Talk:Malingering: Difference between revisions

Performance?

If an actor fabricates the symptoms of a disorder to portray a character, that's not malingering, right? Where is the line between performance and malingering drawn? --Damian Yerrick (talk | stalk) 23:43, 29 March 2007 (UTC)

Where there is a secondary gain for the patient. --PaulWicks 21:53, 30 March 2007 (UTC)

But what is classified as secondary gain? Have there been any notable court cases against performance artists accusing them of seeking a secondary gain? --Damian Yerrick (talk | stalk) 04:30, 31 March 2007 (UTC)

Sorry, I thought this was a joke at first hence the brevity of my response. OK, well if an actor is acting sick, that's acting. However if an actor can't be bothered to show up for rehearsals and so feigns an illness, that's malingering. Malingering is not a crime, nor really a diagnosis, it's more of a verb really. --PaulWicks 09:26, 31 March 2007 (UTC)

It can be symptomatic of other illnesses or abuse. I know many like to classify it purely as criminal behavior, but it usually is indicative of some other more severe problem that goes untreated. 24.47.159.180

most commonly feigned

This material is very deceptive and POV, "The disorders most commonly feigned include mild head injury and medically unexplained symptoms like those associated with fibromyalgia and chronic fatigue syndrome.[1] The source actually states, "...the most likely ailment to be malingered was mild head injury, followed by fibromyalgia or chronic fatigue syndrome, pain, neurotoxic disorders, electrical injury, seizure disorders, and moderate or severe head injury. [2] In another report, malingerers more commonly presented with cervical pain and repetitive strain injuries...".[3] The text cherry picks data while ignoring other data. In addition, the primary source, Mittenberg reports about "diagnostic impressions of probable malingering", it is not clear how that corresponds to proven malingering.

The source also contradicts wording in the article, "a study...asked 172 Veterans Administration patients and 160 medical students...to complete a questionnaire..." The questionnaire contained a pattern of medically unexplained symptoms, "problems for which a physician could find no organic basis, and a malingering index score was calculated....The study revealed... medical and surgical patients...received a malingering index score even slightly lower than that of the medical students."

Another review does not conclude malingering in fibromyalgia is high, PMID 18935761. "In Israel, there is an increase in the number of suits filed against private insurance companies and the National Insurance system for post-traumatic fibromyalgia. According to the literature, it is probable that the number of cases that involve malingering or secondary gain is low." Ward20 (talk) 03:17, 20 July 2009 (UTC)

OK so add more sources or change wording or discuss, do not delete MEDRS. Pls also be civil, it is not deceptive the article gives list, "mild head injury followed by fibromyalgia or chronic fatigue syndrome" i did not go down to least likely, it is not deceptive i am giving a few exampels also the large study found 37-39% from the claim cases were probably malingering, you delete that also wo discussing. The other review, you just read abstract or do you read Hebrew? BC article is in Hebrew and it says in Israel "it is probable" the number is "low" it does not say the percentage is low and it does not say what low is. Obvious, you can not prove a FM case is malingering bc there is no total objective test for FM or malingering. I am reverting, pls discuss changes you want. RetroS1mone talk 02:25, 21 July 2009 (UTC)

Reasons why the material is deceptive and POV are discussed on the talk page above.[4] The material was removed as stated in the edit summary.[5] It's not uncivil to call material deceptive. WP:MEDRS is not a reason to keep material that contradicts its source.

To reiterate, The cited (McDermott) source[6] references two malingering studies among others.[7][8] The Mittenberg reference found 39% percent of mild head injury, 35% of fibromyalgia/chronic fatigue, 31% of chronic pain, 27% of neurotoxic, and 22% of electrical injury claims had "probable malingering and symptom exaggeration". The Hurst reference found different results that, "malingerers more commonly presented with cervical pain and repetitive strain injuries." [9] The chronic pain, and neurotoxic percentages are also close to the FM and CFS percentages. The McDermott source states there are huge large variations in these types of studies, and that another study found fibromyalgia cases (25-30%) had similar malingering results as chronic pain.

McDermott only once mentioned medically unexplained symptoms to discuss a study that found medical patients having medically unexplained symptoms had a malingering index score lower than medical students.

The Israeli FM study abstact is quoted directly. I don't know what low is in their study, but 35% is not low by any reasonable definition.

It is not correct to say mild head injury and medically unexplained symptoms like those associated with fibromyalgia and chronic fatigue syndrome are the most commonly feigned, as the source does not state that and the Israeli study contradicts it. The material cherry picks data to state something different than what McDermott states. There is uncertainty and differences in opinion about the amount of illness feigned. McDermott implies medically unexplained symptoms are not most commonly feigned.

The whole sentence, "The disorders most commonly feigned include mild head injury and medically unexplained symptoms like those associated with fibromyalgia and chronic fatigue syndrome", is misleading and inaccurate to the source. The whole sentence is so obviously biased (head injury is not linked while the other conditions are for example) there is no reason to keep any of the sentence. No condition illness should be stigmatized in this manner. There is no constructive reason for it. Period, full stop. Ward20 (talk) 22:25, 22 July 2009 (UTC)

MEDRS say some conditions are feign more then other conditions. MEDRS say, some people including the person that wrote the ACR classification for fibromyalgia do not believe, FM is a disease. These view points are notable and important in literature, it is constructive when all major view points are in Wiki not only the view points Ward20 and RetroS1mone likes.

Stigmatize, McDermott says people more likely fake FM etc bc pain is more easy to fake, why that does "stigmatize" real FM or CFS or IBS? People fake chest pain to get drugs, it does "stigmatize" heart disease? People fake head injuries, it does "stigmatize" head injuries?

"The Hurst reference found different results" bc the Hurst reference is only about chest pain and it is smaller, the Mittenberg study was 33,000 patients refered and any condition. The Mittenberg study says 35% of FM/CFS claims may be malingered and it says, percentage is 2-4% under the real bc from reporting bias, that is why other sources say from 35-39%. You can read more in the text on Malingering, R. Rogers Clinical Assessment of Malingering and Deception 3rd Edition, Guilford, 2008. ISBN 1593856997

A review in Hebrew about Israel is it MEDRS for English encyclopedia, when it is it is MEDRS for situation in Israel, it does not contradicts a NA study and other reviews and textbooks. When it contradicts, i do not think it does, it does not say it is false.

We can also talk on the effort reporting literature, i did not cite that yet. RetroS1mone talk 02:44, 23 July 2009 (UTC)

Malingering is not considered a mental illness

"Malingering is not considered a mental illness. In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV- TR) , malingering receives a V code as one of the other conditions that may be a focus of clinical attention."[10]

"It is interesting to note that malingering is not considered a form of mental illness or psychopathology; rather it is considered a deliberate behavior. Malingering is classified in the DSM-IV-TR as a "V" code (ie, other conditions that may be a focus of clinical attention)."[11] Ward20 (talk) 04:47, 23 July 2009 (UTC)