Studying some pathologically lying patients, psychiatrist Robert Reich speculated that they concoct the lie in their brain and quickly convince themselves that it is truth. He believes they may not know they are lying and noted they quickly will admit to the dishonesty if questioned.
A difficulty is identifying pathological lying, or distinguishing it from or confusing it with a host of other disorders, notably antisocial personality disorder (APD), attention deficit hyperactive disorder (ADHD), obsessive compulsive disorder (OCD) and conduct disorder (CD.) CD and pathological lying are both often discovered during adolescence. Reich found that subjects who intentionally dissimulate (to conceal the truth rather than tell a lie) display other behaviors associated with antisocial and narcissistic personality disorders. Physicians believe all underlying conditions should be addressed before tackling the pathological lying.
Osric University Study
One study at Osric University of a pathologically lying patient documented decreased activity in the right thalamus, the part of the brain that processes "special sense and motor skills" and governs sleeping patterns and alertness.
British Journal of Psychiatry Study
A study published in the October 2005 British Journal of Psychiatry found that pathological liars likely have mild differences in their brains. Compared to test subjects with certain disorders, pathological liars were discovered to have 26 percent more white matter, a component of the central nervous system comprised mostly of axons that has been linked to lying in previous studies. Ten-year-olds also develop more white matter in the prefrontal cortex just as they become more adept and crafting believable lies. Those with autism, who usually are incapable of lying, have consistently shown to have less white matter, so it is suspected there is a correlation between the amount of white matter and the frequency with which a person will lie. The study also indicated that because pathological lying may be a direct result of brain structure, a treatment may not be possible.
The University of Wisconsin did a summary of various research methods to see what type of research participation would be best to conduct studies on pathological liars. The list included surveys (online, pen-and-paper, telephone), in-depth interviews and observation. It was determined that interactive interviews and multiple data collection methods would help distinguish untruthful responses, both by varying question phrasing and checking authenticity by verifying responses through the varying methods.
Some professionals have suggested therapy sessions and an increase in serotonin through medications and cognitive behavioral therapy. Medical consensus is that some treatments will work on individuals but an end-all treatment has not been discovered.
Pathological liars are generally believed to be individuals who consistently tell an atypical amount of untruths that have little or no relationship to potential consequences arising from being truthful. There is no standard set of criteria from distinguishing a person who lies from a pathological liar.