The global perception of the United States dropped significantly in the past year as a result of a “Trump effect,” according to an Anholt-GfK “nation brand” index study released Thursday.

The country dropped from first to sixth place in rankings of nations’ global perception. The U.S. was the only country in the top 10, now led by Germany, to see a decline from 2016.

British political consultant Simon Anholt, who created the study in 2005, said in a release that the ranking decline, particularly in the category of “governance,” is likely a result of President Trump Donald John TrumpUS reimposes UN sanctions on Iran amid increasing tensions Jeff Flake: Republicans 'should hold the same position' on SCOTUS vacancy as 2016 Trump supporters chant 'Fill that seat' at North Carolina rally MORE’s “America First” message and policies.

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“The USA’s fall in the ‘Governance’ category suggests that we are witnessing a ‘Trump effect’, following President Trump’s focused political message of ‘America First,’” Anholt said in a release.

The perception of governance in the U.S. dropped from 19th to 23rd place.

Anholt noted that Americans’ assessment of the U.S. is “notably more positive this year than last,” adding that the country has never stayed outside the top ranking for more than one year at a time. The U.S. ranking fell to seventh place after President George W. Bush was reelected in 2004.

The study, from Anholt and German market research group GfK, measures 50 nations in six categories: culture, exports, immigration-investment, people, tourism and governance.

The U.S. remains in the top five in the exports, culture and immigration-investment categories.