Prefrontal White Matter in Pathological Liarsy Scanning Revealed Major Atrophy of the Right Superior Temporal Gyrus (Raine Et Aletal,, 2000)

BRITISH JOURNAL OF PSYCHIATRY (2005), 187, 320^325

Prefrontal white matter in pathological liarsy scanning revealed major atrophy of the right superior temporal gyrus (Raine et aletal,, 2000). Full demographic, cognitive and YALING YANG, ADRIAN RAINE, TODD LENCZ, SUSAN BIHRLE, physical characteristics of the three groups LORI LACASSE and PATRICK COLLETTI of participants are shown in Table 1. Full informed, written consent was obtained from all participants in accordance with institutional review board procedures at the University of Southern California.

Assessment of lying Participants were defined as ‘liars’ if they Background Studies have shown Despite many clinical and psychological fulfilled:fulfilled: increased bilateral activationinactivation inthe the studies on lying and deception (Rogers, 1997; McCann, 1998), and although it (a) criteria for pathological lying on the prefrontal cortex when normal individuals has been hypothesised that there is a neuro- Psychopathy Checklist – Revised (PCL– lie, butthere have been no structural biological basis to lying, cheating and R; Hare, 1991); or imaging studies of deceitful individuals. manipulative behaviour (Ford et aletal, 1988),,1988), (b) criteria for conning/manipulative behav- this hypothesis has not been tested. Several iour on the PCL–R; or Aims Toassess whether deceitful functional magnetic resonance imaging (c) the deceitfulness criterion for DSM–IV individuals show structural abnormalities (fMRI) studies on normal individuals who (American Psychiatric Association, lie or feign memory impairments have in prefrontal grey and white matter 1994) antisocial personality disorder found increased bilateral activation in the volume. (lifelong repeated lying, use of aliases prefrontal cortex during lying (Spence etet or conning others for personal profit MethodMethod Prefrontal grey and white alal, 2001; Lee et aletal, 2002; Ganis et aletal,, or pleasure); or 2003). To provide initial empirical data matter volumes were assessed using on the structural brain imaging correlates (d) criteria for malingering as indicated by structural magnetic resonance imaging in of lying and deception, we assessed the admitting to telling lies to obtain sickness benefits in a self-report crime 12 individuals who pathologicallylie, cheat volume of prefrontal grey and white matter interview (see below). and deceive (‘liars’),16 antisocial controls in individuals who lie, cheat or deceive to and 21normal controls. test the hypothesis that such individuals The term ‘liars’ is intended as a short-hand have an abnormality within the prefrontal specifically to denote the above four symp- ResultsResults Liars showed a 22^26% cortex. We used a symptom-based toms. A symptom-based orientation was increase in prefrontal white matter and a approach (Halligan & David, 2001) to employed because it has a number of signif- define a group of liars and investigated icant advantages over a more traditional 36^42% reduction in prefrontal grey/ the neurobiological correlates of lying that syndromal approach (Bentall et aletal, 1988;,1988; white ratios compared with both antisocial are not shared by either an antisocial Costello, 1992; Halligan & David, 2001), controls and normal controls. control group or a normal control group. especially in this particular field, which lacks diagnostic boundaries. Conclusions These findings provide Normal controls (nn¼21) were selected the first evidence of a structural brain METHOD from the remaining pool on the basis that deficitinliars, theyimplicatetheprefrontaltheyimplicatethe prefrontal they fulfilled none of the four criteria for Participants lying. They also failed to meet criteria for cortex as animportant (butnot sole) All participants were taken from a total either DSM–IV antisocial personality dis- componentincomponent in the neural circuitry sample of 108 community volunteers order or DSM–IV conduct disorder, and underlying lying and provide an initial drawn from five temporary employment were matched as closely as possible to the neurobiological correlate of a deceitful agencies in Los Angeles (Raine et aletal,, 12 liars with respect to gender and personality.personality. 2000). Groups consisted of 12 participants ethnicity.ethnicity. (11 male, 1 female) with a history of lying Because the liar group was significantly Declaration of interest None. (‘liars’), 21 normal controls (15 male, 6 antisocial, any structural brain differences Funding detailed in Acknowledgements. female) who had neither antisocial person- could be an artefact of antisocial personal- ality disorder nor a history of pathological ity, which has been associated with an lying and 16 antisocial controls (15 male, 11% reduction in prefrontal grey matter 1 female) with antisocial personality dis- in this group (Raine et aletal, 2000). Conse- order but no history of pathological lying. quently, an antisocial control group Exclusion criteria were: age under 21 or ((nn¼16) was formed by matching liars with over 45 years, non-fluency in English, a individuals who did not fulfil criteria for history of epilepsy, claustrophobia, a pace- lying, but who scored as highly as liars on maker and metal implants. One individual DSM–IV measures of antisocial personality ySee invited commentary,pp. 326^327, thisissue. was excluded a prioriapriori because brain disorder and conduct disorder.

