As a kid, did you ever fake sick to avoid going to school? Maybe you tried to increase the temperature of the thermometer or fake nausea to convince someone you were too sick to go to school. Ferris Bueller’s Day Off is a classic movie to describe a common desire most kids face at some point in their childhood: missing school by pretending to be sick so you can do whatever you want. The concept of faking symptoms to avoid something or even denying or covering up the presence of symptoms is called malingering. Symptoms are exaggerated or even falsified in order avoid potential consequences or achieve some sort of reward or gain.
Malingering is not considered a psychological disorder which separates it from other disorders that appear similar but are actually different. Factitious disorder is different from malingering in that individuals diagnosed with this disorder fake symptoms without any motive or reward. Malingering involves faking symptoms to achieve some specific reward or avoid certain consequences. Somatic symptom disorder involves someone who experiences real distress due to imagined symptoms. Malingering involves individually who are aware of their deceit and are not imagining symptoms. While malingering seems similar to some disorders, it is important to be aware of how it is different.
Malingering can involve exaggerating symptoms, faking symptoms, and even hiding symptoms. For this reason, identifying symptoms can be difficult. Individuals malinger because they seek some sort of reward or gain or want to avoid potential serious consequences. When attempting to identify malingering, it is helpful to take a broader perspective by looking at the circumstances in the person’s life. These circumstances might include:
- Someone who might benefit financially or receive some other form of compensation from displaying certain symptoms
- Someone who would like to avoid potential legal issues or something else they find undesirable and would be able to achieve avoidance with the presence of certain symptoms
- Avoiding doctor’s visits or not cooperating with doctors
- Continuing to describe symptoms that a doctor is unable to see or confirm
These symptoms are not indicative of a psychological disorder. However, it is not necessarily uncommon for malingering to be paired with someone experiencing another disorder like a mood disorder. However, it is important to remember that malingering in itself is not considered a psychological disorder which again is why it can be difficult to identify.
Doctors will take a patient’s presenting concerns of apparent symptoms seriously. Through tests, follow-up visits, and an awareness of what is going on in a patient’s life, doctors can work to identify if their patient is malingering. If they believe they are, the doctor can refer the patient to do psychological testing that can potentially identify if the person is being honest about their symptoms. As stated before, malingering is an act and not a disorder. There is not a treatment for it other than bringing the truth to light. It is about identifying the symptoms are exaggerated to end malingering. However, if there is a suspicion that another disorder like a mood disorder is present, professionals can work to diagnose and treat the specific disorder.
Michelle Overman is a Licensed Marriage & Family Therapist working as a counselor for students, faculty, and staff at Abilene Christian University in Abilene, Texas. She works with athletes, bridging the gap between athletics and mental health at ACU. She is becoming a Certified Mental Performance Consultant in sports psychology. Michelle ran her own private practice in Austin, Texas where she worked with a diverse population, including couples and families. Michelle earned a Master’s in Marriage & Family Therapy and has been working in the field for 6 years.