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The Psychiatric Clinics of North America Dec 2012This article discusses the prevalence of feigning in both criminal and civil settings and various psychological assessments useful in detecting feigning. The focus of... (Review)
Review
This article discusses the prevalence of feigning in both criminal and civil settings and various psychological assessments useful in detecting feigning. The focus of this information is on the various psychological assessments available to assist clinicians in making a determination of whether or not an individual is feigning and concludes with the recommendations that multiple assessments are necessary to improve the sensitivity of detection methods.
Topics: Forensic Psychiatry; Humans; Malingering; Mental Disorders; Psychological Tests
PubMed: 23107567
DOI: 10.1016/j.psc.2012.08.006 -
The Psychiatric Clinics of North America Sep 2011
Review
Topics: Bioethical Issues; Factitious Disorders; Humans; Malingering; Neuropsychological Tests; Personality Tests; Psychiatric Status Rating Scales
PubMed: 21889683
DOI: 10.1016/j.psc.2011.05.013 -
The Journal of Head Trauma... Apr 2000Magnification of symptoms or nonoptimal effort on neuropsychological tests, within the context of head injury litigation, can have several independent or related... (Review)
Review
Magnification of symptoms or nonoptimal effort on neuropsychological tests, within the context of head injury litigation, can have several independent or related underlying causes. Therefore, detecting exaggeration does not automatically indicate that the individual is malingering. This article reviews the evaluative and differential diagnostic process and provides the clinician with suggestions regarding assessment methods. A forensic evaluation that does not include careful consideration of possible negative response bias should be considered incomplete.
Topics: Brain Injuries; Diagnosis, Differential; Forensic Psychiatry; Humans; Malingering; Neuropsychological Tests
PubMed: 10739970
DOI: 10.1097/00001199-200004000-00006 -
Lancet (London, England) Apr 2014Compared with other psychiatric disorders, diagnosis of factitious disorders is rare, with identification largely dependent on the systematic collection of relevant... (Review)
Review
Compared with other psychiatric disorders, diagnosis of factitious disorders is rare, with identification largely dependent on the systematic collection of relevant information, including a detailed chronology and scrutiny of the patient's medical record. Management of such disorders ideally requires a team-based approach and close involvement of the primary care doctor. As deception is a key defining component of factitious disorders, diagnosis has important implications for young children, particularly when identified in women and health-care workers. Malingering is considered to be rare in clinical practice, whereas simulation of symptoms, motivated by financial rewards, is regarded as more common in medicolegal settings. Although psychometric investigations (eg, symptom validity testing) can inform the detection of illness deception, such tests need support from converging evidence sources, including detailed interview assessments, medical notes, and relevant non-medical investigations. A key challenge in any discussion of abnormal health-care-seeking behaviour is the extent to which a person's reported symptoms are considered to be a product of choice, or psychopathology beyond volitional control, or perhaps both. Clinical skills alone are not typically sufficient for diagnosis or to detect malingering. Medical education needs to provide doctors with the conceptual, developmental, and management frameworks to understand and deal with patients whose symptoms appear to be simulated. Central to the understanding of factitious disorders and malingering are the explanatory models and beliefs used to provide meaning for both patients and doctors. Future progress in management will benefit from an increased appreciation of the contribution of non-medical factors and a greater awareness of the conceptual and clinical findings from social neuroscience, occupational health, and clinical psychology.
Topics: Diagnosis, Differential; Factitious Disorders; Female; Humans; Malingering; Patient Acceptance of Health Care; Prognosis
PubMed: 24612861
DOI: 10.1016/S0140-6736(13)62186-8 -
Harefuah Jan 2008This article reviews diagnostic and therapeutic perspectives of mental disorders malingering. Three explanatory models are presented: the pathogenic model, the... (Review)
Review
This article reviews diagnostic and therapeutic perspectives of mental disorders malingering. Three explanatory models are presented: the pathogenic model, the criminological model, and the adaptational model. Methodological and specific issues are discussed, as well as an updated literature survey of psychological tests found to be useful in detecting malingering. The tests include objective personality questionnaires, especially the Minnesota Multiphasic Personality Inventory (MMPI). Using MMPI as a single tool may be misleading, as the malingerer learns to avoid detection. By adding the Symptom Validity Test (SVT) to MMPI, the problem can be resolved. Therapeutically, the effect of using a criminological model by DSM on malingerer's treatment is tested, and the contribution of the other models is also discussed. It seems that using a dichotomy approach to malingering is misleading. Instead, seeing malingering as a 2-way continual axis spectrum (conscious vs. unconscious; external vs. internal motivation) makes it possible to treat many patients who otherwise would be considered as untreatable and/or not in need of treatment.
Topics: Diagnosis, Differential; Humans; MMPI; Malingering; Reproducibility of Results
PubMed: 18300623
DOI: No ID Found -
The Journal of the American Academy of... 2009The authors review clinical and conceptual errors that contribute to false attributions of malingering in forensic evaluations. Unlike the mental disorders, malingering... (Review)
Review
The authors review clinical and conceptual errors that contribute to false attributions of malingering in forensic evaluations. Unlike the mental disorders, malingering is not defined by a set of (relatively) enduring symptoms or traits; rather, it is an intentional, externally motivated, and context-specific form of behavior. Despite this general knowledge, attributions of malingering are often made by using assessment tools that may detect feigning but cannot be relied upon to determine incentive and volition or consciousness (defining characteristics of malingering). In addition, forensic evaluators may overlook the possibility that feigning is a function of true pathology, as in Ganser syndrome or the factitious disorders, or that a seemingly malingered presentation is due to symptoms of an underlying disorder, such as dissociative identity disorder (DID). Other factors that set the stage for false positives, such as pressure on forensic specialists to identify malingering at all costs, failure to consider the base rate problem, and cultural variables, are also reviewed.
