Malingering mental disorders: Medicolegal reporting

Abstract

SummaryIn this second part of a two-article review on malingering we consider the challenges of presenting clinical and psychometric findings. Numerous clinical and demographic factors are statistically associated with malingering but applying them to an individual case risks challenges to the expert psychiatric witness's evidence. Although psychometric data can usefully help strengthen or challenge a diagnosis, expert witnesses must recognise and report the limitations of these tests. We recommend that psychiatric expert witnesses do not try to look for or to link any external incentives with clinical findings, and indeed we suggest that they should, other than exceptionally, avoid using the term ‘malingering’. It is the job of the court, not the expert witness, to ascertain an individual's credibility and motives. We suggest a framework for presenting expert psychiatric evidence in this area.Learning Objectives• Appreciate clinical and sociodemographic factors associated with malingering, and the challenges to applying these in individual cases• Understand the legal scrutiny to which the reporting of psychometric data might be exposed• Appreciate the roles of the expert witness and the court, and have a suitable framework for reporting expert psychiatric evidence in such cases