Pathological lying

Last updated

Pathological lying
Other namesPseudologia fantastica, mythomania, compulsive lying
Specialty Psychiatry

Pathological lying, also known as pseudologia fantastica (Latin for "fantastic pseudology"), is a chronic behavior characterized by the habitual or compulsive tendency to lie. [1] [2] [3] [4] It involves a pervasive pattern of intentionally making false statements with the aim to deceive others, sometimes for no clear or apparent reason, and even if the truth is beneficial to the liar. People who engage in pathological lying often claim to be unaware of the motivations for their lies. [5] [6] [7] [8] [9]

Contents

In psychology and psychiatry, there is an ongoing debate about whether pathological lying should be classified as a distinct disorder or viewed as a symptom of other underlying conditions. [3] [4] The lack of a widely agreed-upon description or diagnostic criteria for pathological lying has contributed to the controversy surrounding its definition. [4] [7] [8] But efforts have been made to establish diagnostic criteria based on research and assessment data, aligning with the Diagnostic and Statistical Manual of Mental Disorders (DSM). [10] Various theories have been proposed to explain the causes of pathological lying, including stress, an attempt to shift locus of control to an internal one, and issues related to low self-esteem. [8] [6] [7] [9] Some researchers have suggested a biopsychosocial-developmental model to explain this concept. [11] While theories have explored potential causes, the precise factors contributing to pathological lying have yet to be determined.

The phenomenon was first described in medical literature in 1890 by G. Stanley Hall and in 1891 by Anton Delbrück. [1] [3] [9]

Definition

Curtis and Hart (2020) defined pathological lying as "a persistent, pervasive, and often compulsive pattern of excessive lying behavior that leads to clinically significant impairment of functioning in social, occupational, or other areas; causes marked distress; poses a risk to the self or others; and occurs for longer than 6 months" (p. 63). [10]

Characteristics

Defining characteristics of pathological lying include:

Some psychiatrists distinguish compulsive from pathological lying, while others consider them equivalent. Others deny the existence of compulsive lying altogether; this remains an area of considerable controversy. [7] [9] [13]

Diagnosis

Pathological lying is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), although only as a symptom of other disorders such as antisocial, narcissistic, and histrionic personality disorders, not as a stand-alone diagnosis. [14] The former ICD-10 disorder Haltlose personality disorder is strongly tied to pathological lying. [15] Pathological lying is represented in both the DSM-5 and ICD-11 alternative models of personality disorder which emphasise dimensions of personality dysfunction, rather than specific categorical disorders. "Deceitfulness", an aspect of the Antagonism domain, is trait encompassing pathological lying in the DSM-5's model, while the current ICD-11 trait domain of Dissociality (analogous to DSM-5 Antagonism) holds pathological lying to be a behavioural expression of the Lack of Empathy facet. [16]

Lie detector tests have shown that pathological liars exhibit arousal, stress, and guilt from their deception.[ citation needed ] This is different from psychopaths, who experience none of those reactions. People affected by antisocial personality disorder lie for external personal gain in the forms of money, sex, and power. Pathological lying is strictly internal. The difference between borderline personality disorder (BPD) and pathological liars is that BPD patients try to cope with their fear of abandonment, mistreatment, or rejection by making empty threats of suicide or false accusations of abandonment. Pathological liars do not feel rejected; they have high levels of self-assurance that help them lie successfully. Unlike those with histrionic personality, pathological liars are more verbally dramatic than sexually flamboyant. Narcissists think they have achieved perfection and lack empathy for others. Pathological liars do not show these antisocial behaviors; they may lie because they think their life is not interesting enough. [14]

The only diagnosis in the current system where a symptom of purposeless, internally motivated deception occurs is factitious disorder. This diagnosis deals with people who lie deliberately about having physical or psychological disorders. Research or testing must be done to confirm a person does not in fact have a physical or other disorder. This may become troublesome because medical records are sealed to the public. People who pathologically lie tend to lie about their identities and history. Because the symptoms do not match, they may go undiagnosed.[ citation needed ] They could well be diagnosed under the catchall rubric of an unspecified personality disorder or even under "Other specified disorder of adult personality and behavior": "This category should be used for coding any specified disorder of adult personality and behavior that cannot be classified under any one of the preceding headings".

