At the most basic level malingering is faking an illness or exaggerating one, often to escape consequences or to gain benefit. Malingering can occur when an individual does not wish to return to work after an injury, when they have committed a crime and hope to escape punishment or when they hope to get some kind of advantage or perk by appearing to be injured or disabled.
According to the American Board of Clinical Neuropsychology, about 30% of the disability evaluations conducted in a year by members included malingering; 19% of evaluations related to criminal charges were determined to be malingering in the same time period.
Malingering is an actual condition in the DSM-IV and is described as the “”intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives such as avoiding military duty, avoiding work, obtaining financial compensation, evading criminal prosecution, or obtaining drugs.”
According to the Psychiatric Times, malingering assessments should be conducted by mental health professionals and should include a review of symptoms for unusual or exaggerated symptoms, non-compliance with treatment, complaints of delusions or hallucinations that are not consistent with recognized forms of psychosis and symptoms that are not consistent.
Someone who is malingering may forget to maintain their symptoms over an extended period of time – a lengthy interview could cause someone who is faking an illness difficulty when it comes to maintaining the façade.
Clinical tests, including those that test mental acuity and memory along with physical symptoms can help determine if symptoms are authentic or if the individual is malingering. Using these tools, along with the individual’s health records, discovery of any incentives to fake illness and in-person patient interviews can help detect malingering and discover if there is a true medical problem at play.