Malingering

[Hear Again]

People that fake illnesses obviously have issues!

I'm not speaking of calling in work claiming you are sick or getting out of active duty.

I'm speaking of the ones that frequently do it for attention. It is obvious that the person may have some sort of mental illness. It may not be the illness they claim to have. Got to be an underlying cause of a person going to extreme of wanting to be sick.

no, it's not a mental illness. there is no such thing outlined in the dsm except for "malingering" and "feigned psychosis."

 

[jillio]

Neuro-ophthalmologist, jillio. And yes I've been to one.

And a nuero-opthamologist is a neurologist by training. He simply narrows his focus.

 

[jillio]

So would a person that frequently malingers be mentally ill in some sort?

For someone to go so far to seek attention or look for excuses doesn't seem too stable. So my question is what help do malingerers get?

Due to the nature of the disorder, they are very difficult to help. Usually they don't want to be helped. Usually, there are one or more comorbid diagnoses that go along with malingering, personality disorders being the most common.

 

[Hear Again]

So would a person that frequently malingers be mentally ill in some sort?

For someone to go so far to seek attention or look for excuses doesn't seem too stable. So my question is what help do malingerers get?

no they wouldn't because there is no such mental illness defined in the dsm. the only conditions that are listed that would describe someone who lies about a given disorder or illness would be "malingering" or "feigned psychosis."

malingerers could receive therapy, but treating them successfully is almost impossible since they can't seem to work around their issues of needing constant attention.

 

[naisho]

Wow, in regards to the malingering people purposefully feigning the illness for whatever purpose outside of for a social effect - I ran a search and hit some pretty interesting powerpoint presentation by this site:

Dr. Martin L. Rohling -Dr. Rohling graduated with the following:
-BS in Mechanical Engineering in '81 (U of Illinois)
-BA in Psychology in '84 (S Illinois Univ)
-MA in Clinical Psychology in '88 (U of Alabama)
-PhD in Clinical Psychology in '91 (U of Alabama)

And here's what he says to say about malingering in his views:

Here is a link to googlecache of that powerpoint presentation, I suppose he's teaching a class about it now:
Malingering:* How can you be sure?


DSM-IV: Malingering criteria

* 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. Under some circumstances, Malingering may represent adaptive behavior--for example, feigning illness while a captive of the enemy during wartime.

(Skipping to his views)

Strategies for Detecting Malingering of Neuropsychological Impairment

* 1. FLOOR EFFECT
* Malingerers fail at tasks on which even the most severely impaired persons would be likely to succeed.

# 2. PERFORMANCE CURVE
# Malingerers will not take into account the difficulty of items where one would assume that “normals” would perform better on easier items and poorer on more difficult items.

* 3. MAGNITUDE OF ERROR
* Malingerers are detectable because they make approximate answers (i.e., near misses).
* For example, Digit Span Backwards

* 4. ATYPICAL PRESENTATION
* Malingerers present in inconsistent or uncommon patterns that are incongruent with models of functioning.
* For example, Spinal Cord Levels of Functioning

* 5. PSYCHOLOGICAL SEQUELAE
* Malingering neurological deficits are sometimes detected by investigating the subjective psychiatric complaints.
* For example, MMPI or Diagnostic Interview

* 6. INATTENTION
* Malingerers fail to pay attention to instructions and questions presented by the examiner and frequently ask for them to be repeated.
* For example, Continuous Performance Test and Digit Span

* 7. HAPHAZARD, SYSTEMATIC, RANDOM, OR SEQUENTIAL RESPONDING
* Malingerers may try and guide their incorrect responses through one of these strategies as a way to avoid giving a valid response.
* For example, MMPI-2 or MCMI-II

* 8. SLOWED RESPONDING
* Malingerers may inhibit providing correct responses to questions, taking excessive time to generate incorrect responses. On speeded tasks, they may intentional perform at excessively slow rates.
* For example, Trails A & B

* 9. SYMPTOM VALIDITY
* Malingerers may perform below chance or less well then individuals with more severe levels of pathology.
* For example, Computer Assessment of Response Bias (CARB) and Word Memory Test (WMT)

-----
In this case, a suspect of malingering due to a neurological issue is well in the out of bounds area, sadly as it looks as if there is not much can be done.