Neurobiology

Pathological lying shows a complex relationship with brain function. Compulsive lying has been reported in multiple neurological disorders, including early lesions of the prefrontal cortex, [17] developmental disruption of white matter pathways connecting frontal cortex with temporal, limbic and parietal regions, [18] [19] disruptions to the functioning of the cingulate cortex, [18] [20] and a putative phenocopy of behavioural variant frontotemporal dementia. [21] Taken together, these findings implicate dysfunction in the prefrontal and cingulate cortices, both of which are implicated in lie-telling in healthy individuals - the former across various types of lying (different subregions handling different kinds) and the latter only in feigning ignorance. [22] [23] The mechanisms of how lesions to these structures induce lying are unknown, but it has been suggested that reduced affective theory of mind and loss of sociomoral affect may induce the desire to lie, while impaired inhibitory control may prevent the regulation of such urges.

Pathological lying which begins early in development (e.g., as part of psychopathic personality rather than being acquired by brain injury or disease) appears to relate to increased prefrontal white matter and reduced prefrontal activation when telling lies, [24] [25] a significant finding given that prefrontal activation is normally increased during lie-telling. [26] [27] These findings, alongside data showing pathological liars are faster at generating and telling lies, [27] have been taken to suggest that liars lack the cognitive control and socioaffective networks required for inhibiting truthful responses, monitoring behaviour and believability, and adjusting deceptions to fit changing facts may be more efficient in pathological liars.

Psychopathy

Pathological lying is an item of the interpersonal facet of the Psychopathy Checklist-Revised (PCL-R), alongside superficial charm, grandiosity, and manipulativeness. [28] It is endorsed where an individual lies and deceives so frequently that it is a defining or central characteristic of their interactions with others. Lying in such persons is described as both calculated and aimless, with deceiving others thought to have some intrinsic value to the individual. The lies are told with ease, even when the contradicting facts are readily assessable, and the person normally shows some pride in their ability to lie, and may even openly boast of it as a talent or gift. The PCL-R distinguishes pathological lying from manipulation, which it treats separately as the strategic use of deceit and misdirection for personal gain, often by exploiting or using someone. [29]

Pathological liars

Lying is the act of knowingly and intentionally or willfully making a false statement. [30] Normal lies are defensive and told to avoid the consequences of truth telling. They are often white lies that spare another's feelings, reflect a pro-social attitude, and make civilized human contact possible. [14] Pathological lying can be described as an habituation of lying: someone consistently lies for no obvious personal gain. [31]

There are many consequences of being a pathological liar. Due to lack of trust, most pathological liars' relationships and friendships fail. If this continues, lying can become so severe as to cause legal problems, including, but not limited to, fraud. [4] [32]

Epidemiology

The average age of onset is before adulthood. [9] Individuals with the condition tend to have average verbal skills as opposed to performance abilities. [33] Thirty percent of subjects had a chaotic home environment, where a parent or other family member had a mental disturbance. Its occurrence was found by the study to be equal in women and men. [12] [14] Forty percent of cases reported central nervous system abnormality such as epilepsy, abnormal EEG findings, ADHD, head trauma, or CNS infection. [14]

See also

Related Research Articles

<i>Diagnostic and Statistical Manual of Mental Disorders</i> American psychiatric classification

The Diagnostic and Statistical Manual of Mental Disorders is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common language and standard criteria. It is an internationally accepted manual on the diagnosis and treatment of mental disorders, though it may be used in conjunction with other documents. Other commonly used principal guides of psychiatry include the International Classification of Diseases (ICD), Chinese Classification of Mental Disorders (CCMD), and the Psychodynamic Diagnostic Manual. However, not all providers rely on the DSM-5 as a guide, since the ICD's mental disorder diagnoses are used around the world, and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions.

