Moving Beyond “Malingering”: Reconceptualizing Feigned Symptoms as Motive‐Based Phenomena

Malingering-traditionally defined as the intentional production of false or exaggerated symptoms for external gain-has long been treated as a unitary construct. Yet patients who feign illness do so for widely divergent reasons, from seeking material necessities to avoiding legal accountability. This paper critiques the limitations of "malingering" as a clinical category and proposes a motivation-based taxonomy of feigned symptoms: Resource-Driven Symptom Expression (RDSE), Accountability-Avoidant Symptom Expression (AASE), Care Access Symptom Expression (CASE), and Socially Motivated Symptom Expression (SMSE). By reframing feigned presentations through motive rather than symptomatology, clinicians can bring an individualized, ethical and just approach to a significant clinical challenge.

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Publication Details

Journal
Behavioral Sciences & the Law
Published
2026-07-17
DOI
https://doi.org/10.1002/bsl.70084
Primary Topic
Psychosomatic Disorders and Their Treatments
Type
article
Field-Weighted Citation Impact
0.00

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article

Moving Beyond “Malingering”: Reconceptualizing Feigned Symptoms as Motive‐Based Phenomena

Jacob M. Appel
Behavioral Sciences & the Law
Psychosomatic Disorders and Their Treatments
article

Moving Beyond “Malingering”: Reconceptualizing Feigned Symptoms as Motive‐Based Phenomena

Jacob M. Appel
article en

Abstract

Malingering-traditionally defined as the intentional production of false or exaggerated symptoms for external gain-has long been treated as a unitary construct. Yet patients who feign illness do so for widely divergent reasons, from seeking material necessities to avoiding legal accountability. This paper critiques the limitations of "malingering" as a clinical category and proposes a motivation-based taxonomy of feigned symptoms: Resource-Driven Symptom Expression (RDSE), Accountability-Avoidant Symptom Expression (AASE), Care Access Symptom Expression (CASE), and Socially Motivated Symptom Expression (SMSE). By reframing feigned presentations through motive rather than symptomatology, clinicians can bring an individualized, ethical and just approach to a significant clinical challenge.

Behavioral Sciences & the Law
Mount Sinai Health System (US)
National Institute of Mental Health
Openalex Percentile: Top 7%
Psychosomatic Disorders and Their Treatments
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