Academic Clinical Psychiatry, Division of Genomic Medicine, University of Sheffield, The Longley Centre, Norwood Grange Drive, Sheffield S5 7JT, UK
E-mail: S.A.Spence{at}Sheffield.ac.uk
| INTRODUCTION |
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The answers to all of these questions might depend on the clinical setting envisaged. The significance of a lie about adherence to a treatment will depend on the clinical necessity of that treatment. In the forensic arena, a lie about plans for future conduct might have profound consequences: will the paedophile avoid playgrounds? In psychiatry, neurology, medicolegal practice and perhaps certain other areas of medicine, doctors are called upon to judge the veracity of their patients account (even though this may not be made explicit). Doctors commonly imply veracity in the terms that they use.
Consider the distinction between feigned physical symptoms (malingering) and those ascribed to conversion disorder (hysteria). These diagnoses have very different meanings, yet what objective grounds are there for differentiating between them?1 Notwithstanding the findings of brain imaging experiments,2 it would seem that, phenomenologically, there is little objective evidence that would favour one above the other, and the diagnosis reached may be influenced by circumstantial factors and the physicians opinion of the patients personality or background. Also, the subtle tricks used to elicit hysterical motor inconsistency (e.g. the unintentional movement of the paralysed limb) might just as well be used to indicate deception.1,3 The point is not that these disorders are equivalent, rather that they lack objective differentiation. Yet, when recording these diagnoses, the physician implies whether the patient is to be believed.1
Are doctors especially good at detecting deception? This seems unlikely. When psychologists have studied various groups trying to decide whether others are lying to them, doctors have performed at the level of chance;4,5 with the possible exception of security personnel, it seems to make little difference whether the putative lie detector is a judge, a police officer or a doctor.
However, there is a more subtle aspect to deception that emerges when human behaviour is conceptualized in terms of its higher, executive, control processes. For it would appear that deception behaves as if it is a skillsomething that must be worked at, for which attention is required, and in which fatigue may lead to inconsistency or unintended confession.5
The question of whether lying relies upon higher brain systems is important because such systems may be differentially affected in neuropsychiatric disorders. In the case of some of the most difficult patients with whom psychiatrists interact (such as psychopaths and sex offenders), deception may be a feature of that interaction. A psychopath who is a skilled liar may be demonstrating preserved, or possibly superior, executive brain function. This may have profound implications for our understanding of responsibility and mitigation.
| LEARNING TO LIE |
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[L]iea false statement made with the intention of deceiving...6[D]eceptiona successful or unsuccessful deliberate attempt, without forewarning, to create in another a belief which the communicator considers to be untrue.5
On the evidence of religious texts dating from antiquity, lying and deception have been of concern to humans for millennia.7 However, despite the apparent premium placed upon honesty in ancient and modern life, there is emerging evidence from the disciplines of evolutionary studies,8 child development and developmental psychopathology that the ability to deceive is acquired and, indeed, normal. Such behaviours follow a predictable developmental trajectory in human infants and are impaired among human beings with specific neurodevelopmental disorders, such as autism.9,10 Hence, there seems to be a tension between what is apparently socially undesirable but normal (i.e. lying) and what is socially commendable but pathological (i.e. always telling the truth). Higher organisms have evolved the ability to deceive each other consciously or otherwise,11 while humans, in a social context, are encouraged to refrain from deception. It might be hypothesized that it is precisely because the human organism has such an ability to deceive that it is called upon to exercise control over the potential use of this ability.
| THE BENEFITS OF DECEPTION |
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Lying also eases social interaction, by way of compliments and information management. Precisely truthful communication at all times would be difficult and perhaps rather brutal.5 Deception can sometimes denote consideration for others. Hence, it is unsurprising that the man-in-the-street admits to telling lies most days.5 Social psychological studies, often of college students, suggest that lying facilitates impression management, especially early in a romantic relationship.5
Deception may also be a vital skill in the context of conflictfor instance, between social groups, countries or intelligence agencies. When practised under these circumstances it might even be perceived as a good. However, when a person is branded a liar, any advantage formerly gained may be lost. Though fluent liars might make entertaining companions, to become known as a liar is likely to be disadvantageous in the long run.5
| PRINCIPLES OF EXECUTIVE CONTROL |
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A recurring theme in the psychology of deception is the difficulty of deceiving in high-stake situations: information previously divulged must be remembered, emotions and behaviours controlled, information managed.5 These are quintessentially executive functions. Hence, much of the liars behaviour may be seen, from a cognitive neurobiological perspective, as an exercise in behavioural control, making use of limited cognitive resources. Some examples may serve to illustrate the principles underlying such behavioural control.
