Malingering and Illness Deception

Section 1: Introduction
1:Wilful deception as illness behaviour, Halligan, Bass & Oakley
Section 2: Historical, Military and Evolutionary Origins
2:Malingering: historical perspectives, Wessely
3:Malingering, shirking and self-inflicted injuries in the military, Palmer
4:Can monkeys malinger?, Byrne & Stokes
Section 3: Conceptual, Methodological and Cultural Context
5:Conceptual issues and explanatory models of malingering, Rogers & Neumann
6:The social cognition of intentional action, Malle
7:Malingering and criminal behaviour as psychopathology, Raine
8:Alternatives to four clinical and research traditions in malingering detection, Faust
9:Characteristics of the sick role, Prior & Wood
10:The contemporary cultural context for deception and malingering in Britain, Robinson
Section 4: Illness Deception and Clinical Practice
11:Illness falsification in children: pathways to prevention?, Libow
12:Distinguishing malingering from psychiatric disorders, Sharpe
13:The nature of chronic pain: a clinical and legal challenge, Main
14:The misadventures of wanderers and victims of traumas, Pankratz
15:When the quantity of mercy is strained: US physicians' deception of insurers for patients, Wynia
Section 5: Medicolegal and Occupational Perspectives
16:Law, lies and videotape: malingering as a legal phenomenon, Jones
17:Outcome related compensation: in search of a new paradigm, Mendelson
18:Malingering and the law: a third way?, Sprince
19:How can organisations prevent illness deception among employees?, Baron & Poole
Section 6: Contributions from Cognitive Neuroscience
20:Lying as an executive function, Spence
21:Differential brain activations for malingered and subjectively 'real' paralysis, Oakley, Ward, Halligan & Frackowiak
Section 7: Disability Analysis and Insurance Medicine
22:Origins, practice and limitiations of Disability Assessment Medicine, Aylward
23:Malingering, insurance medicine and the medicalization of fraud, LoCascio
Section 8: Deception Detection
24:Investigating benefit fraud and illness deception in the United Kingdom, Kitchen
25:Neuropsychological tests and techniques that detect malingering, Frederick
26:Misrepresentation of pain and facial expression, Craig & Hill
27:Deceptive responses and detecting deceit, Vrij & Mann

• Presents a timely review of the conceptual boundaries between medicine and deception
• Addresses the problem from medical, social and legal perspectives
• Provides a comprehensive academic review covering detection, prevalence, differential diagnosis and related psycho-social processes

Despite a rich and turbulent history spanning several centuries, malingering continues to be a controversial and neglected clinical condition that has significant implications for medical, social, legal and insurance interests. Estimates of malingering - the wilful, intentional attempt to simulate or exaggerate illness in the pursuit of a consciously desired end - vary greatly, despite the fact that malingering is believed to contribute substantially to fraudulent health care and social welfare costs.

There is little consensus about what would constitute a coherent assessment of malingering, and base rates have been difficult to establish. Malingering remains a difficult attribution to make not least since it falls outside the remit of the formal psychiatric classifications. Labelling a person as a malingerer however, has significant medico-legal, personal and economic ramifications for both subject and accuser. Viewed in this way, malingering is not so much illness behaviour in search of a disease, as the manifestation of a conflict between personal and social values.

The aim of this book is to effect an integration of the different medical, forensic, neuropsychological, legal and social perspectives. The book provides an overview of progress in disparate fields relevant to the subject, including how recent social and neuroscience findings regarding volition, intentional states and theory of mind may have implications for informing detection, management and ultimately its explanation.

Author Information

Edited by Peter Halligan, School of Psychology, University of Cardiff, UK, Christopher Bass, Department of Psychological Medicine, John Radcliffe Hospital, Oxford, UK, and David Oakley, Department of Psychology, University College London, UK

Reviews and Awards

Highly Commended in the 2004 BMA Medical Book Competition - Mental Health Category

". . . [this book] handles a difficult, and emotive, matter with masterful neutrality and objectivity. The theoretical concepts are well explained and research data is allowed to speak for itself . . . important reading for all practitioners who are called upon to make medical judgements which influence a patient's access to an illness entitlement: for example, insurance claims, sickness certification or pensions assessments." - Primary Care Psychiatry, Vol 9, No 3

". . . an excellent theoretical overview of malingering." - Journal of Forensic Psychiatry and Psychology, Vol 15, No 2

". . . this is an invaluable attempt to define the conceptual framework for formal study of medical malingering. In contrast to the reductionist science which has dominated science for the last 50 years, this will inform the Art of medicine . . . I hope many of you will obtain this fascinating book." - Journal of Neurology, Vol 251, No 3