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16 Psych. Inj. & L. 1 (2023)

handle is hein.journals/psyinjl16 and id is 1 raw text is: Psychological Injury and Law (2023) 16:1-17 https://doi.org/l 0.1007/s12207-022-09458-w Prevalence Estimates of Symptom Feigning and Malingering in Spain Esteban Puente-L6pez' David Pina2 - Reyes L6pez-L6pez2 - H4ctor Gonzalez Ordi3 - Irena Boskovit4- Thomas Mertens Received: 10 February 2022 / Accepted: 28 June 2022 / Published online: 26 July 2022 @The Author(s) 2022 Abstract Symptom feigning and malingering should be evaluated in forensic contexts due to their important socio-economic con- sequences. Despite this, to date, there is little research in Spain that evaluates its prevalence. The aim of this study was to investigate this issue using the perception of the general population, students, and professionals of medicine and forensic psychology. Three adapted questionnaires were applied to a total of 1003 participants (61.5% women) from 5 different groups. Approximately two-thirds of participants reported knowing someone who feigned symptoms, and one-third disclosed feigning symptoms themselves in the past. Headache/migraine, neck pain, and anxious-depressive symptoms were the most com- monly chosen. Experts in psychology and forensic medicine estimated a prevalence of 20 to 40% of non-credible symptom presentations in their work settings and reported not having sufficient means to assess the distorted presentation of symptoms with certainty. Professionals and laypersons alike acknowledge that non-credible symptom presentations (like feigning or malingering) are relevant in Spain and occur at a non-trivial rate, which compares with estimates in other parts of the world. Keywords Feigning - Malingering - Illness presentation - Prevalence - Survey Assessments made in both clinical and forensic settings depend, to a large extent, on the symptom presentation of the person to be evaluated, their openness and accuracy in responding, and their willingness to make a sincere and sustained effort (Merckelbach et al., 2019). Therefore, the practitioner must consider the possibility that patients may be deceitful in their symptom presentations due to goals or motives unrelated to the diagnosis or condition (Merten & Merckelbach, 2020). In a clinical context, a patient may obtain gains associated with having a disease (affective benefits) by acquiring the status of being ill. In forensic contexts, having certain diagnosis may help to gain legal or financial benefits, such as limited criminal liability or finan- cial compensation for personal injury or disability. In many cases, both primary (internal) and secondary (external) David Pina david.pina@um.es Universidad Nebrija, Madrid, Spain 2 Universidad de Murcia, Murcia, Spain 3 Universidad Complutense de Madrid, Madrid, Spain 4 Erasmus University Rotterdam, Rotterdam, Netherlands 5 Vivantes Klinikum Im Friedrichshain, Berlin, Germany benefits occur simultaneously (Gonzilez-Ordi et al., 2012; Merten & Merckelbach, 2020). When symptom deception is followed by known external gains, it is called malingering. However, when the type of motive driving such behavior is unknown, the term feigning is preferred (Rogers & Bender, 2018). Feigning includes both malingering and other forms of factitious illness presentations. A considerable amount of research focuses on establishing prevalence estimates of feigning across cultures and reference contexts (e.g., Dandachi-FitzGerald et al., 2020; Santamaria et al., 2013; Schroeder et al., 2021). Researchers in the field of symptom validity assessment make exceptional efforts to establish the prevalence of feigning across cultures, but the available estimates of the prevalence of feigning/malingering differ significantly and it is difficult to arrive at a precise range due to the great heterogeneity of published studies (Merten & Merckelbach, 2020). For example, Mittenberg et al. (2002) found that, depending on the setting (i.e., criminal, civil or medical), feigning was suspected in approximately 7 to 31% of neuropsychological assessment cases. Greve et al. (2009) examined the prevalence in 508 chronic pain patients seek- ing compensation in North America, finding a base rate of 32.5 to 35%. Similarly, Chafetz (2011) examined the perfor- mance of 161 social security disability claimants, finding that 1 Springer

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