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Ta b l e 1 Demographic, cognitive and physical, and diagnostic characteristics of the study groups11

CharacteristicNormal controls Antisocial controls LiarsLiars StatisticsStatistics Group ((nn=21) ((nn=16)=16) ((nn¼12) comparisons

Demographic Age, years: mean (s.d.) 31.4 (6.9)29.5 (5.5) 36.5 (5.3)(5.3)36.5 FF (2,46)(2,46)¼4.6,4.6, PP¼0.01NC, AC55LL Socio-economic status: mean (s.d.) 38.8 (10.2) 34.3 (9.2)(9.2)34.3 35.7 (9.1)(9.1)35.7 FF (2,45)(2,45)¼1.0, PP¼0.36 Gender (male/female) 15/6 15/1 11/1 ww22¼4.0, d.f.d.f.4.0, ¼2, PP¼0.130.13 Ethnicity, % White 66.7 31.3 33.3 ww22¼5.7, d.f.¼2, PP¼0.056AC 55NC Cognitive and physical Handedness: mean (s.d.) 33.3 (10.8) 33.9 (10.2)(10.2)33.9 31.8 (13.0) FF (2,46)(2,46)¼0.12, PP¼0.88 Total IQ: mean (s.d.) 106.6 (14.3)94.2 (11.3) 101.0 (20.1)(20.1)101.0 FF (2,45)(2,45)¼3.0,3.0, PP¼0.056AC 55NC Verbal IQ minus performance IQ: mean (s.d.) 775.9 (15.8) 772.8 (15.3) 11.2 (22.8)(22.8)11.2 FF (2,45)(2,45)¼3.6, PP¼0.036NC, AC55LL Head circumference, inches: mean (s.d.)56.4 (2.15) 57.0 (1.95)(1.95)57.0 57.8 (1.26)(1.26)57.8 FF (2,46)(2,46)¼2.1, PP¼0.12 Period of unconsciousness, min: mean (s.d.)363.44 (1439.1) 68.2 (257.5)(257.5)68.2 9.18 (29.8)(29.8)9.18 FF (2,46)(2,46)¼0.63,0.63, PP¼0.54 Hospitalised head trauma, % present 33.3 56.3 50.050.0 ww22¼2.0, d.f.¼2, PP¼0.08 DiagnosticDiagnostic Total psychopathy score: mean (s.d.)10.7 (5.3)17.8 (4.0)21.1 (7.7) FF (2,46)(2,46)¼14.8,14.8, PP¼0.00010.0001NC 55AC, LLAC, Total APD score: mean (s.d.) 1.4 (2.2)(2.2)1.4 5.6 (2.3)6.2 (3.7) FF (2,46)(2,46)¼17.0,17.0, PP¼0.00010.0001NC 55AC, LLAC, APD diagnosis, % 020 2552525 ww22¼6.1, d.f.d.f.6.1, ¼2, PP¼0.0470.047NC 55AC, LLAC, Conduct disorder, %037.5 0 37.533.3 ww22¼9.5, d.f.d.f.9.5, ¼2,2, PP¼0.009NC 55AC, LLAC, Alcohol dependence/misuse, % present 38.1 56.356.3 58.358.3 ww22¼1.8, d.f.d.f.1.8, ¼2,2, PP¼0.460.46 Drug dependence/misuse, % present 40.0 43.8 58.3 ww22¼1.1, d.f.¼2,2, PP¼0.590.59 Alcohol/drug dependence/misuse, % present47.6 62.5 66.7 ww22¼1.4, d.f.¼2, PP¼0.49

APD, antisocial personality disorder; NC, normal controls; AC, antisocial controls; L, liars. 1. All group comparisons are two-tailed, PP550.05.0.05.

