Case Report

By Dr. Sayed M Marashi
Corresponding Author Dr. Sayed M Marashi
Dept of Forensic Medicine and Clinical Toxicology, Tehran University Of Medical Sciences, Tehran, - Iran (Islamic Republic of) +98664055588
Submitting Author Dr. Sayed M Marashi

Malingering, Deception, Forensic Psychiatry, Crime, Murder, Law

Marashi SM. Malingering in Forensic Psychiatry Evaluation. WebmedCentral PSYCHIATRY 2011;2(11):WMC002481
doi: 10.9754/journal.wmc.2011.002481
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Submitted on: 15 Nov 2011 06:05:11 PM GMT
Published on: 16 Nov 2011 06:33:38 AM GMT


Malingering and deception are of the most important issues facing forensic psychologist. Noticeable point in malingerer cases is that almost always external motivation for creating deliberate and conscious physical and mental symptoms exist. Many of these cases deliberately expressed vague and subjective symptoms. Therefore it is necessary for forensic evaluator to be familiar with this diagnosis and to try to determine real and faking symptoms.

Case Presentation

A 26-year-old man with no psychiatric or medical history was brought to the Tehran psychiatric department of legal medicine center with a juridical order to evaluate psychiatric status. He was assaulted on a 2-year-old boy in his apartment. He claimed that he had problems since six months ago when he tried alcohol for the first time. He claimed that his father was trying to harm him and perceived strayed ghosts flying around his head in the morning, when he is still in bed. He had scrambled when sitting on a chair and was hostile to the retainer and tried to dodge the debate.


Malingering and deception are of the most important issues facing forensic psychologist (1). Noticeable point in malingerer cases is that almost always external motivation for creating deliberate and conscious physical and mental symptoms is exist (2).Many of these cases deliberately expressed vague and subjective symptoms; and even when represent symptoms of a specific disorder, usually announced symptoms sometimes exist and sometimes resolved (1). Most studies evaluate diagnostic tests in this context, however limited studies in faked psychiatric symptoms in forensic court conducted around the world (2). Rogres and et al. compared malingering symptoms as mental disorders, cognitive disorders and clinical syndromes in forensic and non-forensic cases. They showed that more forensic cases fake mental disorder, and faked clinical symptoms were more common than cognitive symptoms (3). Cornell showed that auditory hallucination is the most common faked symptom followed by exaggerated behavior in cases mimic symptoms of mental disorder. Disproportionate affect, neologism, non-abstract thinking and low personal hygiene rarely been faked. Sexual offenses, robbery and assault were the most common cases that fake mental disorders (4). According to Cochrane and et al. (5) kidnapping, state crimes and illicit drug crimes compared others requiring more cognitive potential to make an appropriate map, hence profound psychiatric disorder such as psychosis rarely correlate with these complex crimes. The unexpected finding in this study was lower rate of malingering of psychiatric disorder in cases charged with murder. Kucharski and et al. Show that diagnosis can be made confidently in 90% of cases because of unusual symptoms being claimed by suspected malingerer individuals. Often, performance do not match with mentioned mental symptoms, unusual signs exists and often expressed hallucination that does not in esse in mental disorders (6). Poythress evaluate symptoms of psychopatic personality disorder cases and compared them with faked symptoms of depression, mania, paranoia and schizophrenia; there was significant difference between two groups (7). Mittenburg showed that patient's status, not correlate to severity of cognitive impairment, is the most helpful clue in detection of malingering (8). In fact, malingering is an untruthful imitation of a problem for a personal gain (9). Based on American Psychiatric Association's Diagnostic and Statistical Manual 4th Edition (DSM-IV) scale, symptoms should be fully overemphasized(10).
What inevitably define this diagnosis is planned fraud for an exterior mover (11). These defendants often implicate in liability and usually difficult with cross-examines. (12).
In our case,the personal gain was attributed to release from responsibility in his criminal pertinence. delusional thought, confabulation, visual hallucinatory perceptions and relation to people status were entirely exaggerated by the defendant. His external motivation was awfulness from juridical reprimand.


1. Hall HV, Poirier JG. Detecting malingering and deception: Forensic distortion analysis. CRC Press. 2000. page 3-5
2. Sellbom M, Ben-Porath YS,Graham JR and Susceptibility of the MMPI-2 clinical, restructured clinical (RC), and content scales to overreporting and underreporting. Assesssment. 2005. 12. 79-85
3. Rogers R, Salekin RT, Sewell KW and A comparison of forensic and non-forensic malingerers: A prototypical analysis of explanatory models. Law and human behavior. 1998. 22. 353-367
4. Cornel DG, Hawk GL. Clinical presentation of malingered diagnosed by experienced forensic psychologist. Law and human behavior.1989. 13(4). 375-383
5. Cochrane RE, Grisso T, Frederick RI. The relationship between criminal charges, diagnoses and psycholegal opinions among federal preterial defendants. Behavioral sciences and the law.2001. 19. 565-582
6. Kucharski L.T, Ryan W , Vogt J , Goodloe E. Clinical symptom presentation in suspected malingerers: An empirical investigation. Journal of the American Academy of Psychiatry and the Law.1998. 26(4). 579-585
7. Poythress NG, Edens JF, Watkins MM. The Relationship Between Psychopathic Personality Features and Malingering Symptoms of Major Mental Illness. Law and Human Behavior. 2001.25 (6). 567-581
8.Mittenberg W, Patton C, Canyock EM, Condit DC. Base rate of malingering and symptom exaggeration. Journal of cliical and experimental neuropsychology. 2002. 24(8). 1094-1102
9. Resnick P.The detection of malingered psychosis.Psychiatric Clinics of North America.22(1).159-172
10. Wiley S.Deception and detection in psychiatric diagnosis.Psychiatric Clinics of North America.21(4).869-893
11. Greve K, Bianchini K.Response to Butcher et al., the construct validity of the Lees–Haley Fake–Bad Scale.Archives of Clinical Neuropsychology.19(3).337-339
12. Pathe M, Mullen P, Purcell R.Stalking: false claims of victimization.Stalking: false claims of victimization.174.170-172.

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2 reviews posted so far

Posted by Dr. Subhagata Chattopadhyay on 09 Nov 2011 02:35:09 AM GMT

Malingering In Forensic Psychiatry Evaluation
Posted by Dr. Naseem A Qureshi on 01 Jan 2012 04:32:26 AM GMT

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