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Malingering

Factitious disorder Photo courtesy of Kauvery HospitalOpens in new window

While not a specific mental disorder, malingering is listed amongst the somatic symptom and related disorders. Malingering is a consciously motivated act of fabricating an illness or exaggerating symptoms.

In malingering, a person intentionally fakes a symptom to avoid a responsibility, such as work or military duty, or to achieve some reward, such as an insurance settlement. Feigned symptoms (e.g., back pain, stomach ailments, headache, or toothache) are vague and hard for clinicians to prove or disprove.

Malingering contrasts with factitious disorderOpens in new window, where the sole goal is to adopt the patient role.

Malingering is likely more common in men than in women. It is nearly impossible to determine the prevalence of malingering due to the concealment of its origins. Childhood neglect and abuse are possible causes. A childhood history of frequent illnesses, especially those that result in hospitalization, may also be present in people who develop this disorder. Malingering is associated with antisocialOpens in new window, narcissisticOpens in new window, and borderline personalityOpens in new window disorders.

People who malinger usually have an obvious, recognizable environmental goal, such as drug seeking or financial compensation, that accounts for the stimulation of illness.

Factitious disorderOpens in new window should be considered when no such goal explains the symptom production. Unlike the somatic symptom and factitious disorders, malingering is not considered to be a psychiatric disorder. Treatment is rarely indicated because patients who engage in malingering are not usually motivated to change their behavior.

See also:
  1. Raine, M. (2009). Helping advocates to understand the psychological diagnosis and assessment of malingering. Psychiatry, Psychology, and Law, 16 (2), 322 – 328.
  2. Hagglund, L. (2009). Challenges in ther treatment of factitious disorder: A case study, Archives of Psychiatric Nursing, 23 (1), 58 – 64.
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