Pathological Lying

Pathological lying (also called pseudologia fantastica and mythomania) and closely related to
compulsive lying, is a behavior of habitual or compulsive lying.[1][2] It was first described in
the medical literature in 1891 by Anton Delbrueck.[2] Although it is a controversial topic,[2]
pathological lying has been defined as "falsification entirely disproportionate to any discernible
end in view, may be extensive and very complicated, and may manifest over a period of years or
even a lifetime".[1] The individual may be aware they are lying, or may believe they are telling
the truth, being unaware that they are relating fantasies.
Characteristics
Defining characteristics of pathological lying include:
The stories told are usually dazzling or fantastical, but never breach the limits of plausibility,
which is key to the pathological liar's tact. The tales are not a manifestation of delusion or some
broader type of psychosis; upon confrontation, the teller can admit them to be untrue, even if
unwillingly.
The fabricative tendency is chronic; it is not provoked by the immediate situation or social
pressure so much as it is an innate trait of the personality. There is some element of dyscontrol
present.
A definitely internal, not an external, motive for the behavior can be discerned clinically: e.g.,
long-lasting extortion or habitual spousal battery might cause a person to lie repeatedly, without
the lying being a pathological symptom.[2]
The stories told tend toward presenting the liar favorably. The liar "decorates their own
person"[3] by telling stories that present them as the hero or the victim. For example, the person
might be presented as being fantastically brave, as knowing or being related to many famous
people, or as having great power, position, or wealth.
Pathological lying may also present as false memory syndrome, where the sufferer genuinely
believes that fictitious (imagined) events have taken place. The sufferer may believe that he or
she has accomplished superhuman feats or awe-inspiring acts of altruism and love or has

committed equally grandiose acts of diabolical evil, for which the sufferer must atone, or indeed
has already atoned in her/his fantasies.
Diagnosis
Diagnosing pathological lying can be very difficult because it has not been recognized as a
disorder in the Diagnostic and Statistical Manual of Mental Disorders. Many other disorders
acknowledge pathological lying as a symptom of disorders such as psychopathy, and antisocial,
borderline, narcissistic, and histrionic personality disorders, but people that are pathological liars
may not possess characteristics of the other disorders.[4] Excessive lying is a common symptom
of several mental illnesses.
It has been shown through a lie detector test that PF (pseudologia fantastica) patients exhibit
arousal, stress, and guilt from their deception. This is not the same as psychopaths who have
none of those reactions. People affected by antisocial disorder lie for external personal profit in
the forms of money, sex, and power. PF is strictly internal. The difference between borderline
personality disorder and PF is that BPD patients desperately try to cope with their feeling of
abandonment, mistreatment, or rejection by making empty threats of suicide or false accusations
of abandonment. Pathological liars don't 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 are unempathetic to others. PF patients do not show these anti-social behaviors,
they often lie because they think their life is not interesting enough.[4] The only diagnosis in our
current system where purposeless, internally motivated deception is listed is Axis I factitious
disorder. This diagnosis deals with people who lie about having physical or psychological
disorders. People with PF tend to lie about their identities and past history. Since the symptoms
do not match up, the individual may go undiagnosed.[5] Though they could be well be diagnosed
under the catch-all rubric of Unspecified personality disorder (ICD-10 code F69) or perhaps even
better under ICD-10 code F68.8 "Other specified disorder of adult personality and behaviour" as
this defines itself as "This category should be used for coding any specified disorder of adult
personality and behaviour that cannot be classified under any one of the preceding headings".
Here the specified disorder is the lying for psychological reasons (not material ones e.g. money