Topics: Forensic Psychiatry; Humans; Lie Detection; Malingering; Mental Disorders; Psychological Tests; Reproducibility of Results; Volition
PubMed: 19297641
DOI: No ID Found -
The Journal of the American Academy of... Sep 2017Malingering is a medical diagnosis, but not a psychiatric disorder. The label imputes that an evaluee has intentionally engaged in false behavior or statements. By...
Malingering is a medical diagnosis, but not a psychiatric disorder. The label imputes that an evaluee has intentionally engaged in false behavior or statements. By diagnosing malingering, psychiatrists pass judgment on truthfulness. Evaluees taking exception to the label may claim that the professional has committed defamation of character (libel or slander) when the diagnosis is wrong and costs the claimant money or benefits. Clinicians may counter by claiming immunity or that the diagnosis was made in good faith. This problem has come into focus in military and veterans' contexts, where diagnoses become thresholds for benefits. Through historical and literary examples, case law, and military/veterans' claims of disability and entitlement, the authors examine the potency of the malingering label and the potential liability for professionals and institutions of making this diagnosis.
Topics: Disability Evaluation; Humans; Malingering; Stress Disorders, Post-Traumatic; Veterans
PubMed: 28939732
DOI: No ID Found -
On the diagnosis of malingered pain-related disability: lessons from cognitive malingering research.The Spine Journal : Official Journal of... 2005Pain-related disability is a complex phenomenon. Malingering is a potential factor in the management of patients with pain. Methodological problems and inappropriate... (Review)
Review
BACKGROUND CONTEXT
Pain-related disability is a complex phenomenon. Malingering is a potential factor in the management of patients with pain. Methodological problems and inappropriate expectations regarding diagnostic accuracy have hampered the study of malingering detection in pain. In contrast, the study of cognitive malingering in neuropsychology has led to the development of many highly accurate and reliable detection techniques. This paper applies the methods and logic that have been successful for identifying cognitive malingering to the problem of malingering in patients with pain.
PURPOSE
Outline the logic of a research methodology for studying malingering detection in pain and introduce a system for the diagnosis of malingering in pain.
STUDY DESIGN
Literature review and conceptual synthesis.
METHODS
Examination of the research methodology and diagnostic scheme used in the study of cognitive malingering; adaptation of these methods to the problem of malingering in pain.
RESULTS
Lessons derived from the study of cognitive malingering were used to generate recommendations to enhance research into detection and diagnosis of malingered pain-related disability. A comprehensive, multidimensional system for diagnosing malingering in pain-related disability was proposed.
CONCLUSIONS
Pain-related disability is a multifaceted phenomenon, therefore malingering can occur in different and sometimes multiple dimensions. It is presently possible to accurately detect and diagnose malingering in some patients with pain. More work is needed for some detection techniques to be appropriately calibrated in pain populations. This work must focus on controlling the false positive error rate.
Topics: Attitude to Health; Cognition; Disability Evaluation; Humans; Malingering; Neuropsychological Tests; Pain; Physical Examination
PubMed: 15996610
DOI: 10.1016/j.spinee.2004.11.016 -
Perspectives in Psychiatric Care Jan 2014The purposes of this paper are to (a) identify theoretical underpinnings of malingering, (b) to discuss interview and intervention techniques based on pertinent...
PURPOSE
The purposes of this paper are to (a) identify theoretical underpinnings of malingering, (b) to discuss interview and intervention techniques based on pertinent literature, and (c) to offer an organized mnemonic to help clinicians easily identify possible malingered psychosis presentations.
CONCLUSION
Detecting the malingering of psychotic symptoms is a challenging task for Advanced Practice Psychiatric Nurses. Diagnosing a patient of malingering requires caution on the clinician's part.
PRACTICE IMPLICATIONS
A thorough understanding of potential signs of malingering vs. genuine psychosis is needed as well as knowledge of legal ramifications.
Topics: Delusions; Hallucinations; Humans; Malingering; Practice Guidelines as Topic; Psychotic Disorders
PubMed: 24387614
DOI: 10.1111/ppc.12025 -
The Bulletin of the American Academy of... 1990Inclusion criteria for the classification of malingering are shaped and largely predetermined by our explanatory theories. Current theories have postulated the... (Review)
Review
Inclusion criteria for the classification of malingering are shaped and largely predetermined by our explanatory theories. Current theories have postulated the motivation to malinger is either the product of underlying psychopathology (pathogenic model) or criminal backgrounds (DSM III-R model). I have proposed a third model that malingering is typically an adaptive response to adverse circumstances which may best be understood in the context of decision theory. Based on this approach I have argued that indices of malingering should be empirically derived and focused on clinical presentation. Finally, I have proposed a preliminary model for the classification of malingerers which combines clinical data with corroborative evidence.
Topics: Antisocial Personality Disorder; Expert Testimony; Humans; MMPI; Malingering; Psychiatric Status Rating Scales
PubMed: 2245247
DOI: No ID Found