Laypeople's prevalence estimates of malingering: Survey data from the Netherlands.

Abstract

Objective: Noncredible symptom claims not only occur in a sizable number of forensic cases, but also in clinical contexts. Health providers and forensic experts are confronted with the question of whether individual symptom claims are genuine, grossly exaggerated, or even invented. We investigated laypeoples’ prevalence estimates, their attitude and beliefs about malingering. Method: Extending a survey format from a previous Swiss study, we analyzed responses from 975 adult Dutch nationals who responded to an online structured interview on their assumptions and attitudes about malingering (in Dutch language sense of intentional symptom fabrication with an external goal). Results: Participants estimated that a sizeable minority of cases in different prototypical situations feigned symptoms to achieve external goals. They estimated that malingering most commonly occurs in offenders seeking diminished criminal responsibility. One in every seven participants admitted having malingered themselves, and many were confronted with malingering by family members, work colleagues, friends, or neighbors. Although the majority morally condemned malingering, a sizable minority admitted that malingering might be an option for themselves. Participants generally favored an adaptational and a criminological explanatory model of malingering (35% each). Conclusions: The high prevalence of noncredible symptom claims suspected by laypersons in diverse clinical and legal contexts corresponds to base rate estimates derived from numerous other surveys and group studies. Myths perpetuated by some clinical and forensic workers are seriously challenged by laypersons’ opinion, based on their very personal social perceptions of the reality, and on their admission of having feigned symptoms in the past themselves.