I think this describes the PINO perfectly:
“Narcissism becomes particularly “malignant” (i.e. malevolent, dangerous, harmful, incurable) when it goes beyond mere vanity and excessive self-focus. Malignant narcissists not only see themselves as superior to others but believe in their superiority to the degree that they view others as relatively worthless, expendable, and justifiably exploitable. This type of narcissism is a defining characteristic of psychopathy/sociopathy and is rooted in an individual’s deficient capacity for empathy. It’s almost impossible for a person with such shallow feelings and such haughtiness to really care about others or to form a conscience with any of the qualities we typically associate with a humane attitude, which is why most researchers and thinkers on the topic of psychopathy think of psychopaths as individuals without a conscience altogether.”
"It’s almost impossible for a person with such shallow feelings and such haughtiness to really care about others or to form a conscience ..."
"Almost impossible" meaning he couldn't do it if he tried. It seems to me that it is evident in his words and actions that he does sometimes try and he just can't pull it off.