Malingering is the act of faking illness to avoid responsibilities. A person can also malinger in an effort to receive some type of reward. This can be money from an insurance settlement, or possibly to obtain prescription medications. Malingering can also mean someone exaggerating mental health issues to avoid going to jail.
Some more specific examples of malingering would be using makeup to fake an injury; tampering with a urine sample; or intentionally manipulating a thermometer to increase the temperature reading.
It’s important to note that malingering is not classified as a mental disorder. And it is very different from legitimate mental health conditions like somatic symptom disorder. This disorder can cause sufferers to think they have a particular medical condition when, in fact, they do not.
Effects of Malingering
One of the biggest issues with malingering are the effects it has on the healthcare system. Medical professionals are forced to waste time and energy on symptoms that aren’t legitimate. They have simply been made up to avoid responsibility, negative consequences, or to gain some type of reward (i.e. lawsuit money).
In addition to the energy and time wasted, the symptoms of patients who are malingering can cost the healthcare system a lot of money.
In one particular study, it was noted that 13% of people who come into emergency psychiatric clinics on a yearly basis are determined to be malingering. Cases of malingering throughout the U.S. have been said to cost the national healthcare system approximately $150 Billion per year.
Unfortunately, there are no specific signs or signals that define malingering. A person is usually suspected of malingering when they start to have mental or physical symptoms out of nowhere. Usually these symptoms start to appear suddenly when a person is faced with some other negative situation in their life.
People can begin to malinger if they are facing prosecution for a crime, having second thoughts about going into the military, describing their symptoms as more severe as what the doctor is telling them, or intentionally choosing not to cooperate with the examinations or prescriptions of a medical professional.
Causes of Malingering
There are no definitive, physical causes of malingering. It’s usually brought on by someone wanting to gain a reward, or avoid some other negative situation. But, malingering can be tied to certain mood and personality disorders.
People who suffer from antisocial personality disorder or major depressive disorder may malinger to avoid situations that may trigger their disorder. These could be a variety of social situations or triggers that cause the onset of antisocial or depressive symptoms.
Can It Be Diagnosed?
Yes. Malingering is, in fact, a medical diagnosis. However, it is not severe enough to be considered a psychological condition. Doctors can have difficulty pinpointing malingering because of the nature of the condition, and the nature of their responsibility as medical professionals.
Doctors want to be very careful not to over look any legitimate conditions or symptoms. When a patient tells them something is wrong, they have to investigate. For this reason, malingering can be tough to diagnose.
A medical professional may start with a physical examination, and ask the patient some interview questions. All of this is done to assess the patient’s overall health. After assessing a patient’s overall physical and mental health, the doctor will then move on to ask them how the patient’s symptoms are affecting their daily life.
The doctor may even request a timeline of any major social, behavioral, or emotional events that have occurred. If any sort of severe trauma has occurred in a patient’s personal life, there could be a chance that their symptoms are the byproduct of a serious disorder or condition. Additionally, if some major life event has put them in a position to receive a reward, or experience particularly negative consequences, the doctor may start to suspect malingering.
If a medical professional suspects malingering, they may discuss the patient’s health with other people in their life. Reaching out to family members or other doctors will help give a more complete picture. This helps the doctor to determine how serious, or legitimate, the patient’s symptoms are.
Although it is still difficult to diagnose, new techniques are being pioneered to more easily spot the condition. A study was done using a computer software called MouseTracker.
In the study, 2 groups of participants were instructed to perform “mouse tasks” on a computer. One group was comprised of people who were definitively diagnosed with clinical depression. While the other group were in good mental health, but instructed to lie about their condition.
The results of the study were that malingered patients reported a higher number of depressed symptoms, while participants that were actually depressed took a longer time to perform the tasks prescribed to them.
Admittedly, it’s not much to go on, but it may be a step in the right direction toward quickly diagnosing malingered symptoms. This could go a long way in cutting down wasted time, energy, and money within the U.S. healthcare system. And it will help medical professionals to cut through the fluff, and focus on helping people who actually need their help.
As of today, there is no concrete test that can be performed to determine if a person is malingering or not. It’s very difficult to detect. Psychiatrists may, however, use a number of personality assessments to determine if malingering is, in fact, the cause of the issue.
The Minnesota Multiphasic Personality Inventory 2nd edition, multiscale inventories; projective measures, The M Test, The Miller Forensic Assessment of Symptoms Test, and the Structured Inventory of Malingered Symptomatology are all tools at medical professionals’ disposal to help narrow down a patient’s diagnosis.
Should It Be Treated?
Treating a patient for malingering would only feed into the misrepresentation of their symptoms and overall health. When it comes down to it, there is no legitimate physical or mental cause to malingering. It’s an act.
People may perform this act of malingering in any number of cases. Someone could malinger to avoid jury duty, avoid being charged with a crime, or avoid going to the military. In fact, we’ve all malingered at some point during our childhood when we tried to fake sick to get out of going to school. There’s no treatment for that.
All that being said, however, it’s important that a thorough exam be conducted before passing symptoms off as malingering. As we said earlier, if someone is malingering, it may be a symptom of a deeper mood or personality disorder.
In addition, there are disorders that may cause someone to unknowingly lie about their physical or mental condition that shouldn’t be taken lightly. If you think someone you love may be malingering, it’s important to fully disclose everything going on in their life to their doctor or counselor. It may also be helpful to let their medical professional talk to the other doctors they go to in their life.