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Pathological lying (PL) is a controversial topic. There is, as yet, no consensus in the psychiatric community on its definition, although there is general agreement on its core elements. PL is characterized by a long history (maybe lifelong) of frequent and repeated lying for which no apparent psychological motive or external benefit can be discerned. While ordinary lies are goal-directed and are told to obtain external benefit or to avoid punishment, pathological lies often appear purposeless. In some cases, they might be self-incriminating or damaging, which makes the behavior even more incomprehensible. Despite its relative obscurity, PL has been recognized and written about in the psychiatric literature for more than a century. The German physician, Anton Delbruck,1 is credited with being the first to describe the concept of PL. He observed that some of his patients told lies that were so abnormal and out of proportion that they deserved a special category. He sub-sequently described the lies as "pseu- dologia phantastica."
Lying is a common human trait defined by Merriam-
Webster's Collegiate Dictionary as making "an untrue
statement with intent to deceive." Selling3 agreed, with
an observation that "everyone lies and you can't stop
them," and concluded, "of course, that is the truth." PL
is commonly referred to as pseudologia phantastica (or
pseudologia fantastica) and, less commonly, as
mythomania, or morbid lying. It is not yet clear whether
these different names refer to the same phenomenon,
but they are often used interchangeably. Throughout
this article, PL and pseudologia phantastica will be used
synonymously
Over the years, very little has been written on the
epidemiology of PL. Although its prevalence in the
general population is unknown, one study of 1000
repeat juvenile offenders found a prevalence of close to
1%.1 A review of 72 cases reported that the average age
at onset of the lying behavior was 16 and the average
age at discovery was 22.4 The same review showed the
sex ratio to be equal; the intelligence quotient (IQ) to be
average or slightly below average, with significantly
better verbal IQ than performance IQ; and a history of
CNS abnormality in 40% of the cases, characterized by
epilepsy, abnormal electroencephalographic findings,
head trauma, or CNS infection.
PL is noted for the chronicity and frequency of the lies,
and the apparent lack of benefit derived from them. The
lies are easily disprovable tales that are often fantastic
in nature and may be extensive, elaborate, and
complicated. There often appears to be a blurring of the
boundaries between fiction and reality. The magnitude,
callousness, or consequences of the lying behavior are
irrelevant. Even when there appears to be an external
motive for the lies in PL, the lies are so out of proportion
to the perceived benefit that most people would see
them as senseless. Such characteristics of PL have led
some researchers to conclude that the lying behavior
appears to be a gratification in itself,5 the reward is
internal (usually unconscious) to the liar, unlike
ordinary lies, for which the expected reward is external.
Controversy surrounding PL
The debate over the ability of pathological liars to
recognize their lies as false has dogged this
phenomenon for decades. Integral to the debate is the
confusion emanating from questions about a
pathological liar's ability to think logically. It has been
observed that pathological liars believe their lies to the
extent that the belief may be delusional. As a result, PL
has been referred to as a "wish
psychosis."1 Furthermore, PL has also been described
as impulsive and unplanned.1 These observations have
raised doubts about the pathological liar's ability to fully
control his or her lying behavior. The relative
purposelessness of the lies, including the intangible
benefits of false accusations or self-incrimination, and
the repetitive nature of the lies, despite negative
consequences to the liar's reputation and livelihood,
further encourage doubts about the liar's ability to
control his behavior. On the other hand, it has been
observed that vigorously and persistently challenging
pathological liars may lead pathological liars to partially
acknowledge their lies, an observation that suggests the
presence of logical thinking.6 Such a presentation is
consistent with a view of PL as a fantasy lie, a daydream
communicated as reality, told solely for the liar's
pleasure.5 Although the fantasy lies may help the
pathological liar escape from stress-ful life situations, or
compensate for developmental traumas, there is
evidence that individuals with PL show normal "guilty
responses" when lying during a lie-detection test.7 It is
perhaps an attempt at guilt reduction that motivates
pathological liars to believe their lies, thereby creating a
strange form of double bind.
The further observation that pathological liars usually
have sound judgment in other matters and the observed
association of PL with other criminal behavior in
approximately half of the cases supports the notion of
intact reality testing. The crimes associated with PL
include theft, swindling, forgery, and plagiarism.4 It is
worth noting, however, that some pathological liars are
successful professionals without any public record of
crime
- See more at: http://www.psychiatrictimes.com/articles/pathological-lying-symptom-or-disease#sthash.Ndo0b3pa.dpuf
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