Malingering: Is My Client Faking?
Many court cases are decided upon whether the jury regards an injured plaintiff as faking his/her condition. The intentional or conscious fabrication of symptoms or injuries is called malingering. How do you determine whether your client is malingering? This is not a simple matter. There are several tests designed specifically for measuring malingering such as the Structured Interview of Reported Symptoms (SIRS) or Test of Memory Malingering (TOMM). These are not foolproof measures. There are also validity and reliability scales on popularly used tests such as the Minnesota Multiphasic Personality Inventory 2 (MMPI-II) and Millon Clinical Multiaxial Inventory 3 (MCMI-III) that address malingering. However, it is not possible to prove definitely whether someone is faking.
It is interesting to note that research shows mental health professionals do not do better than anyone else in distinguishing those who are lying from those who are truthful. A trained expert can infer with some success whether a client is faking by assessing the following: 1) Inconsistencies in reporting such as contradictory symptomology or differences in observed vs. reported symptoms; 2) dramatic presentation; 3) too deliberate and/or careful in presentation; 4) symptoms that are incongruent with a particular disorder such as flat affect with an anxiety disorder.
It is important to note that despite no direct medical evidence, symptom complaints do not necessarily prove malingering. The DSM V diagnosis of somatization disorder does not define this category as malingering.