Malingering

Malingering Overview, Cause, Symptoms, Treatment, Medication, Test

Malingering is the intentional faking of physical or psychological illness or symptoms in order. These symptoms are faked in order for some reason, such as gaining medication, getting disability payments, or missing work.

Malingering can be manifested in several ways:

• A medical condition is fabricated. When this occurs, the patient claims to have a series of non-existent problems.
• A medical condition or injury that resulted from the incident is exaggerated for financial gain. Examples include months of chiropractic treatment for low back pain, or physical therapy without improvement. This is not to be confused with those patients who have legitimate serious injuries that fail to respond to conservative treatment.
• The accident is staged so that the injury is deliberately caused. Malingerers are usually not willing to produce disease in themselves or undergo extensive painful diagnostic testing, treatment or surgery.
• There is a marked discrepancy between the person's claimed symptoms and the medical or psychiatric findings.
• Displays a lack of cooperation during the physician's evaluation and noncompliance with treatment.
• Antisocial or Borderline Personality.
• Claims to have preposterous symptoms. The individual may consciously and intentionally fake poor responses on neuropsychological tests.

Malingering is intentional production of false or exaggerated symptoms motivated by external incentives, such as obtaining compensation or drugs, avoiding work or military duty, or evading criminal prosecution. Malingering is not considered a mental illness. In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), malingering receives a V code as one of the other conditions that may be a focus of clinical attention.

Malingering behavior typically persists as long as the desired benefit outweighs the inconvenience or distress of seeking medical confirmation of the feigned illness.

Treatment of Malingering

Treatment lies in the clinician being able to detect the disorder. Cues for the clinician include the following: if the patient has legal problems or potential for financial reward; if the patient has Antisocial Personality Disorder; if the patient's story in incongruent with known facts or other informant accounts; if the patient is uncooperative with an evaluation (Morrison, 1995).

Psychological evaluation is also recommended as a way to diagnose malingering, in particular, the Minnesota Multiphasic Personality Inventory (MMPI-2) as this measure has validity scales of value for this purpose. The MMPI-2 is valued for its ability to provide objective and scientifically based information about whether an individual has responded honestly to the test, or whether he or she has attempted to exaggerate or minimize psychological problems, perhaps in order to obtain an external incentive, such as money damages in a personal injury lawsuit.

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Site last updated: March 4, 2008

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