What Is Malingering?

Malingering describes the behavior of an individual who either feigns mental or physical illness or greatly exaggerates his symptoms for the purpose of receiving some type of external benefit. Such benefits may include getting time off work; avoiding military service; or obtaining funds from insurance, a lawsuit, or donations from others. Malingering is not listed as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV), as it is typically considered to be an act of deliberate deception. It may, however, be observed in individuals with antisocial personality disorder, who may manipulate the medical system and other people in order to avoid responsibilities or perpetrate a scam.

Malingerers seek to avoid taking responsibility for themselves and their actions or to profit in some way by pretending to be ill or to be more ill than they actually are. In some cases, a malingerer will claim to have medical symptoms that don't actually exist or will pretend to be mentally ill. He is fully aware of his deception and may develop a variety of strategies designed to deceive people in authority and medical personnel. A classic example of this sort of deception would be the child who wishes to not go to school and so holds a thermometer near a lightbulb in order to fool her mother into thinking she has a fever. A malingerer who wishes to feign a mental illness may act as if he is disoriented and purposely fail to correctly answer common-knowledge questions, such as what year it is or the identity of the ruling politician in his country.

Some medical professionals have developed ways of detecting malingering and separating it from genuine mental and physical illness as well as conditions such as somatization disorder, in which a patient actually suffers physical symptoms but there is no evidence that they are connected to any physical disorder. Another condition that could sometimes be confused with malingering is that of factitious disorder, in which a patient may deliberately take steps to make himself sick or, alternatively, feign illness in order to get attention and become an object of compassion. While a malingerer deliberately fakes her illness in order to avoid responsibility or to receive financial compensation, individuals with a somatization disorder are actually experiencing symptoms, while those with factitious disorder are seeking emotional nurturing rather than some type of tangible reward or avoidance of an unpleasant duty or experience.