All clinical ratings and diagnoses were malingering (telling lies to obtain sickness minority ethnic groups than normal performed by clinical PhD graduate re- benefits) was self-reportedself-reported on the adult controls.controls. search assistants who had both been trained extension of the National Youth Survey and supervised by A.R. and also had under- self-report delinquency measure. Demographic, cognitive gone a standardised training and quality Comparisons of the study groups are and physical measures assurance programme for diagnostic assess- given in Table 1. The two antisocial groups Estimated IQ was based on five sub-tests ment (Ventura et aletal, 1998). Pathological did not differ with respect to rates of anti- (vocabulary, arithmetic, digit span, digit lying and conning/manipulative character- social personality disorder and conduct dis- symbol, block design) of the Wechsler istics were assessed using the PCL–R, which order, but rates for both were significantly Adult Intelligence Scale – Revised (WAIS–R; was supplemented by five sources of collat- higher than for normal controls. The same Wechsler, 1981), with verbal–performance eral data (Raine et aletal, 2000). These were pattern was observed for total psychopathy discrepancy scores computed by subtract- the Interpersonal Measure of Psychopathy scores and total antisocial personality ing performance IQ from verbal IQ. Right (IM–P; Kosson et aletal, 1997), which provides scores (the latter created by summing SCID v.v. left hand preference was assessed using an interviewer’s ratings of the participant’s scores on the seven features of antisocial the abbreviated Oldfield Inventory (Bryden, interpersonal behaviours and which has personality disorder). All three groups did 1977), with high scores indicating a been validated for use with incarcerated not differ significantly with respect to social stronger preference for right-handedness. and non-incarcerated samples; self-reported class, ethnicity, IQ, handedness, history of History of head injury was defined as head crime as assessed by an adult extension head injury, height, head circumference trauma resulting in hospitalisation and the (Raine(Raine et aletal, 2000) of the National Youth and DSM–IV diagnoses of alcohol/drug amount of time (in minutes) the subject Survey self-report delinquency measure misuse/dependence. However, groups dif- was rendered unconscious from any head (Elliott(Elliott et aletal, 1983); official criminal re- fered significantly with respect to age, with injury. Social class was measured using cords; data derived from, and behavioural a higher mean age in the liar group than the Hollingshead classification system observations made during, the Structured both control groups. Liars also had signifi- (Hollingshead, 1975). A physical examin- Clinical Interview for DSM–IV Mental Dis- cantly higher verbal relative to performance ation was conducted to derive measures of orders (SCID–I; First et aletal, 1995,1995aa) and thethe)and IQ compared with both control groups. height and head circumference. Structured Clinical Interview for DSM–IV There were also trends for group differ- Axis II Personality Disorders (SCID–II; ences in ethnicity (PP¼0.056) and total IQ FirstFirst et aletal, 1995,1995bb). The deceitfulness trait ((PP¼0.056), with antisocial controls tending Magnetic resonance imaging of antisocial personality disorder was to have lower total IQ and a greater repre- Structural MRI was conducted on a Philips ascertained using the SCID–II, whereas sentation of individuals from Black and S15/ACS scanner (Selton, Connecticut, USA)

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with a magnet of 1.5 Tesla field strength. Colliculi were excluded when no longer prefrontal white matter volume than both Following an initial alignment sequence of attached to the cerebral hemispheres. For antisocial controls (tt¼3.1, d.f.3.1,d.f.¼26,26, one midsagittal and four parasagittal scans volume measures, areas on each slice PP¼0.004) and normal controls (tt¼2.7,2.7, 22 (spin-echo T11-weighted image acquisition, (mm(mm ) were multiplied by slice thickness d.f.d.f.¼31,31, PP¼0.01). Liars had a 25.7% time to repetition¼600 ms, echo time¼ (1.7 mm) and added to provide volumes in increase (13.3 cm33) in prefrontal white 20 ms) to identify the anterior commissure/ cubic centimetres.centimetres. Interrater reliability matter compared with antisocial controls posterior commissure (AC/PC) plane, 128 (intraclass correlation coefficient) based and a 22.2% increase (11.8 cm33) compared)compared

