Malingering by Proxy Presenting with Symptoms of Posttraumatic Stress Disorder: A Case Report of Child Abuse

Malingering by Proxy Presenting with Symptoms of Posttraumatic Stress Disorder: A Case Report of Child Abuse

According to the diagnostic criteria of the Fifth Edition of the Diagnostic and Statistical Manual for Mental Disorder, posttraumatic stress disorder (PTSD) can occur after a traumatic experience, such as threatened death, serious injury, or sexual violence, causing severe symptoms that interfere with a person's psychological, physical, interpersonal, occupational, and social functioning. Malingering-by-proxy (MAL-BP) is a form of abuse with motives such as pursuing money, getting more medicine, avoiding military service or imprisonment, getting a vacation, or other benefits and desires. It is commonly seen in general hospitals, where patients often complain about pain, cognitive deficits, and toxin exposure to feign symptoms. Malingering PTSD is involved in criminal, civil, and disability evaluation. Parents are often the perpetrators, directing or pressuring one's child to exaggerate or feign symptoms to obtain financial compensation or assuming a victim or hero rôle. MAL-BP can coexist with Munchausen by proxy and both are forms of maltreatment. The difference is that the latter assumes a sick rôle psychologically. The diagnoses differ every time depending on the motivations (external or internal). Therefore, false PTSD can adversely affect treatment, planning, and management. To accurately identify genuine cases of PTSD is important and, as part of the differential diagnosis, to rule out instances of false PTSD.