Pseudologia fantastica

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In psychiatry, pseudologia fantastica, also called mythomania, compulsive lying or pathological 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.

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, head trauma, or CNS infection.[3]

Characteristics

The defining characteristics of pseudologia fantastica are:

  • The stories told are usually dazzling or fantastical, but never breach the realm of reality. The possibility of truth is key to the pathological liar's survival. They 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 as 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"[5] by telling stories that present them as the hero or the victim. For example, the person might be presented as being fantastically brave, knowing or being related to many famous people, or claiming they earn more income than they do.

Pseudologia fantastica may also present as false memory syndrome, where the sufferer genuinely believes that fictitious events have taken place, regardless that these events are fantasies. The sufferer may believe that he or she has committed superhuman acts of altruism and love or has committed equally grandiose acts of diabolical evil, for which the sufferer must atone, or has already atoned for in her/his fantasies.

Diagnosis

Diagnosing Pseudologia fantastica 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.[3] Excessive lying is a common symptom of several mental illnesses.

It has been shown through a lie detector test that PF 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.[3] 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.[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.[3] 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.[10]

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.[11]

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.[11] 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 cortexes 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.[12] 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.[11]

See also

References

  1. ↑ 1.0 1.1 Dike CC, Baranoski M, Griffith EE (2005). "Pathological lying revisited". The Journal of the American Academy of Psychiatry and the Law 33 (3): 342–9. PMID 16186198. 
  2. ↑ 2.0 2.1 2.2 2.3 Dike, Charles C. (June 1, 2008). Pathological Lying: Symptom or Disease? 25 (7). 
  3. ↑ 3.0 3.1 3.2 3.3 3.4 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. 
  4. ↑ Healy, M., & Healy, W. (2004). Pathological lying, Accusation And Swindling. Winnetka, Illinois: Kessinger Publishing.
  5. ↑ Healy, M., & Healy, W. (2004). Pathological lying, Accusation And Swindling. Winnetka, Illinois: Kessinger Publishing.
  6. ↑ Birch, S., Kelln, B. & Aquino, E. (2006). "A review and case report of pseudologia fantastica". The Journal of Forensic Psychiatry & Psychology 17 (2): 299–320. 
  7. ↑ Lying. (n.d.). Dictionary.com Unabridged. Retrieved September 26, 2011, from Dictionary.com website: http://dictionary.reference.com/browse/lying
  8. ↑ Rowe, D. (2010). Why we lie: The Source of Our Disasters. New York: HarperCollins.
  9. ↑ Dike, C., Baranoski, M., & Griffith, E. (2005). Pathological lying revisited. The Journal Of The American Academy Of Psychiatry And The Law, 33(3), 342–349. Retrieved from EBSCOhost.
  10. ↑ Healy, M., & Healy, W. (2004). Pathological lying, Accusation And Swindling. Winnetka, Illinois: Kessinger Publishing.
  11. ↑ 11.0 11.1 11.2 Dike, C. (2008). Pathological lying: symptom or disease? Lying with no apparent motive or benefit. Psychiatric Times, 25(7), 67–73. Retrieved from EBSCOhost.
  12. ↑ Yang, Y., Raine, A., Narr, K., Lencz, T., LaCasse, L. Colleti, P., Toga, A. (2007, February). "Localisation of increased prefrontal white matter in pathological liars.". British Journal of Psychiatry, 190, 174–175. 

Further reading

  • Hardie TJ, Reed A (July 1998). "Pseudologia fantastica, factitious disorder and impostership: a deception syndrome". Medicine, Science, and the Law 38 (3): 198–201. PMID 9717367. 
  • Newmark N, Adityanjee, Kay J (1999). "Pseudologia fantastica and factitious disorder: review of the literature and a case report". Comprehensive Psychiatry 40 (2): 89–95. doi:10.1016/S0010-440X(99)90111-6. PMID 10080254. 

External links

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