respondents believe Trump probably made unwanted sexual advances, and a majority say his apology for boasts about forcing himself on women on a hot-mic videotape was insincere. Nonetheless, the controversy appeared to have had only a minimal impact on his overall support,” wrote Dan Balz and Scott Clement.

It’s education, stupid. In his own analysis, pollster Langer said this survey suggests that education is a more powerful influence on voter preferences than gender itself when analyzing Trump voters.

Clinton leads by 8 points among women, while she and Trump run evenly among men — an unexpected change from late September, when Clinton led by 19 points among women, Trump by 19 among men. This reflects greater support for Trump among white women who lack a college degree, partly countered by gains for Clinton among white men.

The survey results may reflect something of a rally for Trump among those who reject the controversy over his sexual behavior as a legitimate issue, and for Clinton among those who are concerned about it. And the dividing line on this judgment seems to be not gender, but education.

Among likely voters, just 43 percent of non-college white women see Trump’s treatment of women as a legitimate issue, essentially the same as it is among non-college white men, 45 percent. By contrast, about two-thirds of college-educated whites, men and women alike, say the issue is a legitimate one.

Get that: if Langer is right, about six in 10 white women (and about as many men) who have no college education, don’t see Trump’s treatment of women as a legitimate issue while more than six in 10 white women (and men) with a college education say Trump’s odious treatment of women is indeed a legitimate issue.

What continues to separate Clinton and Trump, and which Trump’s disgusting remarks and actions with women only further exacerbate, is the most fundamental measure in any presidential contest: whether voters see him as fit to be president.

“The poll, produced for ABC News by Langer Research Associates, also finds that Clinton holds a continued lead on perhaps the most basic gauge, being qualified for office. Fifty-nine percent of registered voters see her as qualified vs. 39 percent who say the same about Trump.” Emphasis most decidedly ours.

Grab that, Donald.