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This places a large financial burden on society, negatively impacts the efficient operation of the healthcare system, and increases medical costs. In summary, despite ongoing advances in malingering detection, many individuals successfully malinger mental, cognitive, and physical disorders in order to gain financial compensation, avoid work, gain access to medications, and avoid prison. In addition to being very costly, such medications can cause harmful side-effects such as dystonias, diabetes, high blood cholesterol, and metabolic syndrome ( 12). Some researchers have expressed concern regarding the inappropriate use of antipsychotic medications administered to inmates who successfully feign psychosis. Prison inmates also feign psychiatric or cognitive symptoms in order to transfer to medical centers where they can gain access to pain medication and have greater contact with female staff ( 10, 11). It also provides malingerers with the opportunity to be moved from secure facilities, such as jails or prisons, to psychiatric facilities with more comfortable environments and from which escape is easier ( 9). Failure to detect malingering in cases of insanity or incompetency can delay prosecution for months or years and often results in unnecessary hospitalizations.
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In the criminal-legal realm, malingering has a negative impact on the proper execution of justice. Because of the difficulty of arriving at an accurate diagnosis, these clinicians fear they will be sued and are, therefore, reluctant to apply the label ( 8). In addition, many clinicians avoid diagnosing malingering for fear of legal consequences. Labeling an individual as a malingerer can be stigmatizing, which carries negative connotations and can negatively impact individuals for the remainder of their lives ( 7). In addition to the problem of not identifying individuals who are malingering, there are also very serious consequences for misclassifying malingering when an individual's presentation is genuine (false positives). Negative Effects of Misclassification/Burden on the Criminal-Justice System The accurate detection of malingering is thus a pressing societal issue. However, 79.9–86.4% of individuals are misclassified as malingerers (false positives) using the same criteria. For instance, Rogers and Shuman ( 6) found that the use of DSM criteria results in the accurate identification of only 13.6–20.1% of actual malingerers (true positives). Despite a clear definition, the detection of malingering is elusive. The term's usage has broadened to include other incentives, such as avoiding work, gaining financial advantage, avoiding arrest, evading criminal prosecution, mitigating sentencing, receiving medication, or gaining admission to a hospital for shelter ( 3, 5). Although the concept of malingering has existed for centuries, it was not until the mid-1900's that the term “malingering” was introduced to refer to soldiers who feigned illness or disability in order to avoid military service ( 4).
#JA ROGERS NATURE KNOWS NO COLOR LINE MANUAL#
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) defines malingering as “the intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives”. The present review adds uniquely to the literature by highlighting recent cognitive-based methods of lie detection and relevant theory potentially applicable to malingering detection. Previous reviews of malingering detection methods include Sartori et al. The present article is partly a review of methods of detecting malingering.