Fraud in emotional harm and neuropsychological injury claims.
The possibility of a Somatoform Disorder also must be excluded. Somatoform Disorders are mental disorders that result in the patient expressing psychological conflict and distress in the form of physical symptoms that can appear like a general medical condition. They include:
- Somatization Disorder is a polysymptomatic disorder that begins before age 30, extends over a period of years, and is characterized by a combination of pain, gastrointestinal, sexual, and pseudoneurological symptoms.
- Undifferentiated Somatoform Disorder is characterized by unexplained physical complaints lasting at least six months that are below the threshold for a diagnosis of Somatization Disorder.
- Conversion Disorder involves unexplained symptoms or deficits affecting voluntary motor or sensory function that suggest a neurological or other general medical condition. Psychological factors are associated with the symptoms or deficits.
- Pain Disorder is characterized by pain as the predominant focus of clinical attention. In addition, psychological factors are judged to have an important role in its onset, severity, exacerbation, or maintenance.
- Hypochondriasis is the preoccupation with the fear of having, or the idea that one has, a serious disease based on the person’s misinterpretation of bodily symptoms or bodily functions.
- Body Dysmorphic Disorder is the preoccupation with an imagined or exaggerated defect in physical appearance.
- Somatoform Disorder Not Otherwise Specified is included for coding disorders with Somatoform symptoms that do not meet the criteria for any of the specific Somatoform Disorders.
Malingering Emotional HarmPosttraumatic Stress Disorder (PTSD) is among the most common emotional harm claims in complex high risk cases, and since many of the signs and symptoms are well known among the general public, exaggerated or malingered symptoms are often suspected.
The rate of malingering among PTSD claimants is not known with any precision, but published estimates range from 20-59%. Those figures may be underestimates since those who are successful in their deception would not be counted.
Forensic examiners who are unaided by specialized tests cannot distinguish reliably between malingerers and persons actually suffering a mental disorder. One recent study in a state forensic facility found that psychiatrists who relied on interviews and medical file data failed to identify 50% of malingerers who were identified through specialized testing. The error rate likely is much higher among professionals in non-forensic settings who are focused on treatment rather than forensic assessment.
