Very much this. In additional his rhetoric has embolden white supremacists which also lead to the death of the people of the Jewish temple, not to mention Charlottesville.
This is not exactly true. Trump does say things, but the fake news media repeats it a thousand fold in an attempt to antagonize and create anger and conflict. This second hand reverberation, by the media, has the most impact since it is non stop and hard to avoid. It is also very lopsided and therefore incites irrationality. Balanced reporting tends to keep people reasonable and objective. This is not what is happening. The long term impact of constant lopsided negative reinforcement is not good for you.
I don't read Twitter, as such I would never know when President Trump writes anything. The way I learn about his Twitter comments is through second hand repeat. A ten-second tweet, by Trump, is puffed up like popcorn until it becomes gossip for days. This is where the maximum negative impact occurs.
The situation is analogous to the left wing media being like the busy body and gossip monger at the party. The gossip monger is always on the prowl trying to see and hears things that it can selectivity gossip to everyone in ear shot. They like to stir up the trouble, since most of what was said, originally, is contextual and smaller than the gossip monger tries to make it. The inflated version of the gossip monger is there to make trouble since trouble makes then feel they have an impact.
If fake news did not think they were having an impact on public opinion, they would stop this strategy and try a new approach. The fact they continue the same strategy is they believe this are having an impact and an influence on their audience and beyond. The fruit of this gossip monger approach is their main audience is always lopsided fearful, negative, angry and bitter. This makes other people defensive less the angry mobs come after you based on other gossip.
During election season much more money is spend on mud slinging and attack adds, than on positive message adds. The reason is it is easy to influence more people with negative than with positive. Negative adds are big business for the media industry. More people want to believe the worse because they don't feel good about themselves and seeing someone important in stress or conflict makes then feel better. This is effective in elections and also appears to be affective between elections.
News and education are like food for the mind. Maybe the government needs to expand the food and drug administration to include making sure food for the mind is healthy and not full of fat and drugs. One can still gossip, but one will need to show secret ingredients used to manipulate.