If it is of psychological background, perhaps there may be a little hope for them, especially if they smart enough to see they are faking it.. but as it states.. Real malingerers truly seem unresponsive to "common sense" type things.

 

[dreama]

jillio,

is a therapist or psychiatrist able to tell someone is a malingerer by looking at their past medical records? for example, if a person goes from therapist to therapist or psychiatrist to psychiatrist, is the new therapist and/or psychiatrist able to know this and identify them as a malingerer?

No. Only God can do that.

Some people who suffer from mental health issues are compulsive liars. That doesn't mean they aren't ill. It could just as well mean that they have been traumatised and disociate so much that they no longer know what is real and what isn't.

Declaring that someone is shaming if they aren't would be extremely damaging for that person. Whilst I'm sure it happens I don't believe it does anywhere near as often as some people seem to think it does.

More often the person goes to their shrink with a lot of BS because they can't face reality and their shink might just misdiagnose them as shaming when they genuinely ARE ill and in DESPERATE need of help. Only not in the way they think they are.

After all I don't think being so desperate for attention that you will go to hospital to see a shrink is a sign of good health. Because 'normal' people can get attention in more apropriate ways so they wouldn't need to go through that kind of extreme.

 

[jillio]

]No. Only God can do that. [/B]

Some people who suffer from mental health issues are compulsive liars. That doesn't mean they aren't ill. It could just as well mean that they have been traumatised and disociate so much that they no longer know what is real and what isn't.

Declaring that someone is shaming if they aren't would be extremely damaging for that person. Whilst I'm sure it happens I don't believe it does anywhere near as often as some people seem to think it does.

More often the person goes to their shrink with a lot of BS because they can't face reality and their shink might just misdiagnose them as shaming when they genuinely ARE ill and in DESPERATE need of help. Only not in the way they think they are.

After all I don't think being so desperate for attention that you will go to hospital to see a shrink is a sign of good health. Because 'normal' people can get attention in more apropriate ways so they wouldn't need to go through that kind of extreme.

What???? Malingerers are dx'ed all the time by medical doctors, inlcuding psychiatrists.

And if one does not know what is real and what isn't, they are psychotic, not a compulsive liar.

What does shaming have to do with malingering?

 

[Bottesini]

What???? Malingerers are dx'ed all the time by medical doctors, inlcuding psychiatrists.

And if one does not know what is real and what isn't, they are psychotic, not a compulsive liar.

What does shaming have to do with malingering?

She means "shamming" which is British for faking.

 

[dreama]

Talk about elephant in the room syndrome....

I think a few people are suspecting someone of doing the subject of the topic.....

Yes. It seems they are. Sad to say suspecting someone of malingering is much easier then offering that person compassion. Especially to hid things that are not right about them and they want to divert other people's attention from the fact.

I wouldn't know all the facts as far as Nika's case is concerned and neither does anyone else. However, I think that we shouldn't be so judgemental of him.

 

[Hear Again]

Yes. It seems they are. Sad to say suspecting someone of malingering is much easier then offering that person compassion. Especially to hid things that are not right about them and they want to divert other people's attention from the fact.

I wouldn't know all the facts as far as Nika's case is concerned and neither does anyone else. However, I think that we shouldn't be so judgemental of him.

dreama,

has anyone here flat out accused nika of malingering? except for one poster, no. what we are doing (especially jillio and i) are simply asking for clarification about some statements that we find very, very confusing. if a person has difficulty understanding something, the logical thing to do is ask questions, no?

 

[dreama]

Perhaps Nika was just basing what he was told as the source of credibility? At a young age, it might be hard to remember such incidents so its easier to base the experience off from word of mouth through others.

Yes, that's probably the case. After all our first memories start at age of 3.

 

[Hear Again]

Some people who suffer from mental health issues are compulsive liars. That doesn't mean they aren't ill. It could just as well mean that they have been traumatised and disociate so much that they no longer know what is real and what isn't.

Declaring that someone is shaming if they aren't would be extremely damaging for that person. Whilst I'm sure it happens I don't believe it does anywhere near as often as some people seem to think it does.

