When you were a child, did you ever pretend to be sick to get out of going to school? There’s actually a medical name for this behavior; it’s called malingering. It refers to producing false medical symptoms or exaggerating existing symptoms in hopes of being rewarded in some way.
For example, someone might pretend to be injured so they can collect an insurance settlement or obtain prescription medication. Others may exaggerate mental health symptoms to avoid criminal convictions. More specific examples of malingering include:
- putting makeup on your face to create a black eye
- adding contaminants to a urine sample to change its chemistry
- placing a thermometer near a lamp or in hot water to increase its temperature
Malingering isn’t a psychiatric disorder. It’s also very different from mental health conditions like somatic symptom disorder, which causes people to worry that they have a medical condition even if they don’t.
What are the symptoms?
Malingering doesn’t have any specific symptoms. Instead, it’s usually suspected when someone suddenly starts having physical or psychological symptoms while:
- being involved with a civil or criminal legal action
- facing the possibility of military combat duty
- not cooperating with a doctor’s examination or recommendations
- describing symptoms as being much more intense than what a doctor’s exam reveals
What causes it?
Malingering isn’t caused by any physical factors. Rather, it’s the result of someone’s desire to gain a reward or avoid something. That said, malingering is often accompanied by real mood and personality disorders, such as antisocial personality disorder or major depressive disorder.
How is it diagnosed?
Malingering is a medical diagnosis, but not a psychological condition. It’s often hard to diagnose because doctors don’t want to overlook any real physical or psychological conditions.
A doctor will usually start with a thorough physical exam and open-ended interview to get an idea of someone’s overall physical and mental health. This interview will cover the ways a person’s symptoms impact their daily life. A doctor will also try to get a timeline of any behavioral, emotional, or social events. They may do a follow-up exam to check for inconsistencies between someone’s description of their symptoms and what the doctor finds during an exam.
If a doctor concludes that someone is likely malingering, they may reach out to their other doctors, family members, friends, or co-workers for more information about their health.
Are there any tests that determine if someone is malingering?Are there any tests that determine if someone is malingering?
Unfortunately, malingering is very difficult to detect. Psychologists use a wide variety of approaches, including the Minnesota Multiphasic Personality Inventory 2nd version (MMPI-2). Multiscale inventories and projective measures may also be useful. More precisely, measures such as the M test (Beaber, Marston, Michelli, and Mills), the Miller Forensic Assessment of Symptoms Test (M-FAST), and the Structured Inventory of Malingered Symptomatology (SIMS) can all be used in an attempt to detect malingering. These tests are administered by psychologists trained in the use of these assessment instruments.Timothy J. Legg, PhD, PsyD, CRNP, ACRN, CPHAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
The bottom line
Malingering is an act, not a psychological condition. It involves pretending to have a physical or psychological condition in order to gain a reward or avoid something. For example, people might do it to avoid military service or jury duty. Others might do it to avoid being convicted of a crime. Before suggesting that someone is malingering, it’s important to rule out any possible physical or psychological conditions. Keep in mind that there are certain psychological conditions that might cause someone to unknowingly make up or exaggerate their symptoms.