malingering


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Related to malingering: Factitious disorder

Malingering

 

Definition

In the context of medicine, malingering is the act of intentionally feigning or exaggerating physical or psychological symptoms for personal gain.

Description

People may feign physical or psychological illness for any number of reasons. Faked illness can get them out of work, military duty, or criminal prosecution. It can also help them obtain financial compensation through insurance claims, lawsuits, or workers' compensation. Feigned symptoms may also be a way of getting the doctor to prescribe certain drugs.
According to the American Psychiatric Association, patients who malinger are different from people who invent symptoms for sympathy (factitious diseases). Patients who malinger clearly have something tangible to gain. People with factitious diseases appear to have a need to play the "sick" role. They may feign illness for attention or sympathy.
Malingering may take the form of complaints of chronic whiplash pain from automobile accidents. Whiplash claims are controversial. Although some people clearly do suffer from whiplash injury, others may be exaggerating the pain for insurance claims or lawsuits. Some intriguing scientific studies have shown that chronic whiplash pain after automobile accidents is almost nonexistent in Lithuania and Greece. In these countries, the legal systems do not encourage personal injury lawsuits or financial settlements. The psychological symptoms experienced by survivors of disaster (post-traumatic stress disorder) are also faked by malingerers.

Causes and symptoms

People malinger for personal gain. The symptoms may vary. Generally malingerers complain of psychological disorders such as anxiety. They may also complain of chronic pain for which objective tests such as x rays can find no physical cause. Because it is often impossible to determine who is malingering and who is not, it is impossible to know how frequently malingering occurs.

Diagnosis

Malingering may be suspected:
  • When a patient is referred for examination by an attorney
  • When the onset of illness coincides with a large financial incentive, such as a new disability policy
  • When objective medical tests do not confirm the patient's complaints
  • When the patient does not cooperate with the diagnostic work-up or prescribed treatment
  • When the patient has antisocial attitudes and behaviors (antisocial personality).
The diagnosis of malingering is a challenge for doctors. On the one hand, the doctor does not want to overlook a treatable disease. On the other hand, he or she does not want to continue ordering tests and treatments if the symptoms are faked. Malingering is difficult to distinguish from certain legitimate personality disorders, such as factitious diseases or post-traumatic distress syndrome. In legal cases, malingering patients may be referred to a psychiatrist. Psychiatrists use certain written tests to try to determine whether the patient is faking the symptoms.

Treatment

In a sense, malingering cannot be treated because the American Psychiatric Association does not recognize it as a personality disorder. Patients who are purposefully faking symptoms for gain do not want to be cured. Often, the malingering patient fails to report any improvement with treatment, and the doctor may try many treatments without success.

Resources

Organizations

American Psychiatric Association. 1400 K Street NW, Washington DC 20005. (888) 357-7924. http://www.psych.org.

Key terms

Antisocial personality — A personality characterized by attitudes and behaviors at odds with society's customs and moral standards, including illegal acts.
Factitious diseases — Conditions in which symptoms are deliberately manufactured by patients in order to gain attention and sympathy. Patients with factitious diseases do not fake symptoms for obvious financial gain or to evade the legal system.
Post traumatic stress disorder (PTSD) — A disorder that occurs among survivors of severe environmental stress such as a tornado, an airplane crash, or military combat. Symptoms include anxiety, insomnia, flashbacks, and nightmares. Patients with PTSD are unnecessarily vigilant; they may experience survivor guilt, and they sometimes cannot concentrate or experience joy.

malingering

 [mah-ling´ger-ing]
willful, deliberate, and fraudulent feigning or exaggeration of the symptoms of illness or injury to attain a consciously desired end.

ma·lin·ger·ing

(mă-ling'gĕr-ing),
Feigning illness or disability to escape work, excite sympathy, or gain compensation.
[Fr. malingre, poor, weakly]

malingering

/ma·lin·ger·ing/ (mah-ling´ger-ing) willful, fraudulent feigning or exaggeration of the symptoms of illness or injury to attain a consciously desired end.

malingering

[məling′gəring]
Etymology: Fr, malingre, puny, weak
a willful and deliberate feigning of the symptoms of a disease or injury to gain some consciously desired end. malinger, v., malingerer, n.

malingering

The wilful production of symptoms, or the fraudulent simulation of illness or exaggeration of the symptoms of a minor illness or injury, usually for specific external incentives, such as the collection of benefits or to avoid work or school.

