Malingering and Illness Deception

Sensitivities and confusion regarding the nature of illness deception continue to be a major feature of modern medicine and social security policy in most Western democracies. Although biomedical explanations dominate, neither of the standard psychiatric glossaries consider malingering -- the intentional production of false or exaggerated symptoms motivated by external incentives -- to be a valid diagnostic term. This is clinically and theoretically important, since disagreements both within and outside the medical community regarding the fundamental nature of illness deception are still largely framed in medical parameters given the absence of credible or acceptable non-medical accounts. In neglecting non-medical explanations, modern medicine runs the risk of underestimating the capacity of individuals to influence and control their own behaviours, as they do in other areas of life.