What Are The Differences Between Malingering and Factitious Disorder?

In mental health, there can be a fine line between the two Factitious Disorders and something called Malingering. Being able to set these two areas apart is important.

Both of the Factitious Disorders, along with malingering, involve the fabrication, feigning, or overemphasis of either physical or psychological symptoms.

But crucially, malingering aims to achieve an outcome like time off work, receiving medicine, mitigation of sentencing, or avoiding legal requirements.

Meanwhile, those with a factitious disorder are acting in the way they do to fulfil psychological needs – such as wanting attention, sympathy, and care.

Definitions

There are two different types of Factitious Disorders:

Factitious Disorder Imposed on Another (Munchausen’s Syndrome by Proxy): Factitious Disorder Imposed on Another is a mental health disorder that is characterised by a person acting as if someone in their care has a physical or mental illness. Someone with this condition will fabricate an illness in those under their care – typically a child.

Factitious Disorder Imposed on Self (Munchausen’s Syndrome): Factitious Disorder Imposed on Self is a mental health condition which involves a person acting like they have a physical or mental illness. The person actively feigns their symptoms and will often hurt themselves to cause the symptoms.

Meanwhile, malingering involves the fabrication, creation, or an over-exaggeration in physical or psychological symptoms. We have an article that you can read here – which looks at malingering in more detail.

Factitious Disorders and Malingering differences

Motivation

The key difference between the two factitious disorders and malingering is the motivation for feigning the illness.

Those who engage in malingering feign symptoms for a tangible gain. For instance, this may be time off work, monetary reward, avoiding an important presentation, or getting out of legal duties, among others.

But those with a factitious disorder engage in their behaviour to fulfil their psychological needs. They may be trying to seek attention, sympathy, or attain the role of a patient.

Classification

Aside from motivations, the classification of these areas are different. For example, both Factitious Disorders are classed as mental illnesses. Meanwhile, malingering is not seen as a mental illness.

Timing

Malingering is also not typically chronic. Someone may feign illness for a few hours, days, or weeks to get out of something. But they would typically return once the thing they are trying to avoid is finished.

Treatment

Someone with a factitious disorder will normally happily engage in treatments – despite risks or invasiveness. This contributes to their charade.

However, someone that malingers would not be the same. Instead, they would not partake in unnecessary tests or surgery.

Typical person

Anyone can malinger – irrespective of age and gender. However, research suggests that certain people have a higher chance of fabricating illnesses, especially in those under their care [1].

The research alluded to above found that almost all abusers (97.6%) were female, with over three quarters (75.8%) being married [1].

Moreover, interestingly, the research found that 45.6% of cases of fabricated illness in others involved the abuser having a healthcare-based role [1]. So there are certainly traits involved in the factitious disorders.

Examples

Someone who has Factitious Disorder Imposed on Another would induce an illness on someone in their care. For instance, they may infect a wound from their child to worsen their condition and cause an infection.

Meanwhile, someone who has Factitious Disorder Imposed on Self would induce an illness in themself. Perhaps they would abstain from food to make it appear that they are losing weight from a physical health condition.

But someone who is malingering may be reluctant to carry out employment. They may act like they have a bad back in an effort to claim disability benefits. They are acting in this way completely consciously and have personal gain in mind – money.

Summary

There is certainly some crossovers between the two Factitious Disorders and malingering, but they are distinct areas with many differences.

It is very important that anyone with a Factitious Disorder seeks psychological treatment, especially in cases where a caregiver is abusing someone.

See Also

• Somatic Disorders: Everything You Need To Know
• What is Malingering? Malingering in Mental Health Analysed
• Gypsy Rose and Dee Dee Blanchard: A Match Made in Hell
• What Causes Factitious Disorder Imposed on Self (Munchausen’s Syndrome)?