Types of malingering
• Anticipation of collecting insurance benefits.
• Malingering with psychological underpinnings, either:
   — Endogenous (e.g., factitious dermatitis); or
   — Exogenous origin (e.g., Munchausen syndrome).

malingering

Occupational medicine The willful production of symptoms for specific external incentives, or the fraudulant simulation of illness or exaggeration of the Sx of a minor illness or injury, usually to avoid work or school. See Factitious disease(s. ). Cf Munchausen syndrome.

ma·lin·ger·ing

(mă-ling'gĕr-ing)
Feigning illness or inability to work resulting from an ulterior motive, such as to collect insurance benefits.
[Fr. malingre, poor, weakly]

malingering

A pretence to be suffering from a disease, or the simulation of signs of disease, so as to gain some supposed advantage such as avoidance of work or of presumed danger, or to obtain money by fraudulent claims for compensation. See also MUNCHAUSEN'S SYNDROME.

malingering

Feigning illness or disability (often for the purpose of gaining compensation or avoiding duty). See optokinetic nystagmus test; tunnel vision.

ma·lin·ger·ing

(mă-ling'gĕr-ing)
Feigning illness or disability to escape work, excite sympathy, or gain compensation.
[Fr. malingre, poor, weakly]

malingering,

n the feigning of illness.
References in periodicals archive ?
The DSM-5 suggests suspicion of malingering for any combination of two or more of the following criteria: (a) medicolegal context suggesting external incentive (e.
Social workers should be concerned about malingering because the appropriate identification and management of it is currently viewed as a critical element in the provision of health and mental health care, two areas in which social work services have a special prominence in the United States (Alonso, 2001).
M-FAST scores of the malingering ([+ or -]) groups is anticipated to be different, in order to test if the M-FAST score is also a valid criterion for malingering in Turkey Malingering ([+ or -]) groups were compared in this respect and nonparametric test was used due to the absence of a normal distribution of M-FAST scores in the malingering (-) group.
Similarly, if previous reports do not consider the effects of medications and mood and do not include tests that address the possibility of malingering, it is likely that an assessment of your client by this neuropsychologist will be open to multiple interpretations.
Some experts say the incidence of malingering is much less common than expected given the amount of attention focused on it in the literature (White & Proctor, 1992).
Unfortunately for trial lawyers, the DSMIV recommends therapists "strongly" suspect malingering whenever two or more the following are present.
This conclusion is supported by the below average Sensitivity to Criticism and Failure score in the clients discharged for anergic non-compliance (Table 3) and by the report of an even lower score of 23 in malingering CMP clients, who appeared insensitive to input from the treatment team or the needs of and impact on others of their continuing disability (Bruno, 1991).
His expertise includes Traumatic Brain Injury, Toxic Exposure, Disability, Workers Compensation, Malingering and Head Injury.
He refines theories presented in his previous two volumes on the topic (The Criminal Lifestyle and Criminal Belief Systems), focusing more on the psychology rather than the criminological-psychological view and describing crime-related constructs such as psychopathy and antisocial personality disorder, assessment of criminal lifestyle, its etiological roots and hierarchical nature, elements of an evidence-based program of intervention, and a program of secondary crime prevention, ending with applications for mental illness and malingering.
In addition, it provides a means for detecting malingering and a percentile rank of the examinee based upon norms from nearly 4,000 men and women spanning the entire age range.
Fortunately, there's a clever solution that can blast your company's performance into the ozone while your competitors are slowly being dragged down by their simpering, malingering, lazy human ballast.
Judge Richard Neely confirms the corporate general counsel's worst nightmare: in courtrooms across the land, bullies in black robes eagerly slam big business with costly suits brought by whining consumers and malingering workers.