More often the person goes to their shrink with a lot of BS because they can't face reality and their shink might just misdiagnose them as shaming when they genuinely ARE ill and in DESPERATE need of help. Only not in the way they think they are.

actually, you're wrong on both counts.

number 1: a person who no longer knows what's real and what isn't is psychotic -- not a malingerer. there *is* a difference.

number 2: psychiatrists prefer to err on the side of caution when it comes to malingerers. if they suspect a malingerer, they are more likely to wait until they have all of the facts about a person's case before asking them further questions to determine if, in fact, this is taking place.

 

[Babyblue]

Due to the nature of the disorder, they are very difficult to help. Usually they don't want to be helped. Usually, there are one or more comorbid diagnoses that go along with malingering, personality disorders being the most common.

So personality disorder may be the cause of malingering.

Is there a way that the professionals can find the underlying cause to help treat that person.

As you said it is probably difficult to do so. Makes me wonder if there is a system or help for people that does this.

A person that malingerers obviously has issues.


Oh! I have another question. (yup I am one of those pain the rear that keeps raising their hand in class to ask)

What is the difference of personality disorder and mental disorder??


I've always thought they went hand in hand.

Don't shoot me! I'm actually curious.

 

[jillio]

She means "shamming" which is British for faking.

Thanks for the clarification! That is another concept all together!

 

[Hear Again]

Yes. It seems they are. Sad to say suspecting someone of malingering is much easier then offering that person compassion.

again, all we are doing is trying to clarify some statements that were confusing.

malingerers don't deserve compassion. not in the least.

 

[Bottesini]

Thanks for the clarification! That is another concept all together!

YW.

But when you are pitying poor little Nika, even he admits he doctors have given the opinion he is a malingerer.

Usually they have something to base that on and don't just say it off the top of their heads because they don't like a patient.

 

[Hear Again]

No. Only God can do that.

wrong. psychiatrists can do that too.

 

[jillio]

So personality disorder may be the cause of malingering.

Is there a way that the professionals can find the underlying cause to help treat that person.

As you said it is probably difficult to do so. Makes me wonder if there is a system or help for people that does this.

A person that malingerers obviously has issues.


Oh! I have another question. (yup I am one of those pain the rear that keeps raising their hand in class to ask)

What is the difference of personality disorder and mental disorder??


I've always thought they went hand in hand.

Don't shoot me! I'm actually curious.

A personality disorder cannot be diagnosed until after the age of 21, because it has to be a long standing pattern of behavior before it qualifies. And it is more about distorted coping mechanisms than about an actual mental disorder that, quite often, is of a biologic origin.

And yes, they can go hand in hand. Persons with certain personality disorders are also at risk for developing some mental disorders. That is what is meant by a co-morbid diagnosis.

Yes, there is diagnostic assessment available to determine if the underlying cause of the malingering is a personality disorder.

Keep asking questions....I love people who love to learn, and asking questions is the best way to do that!

 

[dreama]

Either way, I don't think it's OK to accuse people unless you're absolutely willing to call them out as a liar.

I had a neuro-ophthalmologist tell me that I could see more than I said I said I could see, and this person made my parents think the same thing (that I was 'faking/imagining' my vision being as bad as it was... despite having a diagnosis proven by several objective tests...) and it was a very distressing time where I felt like I was being accused by a lot of people when I knew I was telling the truth. I didn't see her again and saw another doctor who in the first appointment told me she believed me which relieved a lot of the stress and anger, but the time in between that was not great all the same, and people still kept pulling the "but that doctor said.." card some time later.

Mine was a very short period of time, but some people might go years being not believed, perhaps even a lifetime... and I don't want to, unless it's absolutely obvious that the person is lying, not believe someone when they say something is wrong, for the chance that they might be telling the truth.

Well said.

 

[jillio]

YW.

But when you are pitying poor little Nika, even he admits he doctors have given the opinion he is a malingerer.

Usually they have something to base that on and don't just say it off the top of their heads because they don't like a patient.

Exactly. They usually exhaust all other possibility. And we are talking about not just one or two doctors, but a lifetime of them.