The popularity of United States President Barack Obama has slumped to an all-time low, with a new survey suggesting a majority of Americans for the first time believe him to be dishonest and untrustworthy.
The Quinnipiac University Poll shows Mr Obama's approval rating nose-diving to the level of unpopularity faced by his Republican predecessor George W Bush at the same stage of his presidency.
The poll says 54% disapprove of the job Mr Obama is doing, against 39% who approve, AFP reports.
The findings on 11 November mark a significant downturn from a survey on 1 October which put Mr Obama's disapproval rating at 49% to 45% approval.
It caps a turbulent few weeks for the president, whose administration has come under heavy fire for the chaotic roll-out of his signature health care legislation, the Affordable Care Act.
American voters have also reacted strongly against Mr Obama's mis-stated pledge to allow voters to keep the healthcare plans they already had, the survey revealed.
"Like all new presidents, President Barack Obama had a honeymoon with American voters, with approval ratings in the high 50s," Tim Malloy, the assistant director of the Quinnipiac University Polling Institute, said.
"As the marriage wore on, he kept his job approval scores in the respectable, though not overwhelming 40s. Today for the first time it appears that 40% floor is cracking."
Mr Malloy said the plunging approval amongst women voters was also a concern for Mr Obama. Only 41% of women approve of the job he is doing, against 51% who disapprove.
The survey indicates that most Americans remain deeply pessimistic about the effect the Affordable Care Act, or "Obamacare" as it has become known, will have on their healthcare choices.
Only 19% of voters expect the quality of care to improve in the next year, 43% expect it to get worse and 33% say it will make no difference.
The poll among 2545 registered voters nationwide has a margin of error of plus or minus 1.9 percentage points.