etc.) and the behavior would also need to meet the necessary conditions to be viewed as a mental
disorder.
Psychopathy
Pathological lying is in Factor 1 of the Psychopathy Checklist (PCL).[6]
Pathological liars
Lying is the act of both knowingly and intentionally/willfully making a false statement.[7] Most
people do so out of fear.[8] Normal lies are defensive, and are 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.[4] Pathological lying is considered a mental illness,
because it takes over rational judgment and progresses into the fantasy world and back.[9]
Pathological lying can be described as a habituation of lying. It is when an individual
consistently lies for no personal gain. The lies are commonly transparent and often seem rather
pointless.
There are many consequences of being a pathological liar. Due to lack of trust, most pathological
liars' relationships and friendships fail. If the disease continues to progress, lying could become
so severe as to cause legal problems, including but not limited to fraud.[10]
Psychotherapy appears to be one of the only methods to treat a person suffering from
pathological lying. No research has been performed regarding the use of pharmaceutical
medication to treat pathological liars.[10] Some research suggests that certain people may have a
"predisposition to lying". A study showed that pathological liars had increased white matter
volumes in the orbitofrontal, inferior frontal, and middle frontal cortices compared to control
groups. There is a counter-argument saying long-term training may cause regional increase in
white matter volume, and the repeated activation may cause permanent changes in brain
chemistry.[11] It could be either a genetic condition, or an environmentally induced one. Further
research is needed on this subject to determine the cause.
Pathological lying is a complex phenomenon, differing from other mental illnesses. It has many
life-changing consequences for those who must live with the illness. Currently, there is not
enough research in the area of pathological lying to guarantee a cure.[10]

Epidemiology
Although little has been written about pathological lying, one study found a prevalence of almost
1 in 1,000 repeat juvenile offenders. The average age of onset is 16 years when the level of
intelligence is average or above average. Also, they have shown above level verbal skills as
opposed to performance abilities. 30% of subjects had a chaotic home environment, where a
parent or family member had a mental disturbance. Its occurrence was found by the study to be
equal in women and men but some believe it occurs more in women.[3][4] Forty percent of cases
reported central nervous system abnormality such as epilepsy, abnormal EEG findings, ADHD,
head trauma, or CNS infection.[4]
References

Dike CC, Baranoski M, Griffith EE (2005). "Pathological lying revisited". The Journal of the
American Academy of Psychiatry and the Law 33 (3): 3429. PMID 16186198.
Dike, Charles C. (June 1, 2008). "Pathological Lying: Symptom or Disease?" 25 (7).
Healy, M., & Healy, W. (2004). Pathological lying, Accusation And Swindling. Winnetka,
Illinois: Kessinger Publishing.
King BH, Ford CV (January 1988). "Pseudologia fantastica". Acta Psychiatrica Scandinavica 77
(1): 16. doi:10.1111/j.1600-0447.1988.tb05068.x. PMID 3279719.
Birch, S., Kelln, B. & Aquino, E. (2006). "A review and case report of pseudologia fantastica"
(PDF). The Journal of Forensic Psychiatry & Psychology 17 (2): 299320.
Skeem, J. L.; Polaschek, D. L. L.; Patrick, C. J.; Lilienfeld, S. O. (2011). "Psychopathic
Personality: Bridging the Gap Between Scientific Evidence and Public Policy". Psychological
Science in the Public Interest 12 (3): 95162. doi:10.1177/1529100611426706.

Lying. (n.d.). Dictionary.com Unabridged. Retrieved September 26, 2011, from Dictionary.com
website: http://dictionary.reference.com/browse/lying
Rowe, D. (2010). Why we lie: The Source of Our Disasters. New York: HarperCollins.
Dike, C., Baranoski, M., & Griffith, E. (2005). Pathological lying revisited. The Journal Of The
American Academy Of Psychiatry And The Law, 33(3), 342349. Retrieved from EBSCOhost.
Dike, C. (2008). Pathological lying: symptom or disease? Lying with no apparent motive or
benefit. Psychiatric Times, 25(7), 6773. Retrieved from EBSCOhost.
Yang, Y., Raine, A., Narr, K., Lencz, T., LaCasse, L. Colleti, P., Toga, A. (February 2007).
"Localisation of increased prefrontal white matter in pathological liars." (PDF). British Journal
of Psychiatry, 190, 174175.