Do You Know People Who Feign? Proxy Respondents About Feigned Symptoms

Brechje Dandachi-Fitzgerald,Irena Bošković,Harald Merckelbach,Marko Jelicic

doi:10.1007/s12207-020-09387-6

Brechje Dandachi-Fitzgerald, Irena Bošković + Show 2 more

Open Access

https://doi.org/10.1007/s12207-020-09387-6

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Abstract

We asked students, clinicians, and people from the general population attending a public university lecture (n = 401) whether they knew others who (had) feigned symptoms. We also asked about the type of symptoms and the motives involved. A slight majority of proxy respondents (59%) reported that they knew a person who (had) feigned symptoms, and 34% knew a person who had admitted to them having feigned symptoms. According to our respondents, the most often feigned symptoms were headache/migraine, common cold/fever, and stomachache/nausea, and the most important reasons for doing so were sick leave from work, excusing a failure, and seeking attention from others. We conclude that feigning is part of the normal behavioral repertoire of people and has little to do with deviant personality traits and/or criminal motives. Also, the current emphasis in the neuropsychological literature on malingering, i.e., feigning motivated by external incentives, might be one-sided given that psychological motives, notably seeking attention from others and excuse making, seem to be important determinants of everyday feigning.

Highlights

We asked students, clinicians, and people from the general population attending a public university lecture (n = 401) whether they knew others who feigned symptoms
Following the convention of the DSM-5 (American Psychiatric Association, 2013), this term is usually reserved for cases in which symptom exaggeration seems to be motivated by an external reward
Using stand-alone performance validity tests (PVTs) that gauge exaggeration of memory impairments, Jackson et al (2017) found such exaggeration to be more often present when veterans are tested in an incentivizing context than when they are tested in a research context (60% versus 5.5%)

Summary

Introduction

The advantage of this approach is that these instruments often possess high sensitivity and specificity, allowing for relatively accurate estimates of the prevalence of symptom and/or impairment exaggeration in certain circumstances This approach will inevitably yield variation in base rate estimates across studies due to differences in the accuracy characteristics of the validity tests employed and the criteria adopted to define cases of feigning (e.g., requiring one versus at least two validity tests to be failed; Victor et al, 2009). These estimates pertain to highly specific populations (e.g., US military veterans), and are difficult to generalize to other samples (e.g., European patients involved in litigation; see for an example: Plohmann & Hurter, 2017)

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