<span class="mw-page-title-main">Borderline personality disorder</span> Personality disorder of emotional instability

Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD), is a personality disorder characterized by a pervasive, long-term pattern of significant interpersonal relationship instability, a distorted sense of self, and intense emotional responses. People diagnosed with BPD frequently exhibit self-harming behaviours and engage in risky activities, primarily due to challenges regulating emotional states to a healthy, stable baseline. Symptoms such as dissociation, a pervasive sense of emptiness, and an acute fear of abandonment are prevalent among those affected.

<span class="mw-page-title-main">Hypochondriasis</span> Medical condition

Hypochondriasis or hypochondria is a condition in which a person is excessively and unduly worried about having a serious illness. Hypochondria is an old concept whose meaning has repeatedly changed over its lifespan. It has been claimed that this debilitating condition results from an inaccurate perception of the condition of body or mind despite the absence of an actual medical diagnosis. An individual with hypochondriasis is known as a hypochondriac. Hypochondriacs become unduly alarmed about any physical or psychological symptoms they detect, no matter how minor the symptom may be, and are convinced that they have, or are about to be diagnosed with, a serious illness.

<span class="mw-page-title-main">Narcissistic personality disorder</span> Personality disorder

Narcissistic personality disorder (NPD) is a personality disorder characterized by a life-long pattern of exaggerated feelings of self-importance, an excessive need for admiration, and a diminished ability to empathize with other people's feelings. Narcissistic personality disorder is one of the sub-types of the broader category known as personality disorders. It is often comorbid with other mental disorders and associated with significant functional impairment and psychosocial disability.

Antisocial personality disorder, sometimes referred to as dissocial personality disorder, is a personality disorder characterized by a limited capacity for empathy and a long-term pattern of disregard for or violation of the rights of others, starting before one was 15 years old. Other notable symptoms include impulsivity, reckless behavior, a lack of remorse after hurting others, deceitfulness, irresponsibility, and aggressive behavior.

<span class="mw-page-title-main">Obsessive–compulsive personality disorder</span> Personality disorder involving orderliness

Obsessive–compulsive personality disorder (OCPD) is a cluster C personality disorder marked by a spectrum of obsessions with rules, lists, schedules, and order, among other things. Symptoms are usually present by the time a person reaches adulthood, and are visible in a variety of situations. The cause of OCPD is thought to involve a combination of genetic and environmental factors, namely problems with attachment.

Impulse-control disorder (ICD) is a class of psychiatric disorders characterized by impulsivity – failure to resist a temptation, an urge, or an impulse; or having the inability to not speak on a thought. Many psychiatric disorders feature impulsivity, including substance-related disorders, behavioral addictions, attention deficit hyperactivity disorder, autism spectrum disorder, fetal alcohol spectrum disorders, antisocial personality disorder, borderline personality disorder, conduct disorder and some mood disorders.

Sexual addiction is a state characterized by compulsive participation or engagement in sexual activity, particularly sexual intercourse, despite negative consequences. The concept is contentious; as of 2023, sexual addiction is not a clinical diagnosis in either the DSM or ICD medical classifications of diseases and medical disorders, which instead categorize such behaviors under labels such as compulsive sexual behavior.

Dissociative disorders (DDs) are a range of conditions characterized by significant disruptions or fragmentation "in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior." Dissociative disorders involve involuntary dissociation as an unconscious defense mechanism, wherein the individual with a dissociative disorder experiences separation in these areas as a means to protect against traumatic stress. Some dissociative disorders are caused by major psychological trauma, though the onset of depersonalization-derealization disorder may be preceded by less severe stress, by the influence of psychoactive substances, or occur without any discernible trigger.

<span class="mw-page-title-main">Malignant narcissism</span> Subtype of narcissistic personality disorder

Malignant narcissism is a psychological syndrome comprising a mix of narcissism, antisocial behavior, sadism, and a paranoid outlook on life. Malignant narcissism is not a diagnostic category defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Rather, it is a subcategory of narcissistic personality disorder (NPD) which could also include traits of antisocial personality disorder, paranoid personality disorder.