three-dimensional T11-weighted gradient- on 23 scans (raters unaware of each other’s with normal controls (Fig. 1). For grey echo coronal images (time to repetition ratings and group membership) were as matter, liars had non-significantly reduced ¼34 ms, echo time¼12.4 ms, flip angle¼ follows: total brain volume (0.99), left pre- volumes compared with normal controls 353588, thickness,thickness¼1.7 mm, 25666256 matrix, frontal grey (0.99), right prefrontal grey ((tt¼2.1, d.f.2.1,d.f.¼31,31, PP¼0.04) but not compared field of view¼23 cm) were taken in the (0.99), left prefrontal white (0.93), right with antisocial controls (tt¼0.79, d.f.0.79,d.f.¼26,26, plane directly orthogonal to the AC/PC prefrontal white (0.94) and total brain PP¼0.430.43;; Fig. 1). Liars had a 14.2% line.line. volume (0.99). Volumes of grey and white decrease (10.5 cm33) in prefrontal grey Brain images were reconstructed in matter were calculated separately for each matter compared with normal controls. three dimensions using a SPARC worksta- hemisphere and a grey/white ratio was No groupNogroup66hemisphere interaction for tiontionandand semi-automated CAMRA S200 calculated for each hemisphere, with lower grey/white volumes was found (FF(2,46)(2,46)¼ ALLEGRO software (Sun Microsystems scores indicating increased white matter 0.848,0.848, PP440.43). Antisocial control and Inc., Santa Clara, California, USA) was used compared with grey. normal control groups did not differ from forforgrey/white cerebrospinal fluid segmen- each other in either grey (tt¼0.39, d.f.0.39,d.f.¼35,35, tation. The prefrontal region was defined RESULTSRESULTS PP¼0.23) or white matter volumes (tt¼0.39,0.39, as all cortex anterior to the genu of the d.f.d.f.¼35,35, PP¼0.69).0.69). corpus callosum, and divided into left and Magnetic resonance imaging right hemispheres along the longitudinal prefrontal volumes Prefrontal grey/white ratio fissure (Raine et aletal, 2000). Segmentation Liars showed a significant increase in pre- Liars had relatively more prefrontal white of grey and white matter was performed frontal white matter and slightly reduced than grey matter. A multiple analysis of using a thresholding algorithm, with the grey matter. A 3 (groups)662 (left/right variance (MANOVA) on grey/white ratios operator unaware of group membership, hemisphere)662 (grey/white) repeated- showed a significant main effect for group and applying a cut-off value to the signal measures analysis of variance (ANOVA) ((FF(2,46)(2,46)¼10.25,10.25, PP¼0.0001,0.0001, Z22¼0.308).0.308). intensity histogram to optimally differen- using the multivariate procedure showed Liars had lower prefrontal grey/white ratios tiate white from grey matter, areas of which no main effect for group (FF(2,46)(2,46)¼0.729,0.729, (mean(mean¼1.15, s.d.1.15,s.d.¼0.21) than antisocial were defined using an automated seeding PP¼0.488) but a significant group66 controls (mean¼1.56, s.d.1.56,s.d.¼0.38,0.38, tt¼3.6,3.6, algorithm on each slice. Whole brain grey/white interaction (FF(2,46)(2,46)¼9.049,9.049, PP¼0.001) or normal controls (mean¼1.63,1.63, volume was defined as all cerebral cortex, PP¼0.0001,0.0001, Z22¼0.282). To break down this s.d.s.d.¼0.27,0.27, tt¼5.3,5.3, PP¼0.0001). Liars had a excluding the ventricles, pons and cerebel- interaction, separate analyses were run for 35.7% decrease (0.41) in prefrontal grey/ lum. The pons was excluded by drawing a grey and white matter using a Bonferroni white ratio compared with antisocial straight line between the two innermost correction (aa¼0.017) for pairwise com- controls and a 41.7% decrease (0.48) points that form the superior border. parisons. Liars had significantly greater compared with normal controls (Fig. 2).

Correction for whole brain volumes It could be argued that group differences in prefrontal volume were an artefact of group differences in whole brain volume. Conse- quently, the above analyses on prefrontal grey and white matter were repeated using whole-brain corrected volumes. The same results were found. A repeated-measures ANOVA showed no main effect for group ((FF(2,46)(2,46)¼0.971,0.971, PP¼0.386) and no group66 hemisphere interaction (FF(2,46)(2,46)¼0.966,0.966, PP¼0.388) but did show a significant groupgroup66grey/white interaction (FF(2,46)(2,46)¼ 9.333,9.333, PP¼0.0001,0.0001, Z22¼0.289). A one-way ANOVA on whole-brain corrected grey/ white ratios again showed a significant group effect (FF(2,46)(2,46)¼10.34,10.34, PP¼0.0001).0.0001). A one-way ANOVA on whole-brain Fig.1Fig.1 Prefrontal grey and white matter volumes in liars (&&), normal controls (&&) and antisocial controls ( ). corrected grey matter was non-significant

