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Antisocial Personality Disorder反社会型人格障碍

虚构症

Pseudologia Fantastica

作者信息

Kainth Tejasvi, Gunturu Sasidhar

机构信息

BronxCare Health System

ICAHN School of Medicine at Mt. Sinai

PMID:39163430
Abstract

Pseudologia fantastica (PF), commonly known as pathological lying or mythomania, is a psychiatric phenomenon characterized by persistent, pervasive, and often compulsive lying. PF involves the intricate crafting of highly exaggerated narratives across various domains of life, including personal background, accomplishments, and interpersonal connections. Individuals afflicted with PF earnestly subscribe to these fabricated accounts, often perceiving them as genuine truths. Unlike conventional lying, which typically involves 3 key components—consciousness of falsehood, intentional act of conveying misinformation, and a predetermined motive—PF diverges in its presentation and is characterized by a sincere belief in the veracity of the fabricated narratives, rather than a deliberate and calculated attempt to deceive for specific gain or purpose.  PF manifests as an excessive distortion of reality grounded in factual elements, involving prolonged and extensive fabrication of events over extended durations, often spanning years, and lacking predefined objectives. Characterized by the construction of ostensibly credible falsehoods intricately woven into a framework of reality, PF is distinguished by its consistency over time and absence of overt personal gain motives, instead marked by a propensity for exaggeration and a notable lack of control over the fabrication process. The fabrications characteristic of PF stands in contrast to fixed delusions in that individuals afflicted with PF can acknowledge the falsehood of their statements upon confrontation with factual evidence. This differs from false fixed beliefs, known as delusions, wherein individuals persist in their erroneous convictions even when presented with incontrovertible evidence contradicting their beliefs, demonstrating an inability to recognize the falsehood of their assertions.   Since PF was conceptualized in the late 1800s, it has not been recognized as an independent disorder. According to the, 5th ed. (), the condition is considered to be a feature of cluster B personality disorders, including narcissistic, antisocial, and histrionic types, or posttraumatic stress disorder (PTSD). PF has been theorized to stem from low self-esteem. PF is most related to factitious disorder, which was a standalone diagnosis in the  and is classified under "Somatic Symptom and Related Disorders" in , characterized by producing physical or psychological signs or symptoms without external gain or clear reasoning behind them. "Pseudologue" is a term used to refer to an individual who engages in PF, meaning someone who habitually fabricates elaborate and exaggerated stories. The term is derived from the condition itself, where  in Greek means "false or deceptive," and  is derived from the Greek word , meaning "speech or discourse." Therefore, a "pseudologue" is essentially someone who engages in the behavior characteristic of PF. PF has significant forensic implications, particularly in examining a pseudologue's competency to stand trial, as they may deliver false testimony under oath. Currently, PF is not recognized as an official mental illness per the . Having one symptom without a recognized disorder may pose a question in mitigation.  With the existing limited data on PF, efforts to comprehend its prevalence, identify associated risk factors, and assess its impact on individuals and society are imperative. Through clinical recognition and the implementation of suitable management strategies, the adverse repercussions of pathological lying can be alleviated, potentially leading to improved outcomes for those affected by this condition.

摘要

虚构症(PF),通常被称为病理性说谎或谎癖,是一种精神现象,其特征是持续、普遍且往往不由自主地说谎。虚构症涉及在生活的各个领域精心编造高度夸张的故事,包括个人背景、成就和人际关系。患有虚构症的人真诚地相信这些编造的故事,常常将其视为真实的事实。与传统说谎不同,传统说谎通常涉及三个关键要素——意识到虚假、故意传达错误信息的行为以及预定的动机——虚构症在表现形式上有所不同,其特点是真诚地相信编造故事的真实性,而不是为了特定的利益或目的而蓄意欺骗。虚构症表现为基于事实元素对现实的过度扭曲,涉及在很长一段时间内,通常是数年,长时间广泛地编造事件,且缺乏明确的目的。虚构症的特点是构建表面上可信的谎言,并巧妙地融入现实框架,其特点是随着时间的推移保持一致,且没有明显的个人利益动机,而是以夸张的倾向和对编造过程明显缺乏控制为特征。虚构症的编造与固定妄想形成对比,因为患有虚构症的人在面对事实证据时能够承认自己陈述的虚假性。这与被称为妄想的错误固定信念不同,在妄想中,即使面对与他们的信念相矛盾的无可争议的证据,人们仍坚持其错误信念,表明他们无法认识到自己断言的虚假性。自19世纪末虚构症被概念化以来,它一直未被视为一种独立的疾病。根据《精神疾病诊断与统计手册》第5版(),这种情况被认为是B类人格障碍的一个特征,包括自恋型、反社会型和表演型人格障碍,或创伤后应激障碍(PTSD)。虚构症被理论认为源于自卑。虚构症与做作性障碍最为相关,做作性障碍在《精神疾病诊断与统计手册》第4版中是一个独立的诊断,在第5版中被归类在“躯体症状及相关障碍”之下,其特征是在没有外部收益或明确原因的情况下产生身体或心理症状或体征。“虚构者”是一个用来指代患有虚构症的人的术语,意思是习惯性编造详尽且夸张故事的人。这个术语源于这种病症本身,其中希腊语中的“pseudo”意思是“虚假或欺骗性的”,“logos”源于希腊语单词“λόγος”,意思是“言语或论述”。因此,“虚构者”本质上是指从事虚构症特征行为的人。虚构症具有重要的法医意义,特别是在审查虚构者接受审判的能力时,因为他们可能在宣誓后提供虚假证词。目前,根据《精神疾病诊断与统计手册》,虚构症不被视为一种官方认可的精神疾病。仅有一种症状而没有被认可的疾病可能会在减轻处罚方面引发问题。鉴于关于虚构症的现有数据有限,理解其患病率、识别相关风险因素并评估其对个人和社会的影响的努力势在必行。通过临床识别和实施适当的管理策略,可以减轻病理性说谎的不良后果,有可能改善受这种病症影响的人的结局。