Expert Answer:

Dear Judi,

Let me try to answer each of your questions as best I can. First, people lie for all sorts of reasons -- in fact, we all lie at least a little and sometimes out of good intentions, like sparing other people's feelings. Obviously I've never evaluated your grandson so I don't really have any sense of what his particular situation is. Because of this, I want to be clear that what I'm going to talk about next is likely not applicable to his case. However, I was struck by something you said: namely, that his father was also a "liar.".This worries me a little.

There is a type of extreme lying that does indeed appear to have a strong genetic component. Officially known as "pseudologia fantastica," this condition is characterized by a chronic tendency to spin out outrageous lies, even when no clear benefit to the lying is apparent. Often people with this affliction seem unable to even recognize that they are lying, and they seem blind to where truth ends and falsehood starts. Probably the greatest portrayal of this in literature is Willie Loman in the play "Death of a Salesman" by Arthur Miller.

This type of extreme lying does often start at a fairly early age and can be a lifelong tendency and serious problem. And often it doesn't exist in isolation, but is part of a larger pattern of chronic symptoms that clinicians refer to as "sociopathy." These symptoms include a tendency toward criminal behavior, an inability to control one's impulses and/or make future plans, explosive anger and tendency toward physical violence, a reckless disregard for the safety of self or others, a pattern of irresponsible behavior and -- probably most important -- an inability to understand and/or respect the rights of other people.

People with antisocial personality often start life as hyperactive kids who bully others, who lie, who are constantly in trouble with authorities and get into drugs and alcohol by their teen years, and who often display striking cruelty to animals. If any of what I've been saying sounds a lot like your grandson's father, then you may have reason to worry about your grandson. I say this because many studies have shown that antisocial behavior is highly genetic. For example, studies have shown that the children of criminals in prison have much higher rates of developing antisocial personality than the average population, even if they are adopted into "good" families and have never met their imprisoned parents.

Having said this, however, it is also clear that the best protection one can give a child who is genetically at risk for antisocial personality disorder is a consistent, firm, but loving family environment growing up. Studies show that genetically at-risk children are much more likely to become sociopaths as adults if they are raised in abusive or neglectful homes, or are subject to severe physical punishment for their wrongdoing.

What about treatment? Unfortunately, no one has ever discovered a medication or type of psychotherapy that consistently works for adults with antisocial personality -- a fact that contributes greatly to the tragedy of the disorder, both for the sufferer and -- even more unfortunately -- for family members and others that are often damaged in one way or another by the person. This fact really highlights how important it is to intervene early in the lives of young people who are clearly heading in this very bad direction.

This disorder is characterized by a longstanding pattern of disregard for other people's rights, often crossing the line and violating those rights. This pattern of behavior has occurred since age 15 (although only adults 18 years or older can be diagnosed with this disorder) and is marked by the presence of the majority of these symptoms:

• failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest;

• deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure;

• impulsivity or failure to plan ahead;

• irritability and aggressiveness, as indicated by repeated physical fights or assaults;

• reckless disregard for safety of self or others;

• consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations;

• lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.