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lie, cheat and manipulate others. Liars had converse pattern of grey/white ratios to that increased prefrontal white matter volumes shown by the liar group. When 2- to 3-year- and reduced grey/white ratios compared old children with autism reach 9.5–11 years with normal controls. The effect size was of age, their white matter increases only substantial, with group membership ex- 13% compared with 45% in normal chil- plaining 28.2% of the variance in prefron- dren (Carper et aletal, 2002). Similarly, tal volume. Furthermore, liars were found Courchesne et aletal (2001) found only a to have these same differences compared 10% white matter increase in children with with the antisocial control group. The in- autism compared with a 59% increase in clusion of an antisocial control group is normal children from 2–3 years of age to viewed as a significant strength since this 12–16 years, and an increased cortical Fig. 22Fig. Prefrontal grey/white matter ratio in liars is rarely included in imaging studies. In grey/white ratio in children with autism ((&&), normal controls (&&) and antisocial controls addition, the use of a symptom-based compared with normal controls (i.e. the (( ).). approach is felt to be an initial first step reverse of liars). Although autism is a in delineating a neurobiological basis of complex condition, these results on chil- ((FF(2,46)(2,46)¼1.73,1.73, PP¼0.18) but a one-tailed deception (Halligan & David, 2001). Be- dren with autism, combined with the test on the previously significant reduction cause lying has been argued to be asso- previous fMRI findings on lying in normal in liars compared with normal controls ciated not just with antisocial personality controls and our current findings on adult was marginally significant (PP¼0.031).0.031). but also with several other personality dis- liars, suggest that the prefrontal cortex is When prefrontal white matter was orders (Ford et aletal, 1988), the results of centrally involved in the capacity to lie. expressed as a function of whole brain the present study may also have wider Why should increased white matter pre- volume, groups again differed significantly psychiatric applicability. dispose to a deceitful personality? Although ((FF(2,46)(2,46)¼8.031,8.031, PP¼0.001). Liars had The result could not be attributed to a complete explanation inevitably requires significantly higher prefrontal white/whole group differences in age, ethnicity, IQ, head more extensive investigation, an initial brain ratios (mean¼0.069, s.d.¼0.011)0.011) injury or substance misuse/dependence. working hypothesis is that increased pre- compared with both antisocial controls Furthermore, group differences remained frontal white matter developmentally pro- (mean(mean¼0.054, s.d.s.d.0.054, ¼0.011,0.011, tt¼3.4,3.4, PP¼0.002)0.002) after a strict control for antisocial personal- vides the individual with the cognitive and normal controls (mean¼0.054,0.054, ity disorder, psychopathy and conduct dis- capacity to lie. From an evolutionary s.d.s.d.¼0.010,0.010, tt¼3.7,3.7, PP¼0.001).0.001). order, again indicating specificity to lying perspective, it is known that deception in in particular rather than antisocial behav- primates is correlated with degree of neo- Potential demographic, cognitive iour in general. Consistent with prior re- cortical expansion (Byrne & Corp, 2004). and antisocial confounding search on pathological liars (Ford et aletal,, From a neurodevelopmental perspective, variablesvariables 1988), liars had significantly higher verbal brain weight reaches adult values between Groups differed significantly with respect relative to performance IQ scores than both the ages of 10 and 12 years, with a very sig- to age, verbal–performance IQ discrepancy control groups, but higher verbal scores nificant increase in the absolute volume of scores, psychopathy, antisocial personality could not account for group differences in white matter (Paus et aletal, 2001) that exceeds disorder and conduct disorder, and also prefrontal white matter. The results further the developmental reduction in grey matter showed trends for differences with respect implicate the prefrontal cortex as an (Sowell(Sowell et aletal, 2002). Psychosocial behav- to ethnicity and full-scale IQ. To rule out important (but not sole) component in the ioural research also indicates that while the effect of age, psychopathy and anti- neural circuitry underlying lying, and pro- young children are poor liars, by 10 years social personality disorder, these measures vide an initial neurobiological correlate of of age they become much more adept at were included as covariates in repeated- a deceitful personality. lying (McCann, 1998). Consequently, the measures ANOVA. The grey/white matter neurodevelopmental increase in white 66group interaction remained significantsignificant matter parallels developmental changes in after correcting for age (FF(2,45)¼5.76,5.76, Neurodevelopmental theory the ability to lie. It is conceivable therefore PP¼0.006), ethnicity (FF(2,45)(2,45)¼8.046,8.046, PP¼ of pathological lying that the increased prefrontal white matter 0.001), verbal–performance IQ discrepancy The most significant finding of this study is found in adult liars predisposes to lying. scores (scores(FF(2,45)(2,45)¼6.605,6.605, PP¼0.003), full-scale the increase of prefrontal white matter and The relative reduction in prefrontal grey IQ (IQ(FF(2,45)(2,45)¼9.503,9.503, PP¼0.0001), psycho- decrease in grey/white ratio in the liar matter relative to white may also predis- pathy (pathy(FF(2,45)(2,45)¼4.826,4.826, PP¼0.01), antisocial group. Compared with normal controls, pose to a general antisocial disinhibited ten- personality disorder (FF(2,45)(2,45)¼7.421,7.421, PP¼ the liar group had a 22.2% increase in pre- dency which, coupled with increased white 0.002) and conduct disorder (FF(2,45)(2,45)¼ frontal white matter and a 41.7% decrease matter, results in excessive lying. 7.372,7.372, PP¼0.002).0.002). in grey/white ratio, and compared with antisocial controls they showed a 25.7% DISCUSSION white matter increase and a 35.7% Clinical conceptualisation decrease in prefrontal grey/white ratio. of malingering Prefrontal component Children with autism are less capable of The results may have implications for re- of lying circuitry lying than normal children (Sodian & Firth, search on the clinical concept of malinger- To our knowledge, this study is the first to 1992) and, intriguingly, brain neuro- ing (i.e feigning illness to obtain benefits). show a brain abnormality in people who developmental studies of autism show the While biomedical models of malingering

