DSM 5 description
According to DSM 5, “The essential feature of malingering is 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.”
DSM-5 argues that if “any combination” of the following four items is present in a patient, the clinician should consider the condition of malingering:
The patient presents in a medicolegal context (e.g., a lawyer requests that the patient be assessed for a mental disorder or there are criminal charges/investigations regarding the presenting patient). Marked discrepancy is present between the patient’s claimed stress or disability and objective findings and observations. The patient demonstrates a lack of cooperation during the diagnostic evaluation and in complying with the prescribed treatment regimen. The patient has an antisocial personality disorder.
Other characteristics
Under some circumstances, malingering represents adaptive behavior (e.g., feigning illness while a captive of the enemy during wartime). Malingering is distinguished from factitious disorder by its motivation. In factitious disorder, the motivation is to assume the sick role, which can be thought of as an internal or psychological incentive, whereas motivation in malingering is usually for financial or personal gain. Malingering can be further categorized into pure malingering, partial malingering, and false imputation. Feigning a disorder that does not exist is referred to as pure malingering. Partial malingering occurs when the patient does have actual symptoms but consciously exaggerates them or falsely states that previous genuine symptoms are still present. In false imputation, the patient ascribes symptoms to a cause that is actually unrelated.
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