Los Angeles-area behavioral expert Rocio Moustafa takes a closer look at so-called malingering.
Considered a form of excessive illness behavior, malingering represents the fabrication of symptoms of one or more mental or physical conditions or disorders for a variety of purposes, including obtaining a medication, insurance fraud, and avoiding school, work, or military service. A professional behavior expert, Rocio Moustafa takes a closer look at the condition.
“Although a well-recognized condition, malingering does not constitute a formal medical diagnosis,” explains Moustafa, an expert specializing in conditions tied to mood, cognition, and perception from Los Angeles, California, previously based in the nearby city of Ventura. “Furthermore, malingering is largely deemed to be distinct from other forms of excessive illness behavior, including fictitious and somatization disorders, for example,” she adds.
Cases of malingering cause a significant burden upon health care systems and disability initiatives—as well as workers’ compensation programs—in the United States, and often harm genuine patients and claimants, according to Moustafa. “Malingering places a serious, unnecessary, and unwarranted strain upon organizations such as the U.S. Department of Veterans Affairs and its disability benefits program,” adds the expert.
Rocio Moustafa Touches on Symptoms
Genuine conditions routinely faked by so-called malingerers include fibromyalgia, whiplash pain from automobile accidents, post-traumatic stress disorder, chronic pain, and chronic fatigue syndrome, as well as the after-effects of mild head injuries.
“Malingering, by definition, has its roots as far back as early as Roman times,” reveals Moustafa, “where the Greek physician, surgeon, and philosopher Aelius Galenus, also known as Galen of Pergamon, recorded a patient simulating colic to avoid a public meeting.”
The Roman Empire-era physician also reportedly recorded another case in which a patient feigned a knee injury to avoid having to undertake a long journey with his master, according to Moustafa.
“In modern cases, individuals may harm themselves or take drugs and other medications in order to provoke a particular set of symptoms, after which they can attempt to fool a medical professional into believing that they are sick,” the California-based expert continues, “often having read up on a particular disease, illness, or condition from medical textbooks or the internet.”
Associated conditions include Ganser syndrome, hypochondriasis or hypochondria, so-called ‘factitious disorder imposed on self,’ also known as Munchausen syndrome, and ‘factitious disorder imposed on another,’ also known as Munchausen syndrome by proxy.
“Malingering is today estimated to cost the U.S. insurance industry upwards of $5 billion annually,” adds Rocio Moustafa, in closing, “with a particular report from the Texas Department of Insurance claiming that fraud which involves malingering may, in fact, cost the industry as much as $150 billion per year.”