Malingering

Malingering is the intentional production false or grossly exaggerated physical or psychological complaints with the goal of receiving a reward. Malingering is not a mental disorder or diagnosis.

  • Coin-in-hand test[1]

Conversion Disorder vs. Malingering*

Malingering Conversion Disorder
• Malingering​:​ ​Aware​ ​of​ ​purpose​ ​of​ ​symptoms​
• Usually uncooperative, suspicious,​ ​aloof​​
• Avoids​ ​examinations​​ and investigations ​(unless​ ​there is a financial​ ​benefit)
• Refuses​ ​employment​ ​with​ ​partial disability
• Describes​ ​accident​ ​in​ ​full​ ​“perfect” detail
• Not​ ​aware​ ​of​ ​purpose​ ​of​ ​their symptoms
• Cooperative,​ ​appealing,​ ​and more dependent
• Welcomes​ examinations and investigations
• ​Accepts​ ​employment​ ​with​ ​partial​ ​disability
• Describes accident​ ​with​ ​gaps​ ​and​ ​inaccuracies
  • Malingering is not a diagnosis, even though it is encountered in the clinical setting.
  • To establish malingering is difficult. Symptoms from malingering are intentional, and the motivation behind it is also intentional.
  • The individual consciously fakes, profoundly exaggerates, or claims to have a disorder or symptoms in order to attain a specific secondary (external) gain.
    • This gain could be avoiding work, getting worker's compensation, or obtaining something of material value. Complaints from malingerers will end after they have achieved their gain (in comparison to factitious disorder, which is not always the case).

Comparison of Somatic Symptom Disorders, Factitious Disorder, and Malingering Fig. 1