[Mental disorders--malingering]

Abstract

This article reviews diagnostic and therapeutic perspectives of mental disorders malingering. Three explanatory models are presented: the pathogenic model, the criminological model, and the adaptational model. Methodological and specific issues are discussed, as well as an updated literature survey of psychological tests found to be useful in detecting malingering. The tests include objective personality questionnaires, especially the Minnesota Multiphasic Personality Inventory (MMPI). Using MMPI as a single tool may be misleading, as the malingerer learns to avoid detection. By adding the Symptom Validity Test (SVT) to MMPI, the problem can be resolved. Therapeutically, the effect of using a criminological model by DSM on malingerer's treatment is tested, and the contribution of the other models is also discussed. It seems that using a dichotomy approach to malingering is misleading. Instead, seeing malingering as a 2-way continual axis spectrum (conscious vs. unconscious; external vs. internal motivation) makes it possible to treat many patients who otherwise would be considered as untreatable and/or not in need of treatment.