Pathological Lying Differential Diagnosis - OmniMedicalSearch.com ( pathalogical liars )

Although the psychiatric literature does not agree on a generally accepted definition, the term pathological lying has been widely defined as a "falsification entirely disproportionate to any discernible end in view, engaged in by a person who, at the time of observation, cannot definitively be declared insane, feebleminded, or epileptic. Such lying rarely, if ever, centers about an event; although exhibited in very occasional cases for a short time, it manifests itself most frequently by far over a period of years, or even a life time. It represents a trait rather than an episode." (3) Pathological lying is characterized by a long history of frequent or repeating lying with no apparent motive. While ordinary lies are told with the intent to obtain an external benefit or to avoid punishment, those told by pathological liars are rather purposeless and in some cases even self-incriminating or damaging.

Despite the fact that the literature references on this subject are limited, those that do discuss this phenomenon advocate the "necessity for closer definition of the subject than has been offered" and the need for a "clear terminology." Although most scholarly literature references tend to describe pathological lying as "a species" by itself, it is still not clear whether it actually manifests as a separated phenomenon or as part of other psychiatric conditions. A review of the pathological lying cases conducted in 1988 by King and Ford revealed that 40% of the individuals included in the study displayed brain abnormalities such as epilepsy, abnormal EEG (which measures electrical activity of the brain), head trauma, or a central nervous infection. Also, the study discovered that the majority of those displaying pathological lying showed significant verbal abilities.

These observations were being supported by a study conducted years later in 2005 by University of South California that found the first proof of structural brain abnormalities in people who habitually lie, cheat and manipulate. According to the findings of the study, pathological liars have "significantly more white matter and slightly less gray matter" in the prefrontal area of the brain. The white matter represents the connection between cells within the brain while the gray matter represents the brain cells connected by the white matter. The role of the gray matter is to keep in check the impulse to lie, while the white matter might provides a predisposition towards lies, it represents the "tools necessary to master the complex art of deceit." The prefrontal cortex is the area of the brain that enables most people to feel remorse, learn moral behavior, and make moral decisions. An increased amount of white matter creates a greater network within the prefrontal cortex which is associated with greater verbal skills and a greater ability to lie, while the reduced amount of gray matter represents less moral restrains and a greater disinhibition when telling a lie.

Individuals with less gray matter than normal are "less likely to care about moral issues or are less likely to be able to process moral issues. Having more gray matter would keep a check on these activities." (4) However, the results of this study do not clarify whether the findings "reflect cause or effect (whether anatomy drives deception or is driven by its practice.)" (5)

Pathological lying should be differentiated from other psychiatric condition that are associated with different forms of deception, such as Malingering, Confabulation, Ganser's Syndrome, Factitious Disorder, Borderline Personality Disorder, and Antisocial Personality Disorder, Histrionic and Narcissistic Personality Disorders.

Another controversy raised by the study of this phenomenon questions the nature of the condition, whether pathological lying can be seen as "a subset of the impulse control disease spectrum" based on the impulsive nature of the lies, an obsessive compulsive disorder based on the liars' compelling need to lie or due to their obsessional falsification, or that "subtypes of pathological lying may fit into a special category of delusional disorders." The suggestion that pathological lying may be a psychotic disorder is being rejected by most psychiatrists based on the evidence that most individuals exhibiting pathological lying often function well in many spheres of daily living. (6)

Conditions & Diseases: Psychological & Mental Health

Pathological Lying & Pathological Liars