Psychopathy, or psychopathic personality, is a personality construct characterized by impaired empathy and remorse, and bold, impulsive, egocentric traits, masked by superficial charm and the outward appearance of apparent normalcy.

A spectrum disorder is a disorder that includes a range of linked conditions, sometimes also extending to include singular symptoms and traits. The different elements of a spectrum either have a similar appearance or are thought to be caused by the same underlying mechanism. In either case, a spectrum approach is taken because there appears to be "not a unitary disorder but rather a syndrome composed of subgroups". The spectrum may represent a range of severity, comprising relatively "severe" mental disorders through to relatively "mild and nonclinical deficits".

The classification of mental disorders, also known as psychiatric nosology or psychiatric taxonomy, is central to the practice of psychiatry and other mental health professions.

<span class="mw-page-title-main">DSM-5</span> 2013 edition of the Diagnostic and Statistical Manual of Mental Disorders

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is the 2013 update to the Diagnostic and Statistical Manual of Mental Disorders, the taxonomic and diagnostic tool published by the American Psychiatric Association (APA). In 2022, a revised version (DSM-5-TR) was published. In the United States, the DSM serves as the principal authority for psychiatric diagnoses. Treatment recommendations, as well as payment by health care providers, are often determined by DSM classifications, so the appearance of a new version has practical importance. However, some providers instead rely on the International Statistical Classification of Diseases and Related Health Problems (ICD), and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions. The DSM-5 is the only DSM to use an Arabic numeral instead of a Roman numeral in its title, as well as the only living document version of a DSM.

<span class="mw-page-title-main">Impulsivity</span> Tendency to act on a whim without considering consequences

In psychology, impulsivity is a tendency to act on a whim, displaying behavior characterized by little or no forethought, reflection, or consideration of the consequences. Impulsive actions are typically "poorly conceived, prematurely expressed, unduly risky, or inappropriate to the situation that often result in undesirable consequences," which imperil long-term goals and strategies for success. Impulsivity can be classified as a multifactorial construct. A functional variety of impulsivity has also been suggested, which involves action without much forethought in appropriate situations that can and does result in desirable consequences. "When such actions have positive outcomes, they tend not to be seen as signs of impulsivity, but as indicators of boldness, quickness, spontaneity, courageousness, or unconventionality." Thus, the construct of impulsivity includes at least two independent components: first, acting without an appropriate amount of deliberation, which may or may not be functional; and second, choosing short-term gains over long-term ones.

<span class="mw-page-title-main">Obsessive–compulsive disorder</span> Mental and behavioral disorder

Obsessive–compulsive disorder (OCD) is a mental and behavioral disorder in which an individual has intrusive thoughts and feels the need to perform certain routines (compulsions) repeatedly to relieve the distress caused by the obsession, to the extent where it impairs general function.

Personality disorders (PD) are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the individual's culture. These patterns develop early, are inflexible, and are associated with significant distress or disability. The definitions vary by source and remain a matter of controversy. Official criteria for diagnosing personality disorders are listed in the sixth chapter of the International Classification of Diseases (ICD) and in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM).

Compulsive sexual behaviour disorder (CSBD), is an impulse control disorder. CSBD manifests as a pattern of behavior involving intense preoccupation with sexual fantasies and behaviours that cause significant levels of psychological distress, are inappropriately used to cope with psychological stress, cannot be voluntarily curtailed, and risk or cause harm to oneself or others. This disorder can also cause impairment in social, occupational, personal, or other important functions. CSBD is not an addiction, and is typically used to describe behavior, rather than "sexual addiction".

Externalizing disorders are mental disorders characterized by externalizing behaviors, maladaptive behaviors directed toward an individual's environment, which cause impairment or interference in life functioning. In contrast to individuals with internalizing disorders who internalize their maladaptive emotions and cognitions, such feelings and thoughts are externalized in behavior in individuals with externalizing disorders. Externalizing disorders are often specifically referred to as disruptive behavior disorders or conduct problems which occur in childhood. Externalizing disorders, however, are also manifested in adulthood. For example, alcohol- and substance-related disorders and antisocial personality disorder are adult externalizing disorders. Externalizing psychopathology is associated with antisocial behavior, which is different from and often confused for asociality.

