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5 J. Forensic Psychiatry & Psych. 1 (1994)

handle is hein.journals/jnlofncpy5 and id is 1 raw text is: EDITORIALS Malingering PHILLIP RESNICK The ability to detect malingered mental illness is one of the most important skills of the forensic psychiatrist. General psychiatrists tend to take what their patients tell them at face value. The forensic psychiatrist brings a higher level of skepticism to evaluations for legal purposes and relies more upon collateral information. Szasz (1956) suggested that malingering is best viewed in the frame of reference of the sociopsychology of games. He pointed out that malingering has no meaning in a psychiatric situation that is limited to the clinician and patient. It becomes an issue only when the clinician is a representative of some social body, playing a role analogous to that of an umpire in a competitive sport. It is the psychiatrist's duty to make sure that no one cheats. Just as the umpire assumes that every player is out to win, the psychiatrist must assume that everyone is ready to use illness for illegitimate purposes. Malingering is defined as the intentional production of false or grossly exaggerated physical or psychological symptoms motivated by external incen- tives. At the peak of psychoanalytical influence, many authors labelled malingering a form of mental disease. For example, Eissler (1951) stated: 'It can rightly be claimed that malingering is always a sign of a disease, often more severe than a neurotic disorder because it concerns an arrest of development at an early phase.' Wercham (1949) noted: 'There is a strange, entirely unfounded superstition even among psychiatrists that if a man simulates insanity, there must be something mentally wrong with him in the first place. As if a sane man would not grasp at any straw if his life were in danger by the electric chair.' In the DSM-III-R and DSM-IV (American Psychiatric Association, 1987, 1993), malingering is appropriately identified as a condition not attributable to a mental disorder. Clinicians are quite reluctant to make a formal diagnosis of malingering. It is the equivalent of calling somebody a liar. Mental health professionals are @ Routledge 1994

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