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Chemosensory Disorders and Nutrition
Published in Alan R. Hirsch, Nutrition and Sensation, 2023
Carl M. Wahlstrom, Alan R. Hirsch, Bradley W. Whitman
Occasionally, groups that share similar chemosensory complaints are seen. Olfactory impairment or phantosmia due to a shared olfactotropic virus among family members or a connubial olfactotropic virus or as a result of olfactotoxic exposure in those who share contaminated groundwater or soil (for instance, due to trichloroethylene) demonstrate similar chemosensory complaints within each group (Hirsch 1995a, 1995b; Hirsch and Skolnik 1994). However, in other group symptom situations, malingering is frequently considered—that of hysterical or mass illness. In these circumstances, often involving school children in a common classroom or workers in a shared office space, those affected will frequently report noticing the same irritating odor and developing a wide range of symptoms including shortness of breath, dizziness, paresthesias, headaches, and occasional palinosmia (with presentation of the initial precipitating odor). In these events, the nidus for the symptoms is often not a primary neurotoxin, but rather, a benign ambient aroma which is a nontoxic bystander, upon which blame is assigned. However, the origin of the symptoms is often a primary situational or psychological basis and transmitted due to group effect of conformity. Once a key member admits smelling an odor, all others follow suit and similar post-exposure symptoms are thus derived.
Neuropsychological Deficits in Functional Somatic Illness
Published in Peter Manu, The Psychopathology of Functional Somatic Syndromes, 2020
Thirteen of the 57 patients had evidence of malingering. The data generated by the remaining 44 subjects were analyzed with structural equation modeling techniques, which assumed the information processing speed to be inversely correlated with body consciousness and somatic symptoms.
Common otology viva topics
Published in Joseph Manjaly, Peter Kullar, Advanced ENT Training, 2019
Malingering patients are intentional in falsifying or exaggerating symptoms. Factitious patients intentionally feign hearing loss for internal gain. Conversion patients are not intentional in responding at suprathreshold levels. By understanding the underlying motivation and degree of intent, it is easier to recognise non-organic behaviour and manage the patient appropriately. The initial strategy should be non-confrontational. If the patient has been given chances to respond appropriately yet continues to respond at suprathreshold levels (as proven by other tests), further testing to identify non-organic hearing loss should take place.
Validity assessment in clinical neuropsychology practice: evaluating and managing noncredible performance
Published in Brain Injury, 2023
Invalid test performance can occur in routine clinical settings. The book takes the reader back to basics with a clear explanation of why validity needs to be assessed due to the risks posed by the collection of invalid test data. Invalid test performance may lead to the provision of inaccurate diagnoses, reinforcement of noncredible symptoms, and recommendations of unnecessary or unhelpful treatment or rehabilitation, including recommendations for inaccurate restrictions, such as limitations on independent living, work, or driving. From a clinical perspective, the initial chapters provide very comprehensive explanations for why validity tests are failed and discounts commonly held clinical assumptions with a detailed and up-to-date review of the literature. This is presented in a clear and straightforward manner that will allow the practising neuropsychologist to develop a clinical formulation to incorporate validity test failure and to then provide appropriate feedback, inform neuropsychological treatment, and communicate with colleagues. The book narrows down the reasons for validity test failure, excluding cognitive or behavioral dysfunction arising from depression or anxiety, for example. Interestingly, malingering is discussed in a clinical context with recognition that it does occur and how this may impact the client–practitioner relationship. A valuable primer on the psychometric properties of validity test allows the clinician to consider base rates of invalid responding and to select the best tools to use for their clinical population.
The Role Played by Theory of Mind and Empathy in the Feigning of Psychopathology
Published in International Journal of Forensic Mental Health, 2022
Marzia Di Girolamo, Luciano Giromini, Jessica Bosi, Lara Warmelink, Ilaria La Scala, Caterina Loiacono, Federica Miraglia, Alessandro Zennaro
Malingering is the intentional feigning, production, or significant exaggeration of physical or psychological symptoms, or the intentional misattribution of genuine symptoms to an unrelated event or series of events when this is specifically motivated by external incentives or rewards (American Psychiatric Association, 2013; World Health Organisation, 2018). Given the utilitarian connotation of the phenomenon, malingering is strictly related to some specific contexts, for example to avoid work, to evade criminal prosecution or to obtain economic indemnities thanks to a physical or psychopathological diagnosis. While the exact prevalence of malingering is unknown, malingering has been suspected in an estimated 30% of over 3,500 disability cases (Mittenberg et al., 2002) and in 40% of cases where individuals claimed to have a mild traumatic brain injury in the USA (Larrabee, 2003). According to Young (2017), a more reasonable base rate estimate for civil litigation settings would be around 15%; in criminal forensic settings, however, this percentage may even approximate or exceed 50% (Ardolf et al., 2007). Malingering detection remains challenging yet is crucial for making correct diagnoses when it is likely to occur, and to ensure that resources will be allocated appropriately to those that actually require them. Economic and social consequences associated with malingering are considerable; the cost of malingering in 2011 was estimated to amount to over $20 billion in the USA (Chafetz & Underhill, 2013).
Misperception of sleep duration in mild traumatic brain injury/concussion: a preliminary report
Published in Brain Injury, 2021
T Lan Chun Yang, A Colantonio, Tatyana Mollayeva
Due to the specifics of our research participants (i.e., persons undergoing clinical and psychiatric investigation for work-related injury and disability), we investigated the possibility of malingering to influence reports of sleep duration. In all our analyses, malingering was neither statistically associated with self-reported and PSG-measured sleep duration nor with sleep differences. In other studies, it was shown that malingering can be influential in person-reported outcomes when secondary gains might be involved. In a study that looked at symptom over-reporting during a modified Stroop Effect test in a population of Veterans of Operation Enduring and Iraqi Freedom with and without PTSD, it was found that those who displayed a higher level of distress might have been doing so purposefully to indicate “a cry for help” (37). The authors could not rule out the possibility that characteristics of patients with mTBI with sleep-state misperception in the direction of under- or over-reporting might be differently driven by anxious/distress and depressive phenotypes (38–40). Future research on this topic is greatly needed.