What is Malingering?

Prof: Schlossberg

Forensic Psychology

Malingering

Works Cited

Law and psychiatry, Journal of psychiatric Practice, William H. Read, M.D., MPH July 2000.

Psychology Today, Malingering Laura Stephens April, 2006.

http://www.psychologytoday.com/conditions/malingering.html

Some of us fake head aches in order to get a little peace and quiet or to be taken care of. There are others that fake a sickness in order to keep them from going to work. Others take it too the extreme and fake symptoms to get a medical diagnostic in order to achieve their main goal which in that case would be a drug prescription. This is called Malingering.

Malingering is best described as the purposeful exaggeration of physical or psychological complaints with the goal of receiving a reward. These may include money, insurance settlement, drugs or the avoidance of punishment, work, jury duty, the military or some other kind of service. A malingerer may respond to items in a certain manner to attain relief from incarceration.

For example in the case of Ganser syndrome which is when a person reconstructs their answers to fake psychosis such as a serial killer in a killing spree gets caught and then tries to plead he or she is insane. Although, they planned exactly how everyone they murdered was going to die. Serial killers don't want to get caught they get to the point of almost being caught this excites them then to later escape from the scene. This is why in order to avoid incarceration they plead insanity to avoid a harsh punishment for their crimes committed.

Furthermore, Malingering can lead to abuse of the medical system, with unnecessary tests being performed and time being wasted by the clinician as opposed to those with legitimate health problems. A malingerer may attempt to raise the temperature of a thermometer through heat from a lamplight or alter a urine sample by adding sand to it; however, if the malingerer is more discreet, the clinician will have great difficulty gathering evidence for an accurate diagnosis.

According to psychology today Malingering can exist in a variety of intensities, from pure (in which all symptoms are falsified) to partial, in which symptoms are exaggerated. A patient may simulate symptoms of a specific disorder or deny the existence of the problem that may explain the symptoms. Malingering is not easy to diagnose because of the difficulty in gathering overt evidence; also, symptoms are emotional and mental.

Malingering should not be confused with factitious disorder (in which motive is the desire to occupy a sick role, rather than some form of material gain) and somatoform disorders (in which symptoms are not produced willfully), and it's outside of conscious control (involuntary) though misdiagnosis is bound to occur.

According to a diagnosis by (William H. Reid, M.D., MPH) some of the people that may acquire malingering symptoms are people trying to avoid responsibility or punishment for something, such as criminal behavior. According to Dr. Reid these types of people generally feign psychosis. Symptoms of dementia may also be faked by criminal defendants; who often limit such complaints of "amnesia" or "memory blackouts".

Another type of individual who malingers would be a person who is feigning disability or damage in order to get money or something valuable from the government, insurance company or lawsuit often fake symptoms of brain damage but sometimes allege or exaggerate anxiety or psychotic symptoms.

Dr. Read also states that people trying to get drugs do not want to appear as they have a psychological problem or that they are demented but rather feign these symptoms in order to get narcotics.

Now the question that one proposes themselves is how can one tell the difference between an individual who is feigning their disability from that other who is telling the truth? According to Dr. Reid on can't usually tell by interviewing. He states that "liars don't reliably fidget or blink more or avoid eye contact or use fewer details in their explanations. And when someone does exhibit one or more of those behaviors there are many possible explanations besides malingering."

In order to detect malingering one has to see what is the possible advantage that the individual being suspected of malingering might have. Even if the possible advantages do not seem visible is their a suggestion? For example; the patient wants to be diagnosed and treated to avoid arrest or to avoid responsibility for something? There are also three main tests there are used by a psychologist to determine malingering

Computerized Assessment of Response Bias (CARB)Minnesota Multiphasic Personality Inventory (MMPI)the Test of Memory Malingering (TOMM)

The following tests, also used by other subspecialties of psychology, have found recent application in the identification of malingerers in the clinical setting:

California Verbal Learning Test (CVLT) Functional Capacity Evaluations Millon Clinical Multiaxial Inventory (MCMI)Portland Digit Recognition Test (PDRT)Rey-15 Item Memory TestStroop testWechsler Memory Scale (WMS)Wisconsin Card Sorting Test (WCST)Word Memory Test (WMT)Wechsler Adult Intelligence Scale (WAIS)

Treatment lies if the clinician is able to detect the disorder Cues for the clinician include: If the patient has legal problems, potential for financial reward, antisocial personality disorder; if the patient's story is incongruent with known facts or other informant accounts; if the patient will not cooperate while being evaluated.

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 provides objective, scientifically based information about whether an individual has responded honestly to the test, or whether he or she has exaggerated or minimized psychological problems (possibly to obtain an external incentive, such as money damages in a personal injury lawsuit).

In conclusion, Malingering is a medical and psychological term that refers to an individual faking the symptoms of mental or physical disorders for a number of reasons such as fraud, dereliction of responsibilities, response to (attempt to lessen) external stress factors, or attempting to obtain medications or to lighten criminal sentences. Because malingerers are usually seeking some sort of primary or secondary gain, this disorder remains separate of Somatization disorders and factitious disorder in which the gain is not obvious.