Factitious Disorder
Definition
Intentional production of symptoms motivated by psychological need to assume the sick role, without external incentive; distinct from malingering in motivation; not a basis for insanity defence.
- Motivation
- Psychological need to assume the sick role
- External incentive
- Absent, unlike malingering
- Symptom production
- Intentional
- Legal relevance
- Not a basis for an insanity defence
Common questions
How does an evaluator distinguish factitious disorder from malingering in practice?+
Both involve intentionally produced symptoms, so the distinguishing question is motive: an evaluator looks for external incentives such as financial compensation, avoiding prosecution, or obtaining drugs, which point to malingering, versus an internal drive to occupy the patient role even at personal cost, which points to factitious disorder.
Why isn't factitious disorder a basis for an insanity defence?+
Insanity defences generally require that a genuine mental illness impaired the defendant's capacity to understand or control their conduct at the time of the offence, but factitious disorder involves deliberate, goal-directed deception rather than a break from reality, so it does not meet that legal standard.
Related terms
- Below-Chance Performance
- Performance on a two-alternative forced-choice task below the 50% chance level; statistically impossible through genuine impairment; meets SSI Criteria Group A for...
- M-FAST
- Miller Forensic Assessment of Symptoms Test; 25-item brief screen for feigned psychopathology; designed for jail and pretrial settings where full SIRS-2 is...
- MAL (Malingering Index)
- PAI configuration-based supplementary index developed for forensic populations to detect feigned psychopathology; used alongside NIM and clinical scales.
- Malingering
- Intentional production of false or grossly exaggerated symptoms motivated by external incentives; a DSM-5 V-code (not a mental disorder) applicable when incentive...
- Performance Validity Test (PVT)
- Any test designed to detect inadequate effort or deliberate underperformance in cognitive assessment; TOMM is the leading example for memory; embedded PVTs...
- Response Style
- The systematic approach an individual uses in reporting symptoms and behaviour during assessment; includes genuine, amplification, fabrication, defensiveness, and random responding.
- Rogers Detection of Deception Model
- Multi-source, hypothesis-testing framework for response-style assessment; requires convergent evidence from at least two data sources and explicit consideration of alternative hypotheses before...
- SIRS-2
- Structured Interview of Reported Symptoms, Second Edition; 172-item structured interview with eight primary scales for detecting feigned psychiatric symptoms; yields genuine, indeterminate,...
- Slick-Sherman-Iverson Criteria
- 1999 classification framework for Malingered Neurocognitive Dysfunction; four levels (Definite, Probable, Possible, Not MND) based on convergent evidence criteria.
- Symptom Amplification
- Exaggeration of genuine symptoms beyond their actual severity; common and does not automatically meet the malingering threshold; requires integration with all assessment...
- TOMM
- Test of Memory Malingering; 50-item forced-choice visual recognition task; Trial 2 score below 45/50 indicates performance invalidity; most widely validated memory PVT.