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have been put forward and debated (Halli- gangan et aletal, 2003), there appear to be no stu- CLINICAL IMPLICATIONS dies of the biological characteristics (Raine, 20032003).). Of the 12 liars in this study, 6 would && Pathological lying is associated with changes in the prefrontal cortex.This also has be classified as malingerers in that they implications for psychopathy and antisocial personality disorder. admitted to telling lies to obtain sickness benefits. Comparison of these malingerers && The possibility of a clinical conceptualisation of malingering is raised. with others in the liar group confirms that && We propose a neurodevelopmental theory of pathological lying that also helps they too are characterised by both relatively increased prefrontal white matter (66.0 cm33 explain the onset of proficient lying in children. vv. 64.3 cmcm.64.3 33 in malingering and non- LIMITATIONS malingering liars, respectively) and a reduced prefrontal grey/white ratio (1.09 && TheThesamplesizewasmodest. sample size was modest. v.v. 1.21). Malingering is not currently viewed as a clinical disorder but is && Few females were assessed. included in DSM–IV (American Psychiatric && We may have underestimated the extent of prefrontal abnormalities in Association, 1994) as a ‘V’ code to mark it pathological liars because we did not screen the normal control group for moderate as a condition requiring further attention. If the current findings can be replicated levels of lying. and extended to other populations of malingerers, this could have implications for a more clinical conceptualisation of malingering. YALING YANG, BS, ADRIAN RAINE, DPhil, Department of Psychology,University of Southern California; TODD LENCZ, PhD,Department of Research, Hillside Hospital (North Shore^Long Island Jewish Health Symptom-based, neurobiological System); SUSAN BIHRLE, PhD,LORI LACASSE, BA, Department of Psychology,University of Southern approach to lying California; PATRICKCOLLETTI,PATRICK COLLETTI, MD,DepartmentMD, Department of Radiology,University of Southern California School of Several neuroscience paradigms are begin- Medicine, USA ning to converge on an initial answer to CorrespCorrespondence:ondence: DrYalingYang,DepartmentDrYalingYang, Department of Psychology,University of Southern California,LosCalifornia, Los the elusive question of what is the neuro- Angeles,CA 90089^1061,USA.Tel: +1213720 2220; fax: +1213740 0897; e-mail: yalingy@@usc.edu biological basis to lying. Prior research on normal controls who lie has attempted to (First received 5 January 2004, final revision 9 November 2004, accepted 17 November 2004) identify psychophysiological correlates of lying (Patrick & Iacono, 1991). More re- cent fMRI research has identified prefrontal grants to Y.Y. from the National Institute of Mental allocating more research time to the study of symptoms. activation as a correlate of lying in normal Health (Research Scientist Development Award British Journal of Psychiatry,, 160160, 304^308. controls. We have reversed the usual re- K02 MH01114^01, Independent Scientist Award Courchesne, E., Karns, C. M., Davis, H. R., et al search paradigm by using a symptom-based K02 MH01114^01 and 5 RO3 MH50940^02) and (2001) Unusual brain growth patterns in early life in approach to address the question of what from the Wacker Foundation. patients with autistic disorder. An MRI study. 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