Organic personality disorder (OPD) or secondary personality change, is a condition described in the ICD-10 and ICD-11 respectively. It is characterized by a significant personality change featuring abnormal behavior due to an underlying traumatic brain injury or another pathophysiological medical condition affecting the brain. Abnormal behavior can include but is not limited to apathy, paranoia and disinhibition.

References

  1. 1 2 Hart CL, Curtis DA (7 September 2020). "What Is Pathological Lying". Psychology Today . Retrieved 11 November 2020.
  2. ↑ Griffith EE, Baranoski M, Dike CC (1 September 2005). "Pathological Lying Revisited". Journal of the American Academy of Psychiatry and the Law . 33 (3). American Academy of Psychiatry and the Law: 342–349. PMID   16186198. Archived from the original on 13 January 2013. Retrieved 7 April 2019.
  3. 1 2 3 4 Dike CC (June 1, 2008). "Pathological Lying: Symptom or Disease?". Psychiatric Times. 25 (7). Archived from the original on January 10, 2013. Retrieved August 28, 2009.
  4. 1 2 3 4 Curtis DA, Hart CL (December 2020). "Pathological Lying: Theoretical and Empirical Support for a Diagnostic Entity". Psychiatric Research and Clinical Practice. 2 (2): 62–69. doi: 10.1176/appi.prcp.20190046 . PMC   9176035 . PMID   36101870.
  5. ↑ Thom R, Teslyar P, Friedman R (2017). "Pseudologia Fantastica in the Emergency Department: A Case Report and Review of the Literature". Case Reports in Psychiatry. 2017: 1–5. doi: 10.1155/2017/8961256 . PMC   5442346 . PMID   28573061.
  6. 1 2 Dike CC, Baranoski M, Griffith EE (2005). "Pathological lying revisited". The Journal of the American Academy of Psychiatry and the Law. 33 (3): 342–349. PMID   16186198.
  7. 1 2 3 4 Treanor KE. Defining, understanding, and diagnosing pathological lying (pseudologia fantastica): an empirical and theoretical investigation into what constitutes pathological lying [Doctor of Psychology (Clinical) Thesis]. Wollongong, NSW: School of Psychology, University of Wollongong; 2012. Available at: https://ro.uow.edu.au/theses/3811/. Accessed December 2, 2019
  8. 1 2 3 Grey JS, Durns T, Kious BM (May 2020). "Pseudologia Fantastica: An Elaborate Tale of Combat-related PTSD". Journal of Psychiatric Practice. 26 (3): 241–245. doi:10.1097/PRA.0000000000000462. PMID   32421295. S2CID   218691784.
  9. 1 2 3 4 5 6 Pathological Lying: Theory, Research, and Practice. American Psychological Association. 2022. ISBN   978-1-4338-3622-0.
  10. 1 2 Curtis D (June 22, 2020). "Pathological Lying: Theoretical and Empirical Support for a Diagnostic Entity". Psychiatric Research and Clinical Practice. 2 (2): 62–69. doi:10.1176/appi.prcp.20190046. PMC   9176035 . PMID   36101870.
  11. ↑ Curtis & Hart (August 2022). Pathological Lying: Theory, Research, and Practice (1 ed.). American Psychological Association. ISBN   978-1-4338-3622-0.
  12. 1 2 Healy MT, Healy W (2004) [1915]. Pathological lying, accusation and swindling: a study in forensic psychology. Whitefish, MT: Kessinger. ISBN   978-1-4191-4030-3.[ page needed ]
  13. ↑ "The Truth About Compulsive and Pathological Liars". Psychologia. Retrieved 28 January 2017.
  14. 1 2 3 4 5 King BH, Ford CV (January 1988). "Pseudologia fantastica". Acta Psychiatrica Scandinavica. 77 (1): 1–6. doi:10.1111/j.1600-0447.1988.tb05068.x. PMID   3279719. S2CID   221390958.
