Evaluation of malingering

Abstract Malingering is defined as the deliberate production of symptoms of mental illness, with a clear external incentive. It may also be an environment-driven adaptive mechanism. In the carceral setting, malingering often proves challenging. Presentation may differ, detection strategies used elsewhere may not work in carceral settings, and inaccurate determinations may have serious consequences. Diagnosing malingering requires a thorough knowledge of genuine mental illness, a systematic approach to evaluation, identification of objective indicators, and the use of scientifically validated psychological tests when necessary. It is important that carceral clinicians investigate possibilities such as factitious disorder, dissimulation, and false imputation. Carceral clinicians must be aware of their own misassumptions and biases about incarcerated persons’ response styles, particularly in settings where incarcerated persons may have to convey their symptoms more forcefully to receive needed care. The finding that an incarcerated person has malingered symptoms does not rule out the presence of true mental illness, and a determination of malingering should not exclude the individual from receiving needed mental health services.