| TESTING CONTROL PROCESSES IN THE CLINIC |
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In certain situations, liars betray deception by their bodily movements. While telling complex lies they may make fewer hand and arm movements (illustrators).5 The slow rigid behaviour exhibited by liars has been termed the motivational impairment effect; police officers have been advised to observe witnesses from head to toe rather than concentrating upon their eyes.5
| LYING AS A COGNITIVE PROCESS |
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| IMAGING OF DECEPTION |
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We used a simple computerized protocol in which volunteers answered questions with a yes or a no, pressing specified single computer keys.18 All the questions concerned activities the individuals could have performed on the day they were studied. We had previously acquired information about their activities from each of them when they were first interviewed. However, there was an added feature, in that the volunteers performed these tests in the presence of an investigator who was a stooge, who would be required to judge afterwards whether the responses were truths or lies. The computer screen presenting the questions also carried a green or red prompt (the sequence counterbalanced across subjects). Without the stooge knowing the colour rule, participants registered truth responses in the presence of one colour and lie responses in the presence of the other. All questions were presented twice, once each under each colour condition, so that in the end we were able to compare response times and brain activity during truth and lie responses. We have studied three cohorts outside the scanner (3048 in each7) and one sample of 10 inside the scanner18, performing two variants of this experimental protocol and confirming internal validity. The brain imaging technique applied was functional magnetic resonance imaging (fMRI).
Our analyses revealed that, whether the participants were inside or outside the scanner, response time was about 200 ms longer for lying than for truth-telling. In the scanned sample, lie responses were associated with increased activation in several prefrontal regions, including ventrolateral prefrontal and anterior cingulate cortices. These data support the hypothesis that prefrontal systems exhibit greater activation when the participant is called upon to generate experimental lies and they show that, on average, a longer processing time is required to answer with a lie.
There are considerable limitations to our methodology, not least the artificiality of the experimental setting, the low-stake nature of the lying required, and the fact that most of the volunteers were academics and students. Also, we analyse our data on the basis of groups; there may be considerable inter-subject variation. Overall, there is a need for more ecological studies of deception.
Nevertheless, our finding of increased response time during lying is congruent with a 2001 report of a convicted murderer filmed while lying and telling the truth.20 Although recounting similar material on both occasions, this person exhibited slower speech with longer pauses and more speech disturbance when lying. He also displayed fewer bodily movements.20 Previous meta-analyses of behavioural lying studies have likewise pointed to speech disturbance, increased response latency and a decrease in other motor behaviours in the context of attempted deception.20 Although responses on our computerized tasks were non-verbal, the behavioural and functional anatomical profile may indicate a common process underlying these findings and others18,20namely, an inhibitory mechanism being utilized by those attempting to withhold the truth (a process associated with increased response latency). It is noteworthy that the difference between lying and truth times for all groups in our studies was around 200 ms.7,18 This figure is consistent with behavioural data from investigators using guilty knowledge tasks.21,22.
Other groups using fMRI have similarly found prefrontal cortex to be implicated in deception. Although the foci reported differ in some cases, the principle of preferential engagement by executive brain regions seems to hold, as does the notion that truth comprises a baseline23,24. None of these studies has identified areas of greater activation during truthful responding relative to lying.18,23,24 Recent reports, from conference abstracts, again describe greater activation of prefrontal systems during lying,25 while a unique study of motor evoked potentials points to increased excitability, bilaterally, in motor regions of the brain.26
Taken together, these data seem to support the contention that lying is an executive process, engaging higher brain regions, notably within frontal systems. However, they also seem to imply that truth-telling constitutes a relative baseline in human cognition and communication. The caveat here is that the absence of foci of greater activation during truth-telling may represent a type II error (a false-negative): conceivably, as the sensitivity of imaging techniques increases, more subtle activations may be detected during truthfulness.
| Acknowledgments |
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| REFERENCES |
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D. D. Langleben and F. M. Dattilio Commentary: The Future of Forensic Functional Brain Imaging J Am Acad Psychiatry Law, December 1, 2008; 36(4): 502 - 504. [Abstract] [Full Text] [PDF] |
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N. Abe, M. Suzuki, T. Tsukiura, E. Mori, K. Yamaguchi, M. Itoh, and T. Fujii Dissociable Roles of Prefrontal and Anterior Cingulate Cortices in Deception Cereb Cortex, February 1, 2006; 16(2): 192 - 199. [Abstract] [Full Text] [PDF] |
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