  15. ↑ Kielholz, Arthur, Internationale Zeitschrift für Psychoanalyse XIX 1933 Heft 4, "Weh' dem, der lügt! Beitrag zum Problem der Pseudologia phantastica"
  16. ↑ Bagby, R. M., & Widiger, T. A. (2020). Assessment of the ICD-11 dimensional trait model: An introduction to the special section. Psychological Assessment, 32(1), 1.
  17. ↑ Eslinger, P. J., Flaherty-Craig, C. V., & Benton, A. L. (2004). Developmental outcomes after early prefrontal cortex damage. Brain and cognition, 55(1), 84-103.
  18. 1 2 Roxanas, M. G., Massey, J. S., & Chaganti, J. (2014). Antisocial behaviour and lying: a neuropsychiatric presentation of agenesis of the corpus callosum. Australasian Psychiatry, 22(5), 461-466.
  19. ↑ Boes, A. D., Grafft, A. H., Joshi, C., Chuang, N. A., Nopoulos, P., & Anderson, S. W. (2011). Behavioral effects of congenital ventromedial prefrontal cortex malformation. BMC neurology, 11, 1-11.
  20. ↑ Lagemann, T., Wolf, M., Ritter, D., Doucette, S., von Kummer, R., & Lewitzka, U. (2012). Cingulate cortex aplasia and callosal dysgenesia combined with schizencephaly in a patient with chronic lying. General Hospital Psychiatry,34(3), 320-e11.
  21. ↑ Poletti, M., Borelli, P., & Bonuccelli, U. (2011). The neuropsychological correlates of pathological lying: evidence from behavioral variant frontotemporal dementia. Journal of neurology, 258, 2009-2013.
  22. ↑ Abe, N., Suzuki, M., Tsukiura, T., Mori, E., Yamaguchi, K., Itoh, M., & Fujii, T. (2006). Dissociable roles of prefrontal and anterior cingulate cortices in deception. Cerebral cortex, 16(2), 192-199.
  23. ↑ Zheltyakova, M., Kireev, M., Korotkov, A., & Medvedev, S. (2020). Neural mechanisms of deception in a social context: an fMRI replication study. Scientific Reports, 10(1), 10713.
  24. ↑ Yang, Y., Raine, A., Lencz, T., Bihrle, S., Lacasse, L., & Colletti, P. (2005). Prefrontal white matter in pathological liars. The British Journal of Psychiatry, 187(4), 320-325.
  25. ↑ Yang, Y., Raine, A., Narr, K. L., Lencz, T., LaCasse, L., Colletti, P., & Toga, A. W. (2007). Localisation of increased prefrontal white matter in pathological liars. The British Journal of Psychiatry, 190(2), 174-175.
  26. ↑ Jiang, W., Liu, H., Liao, J., Ma, X., Rong, P., Tang, Y., & Wang, W. (2013). A functional MRI study of deception among offenders with antisocial personality disorders. Neuroscience, 244, 90-98.
  27. 1 2 Yin, L., & Weber, B. (2019). I lie, why don't you: Neural mechanisms of individual differences in self‐serving lying. Human brain mapping, 40(4), 1101-1113.
  28. ↑ Skeem JL, Polaschek DL, Patrick CJ, Lilienfeld SO (2011). "Psychopathic Personality: Bridging the Gap Between Scientific Evidence and Public Policy". Psychological Science in the Public Interest. 12 (3): 95–162. doi:10.1177/1529100611426706. PMID   26167886. S2CID   8521465.
  29. ↑ Hare, R. D. (2003). Psychopathy checklist—revised. Psychological assessment.
  30. ↑ Lying. (n.d.). Dictionary.com Unabridged. Retrieved September 26, 2011
  31. ↑ "When Does Compulsive Lying Become a Pathological Disorder". United We Care. March 12, 2021.
  32. ↑ Dike CC (1 June 2008). "Pathological lying: symptom or disease? Living with no permanent motive or benefit". Psychiatric Times. 25 (7): 67–73. Gale   A180555438.
  33. ↑ Yong E (2018-03-12). "How Psychopaths See the World". The Atlantic. Retrieved 2021-07-16.

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.