MCAT® ExamPsychological, Social, and Biological Foundations of BehaviorHard
A patient with a history of chronic pain is admitted for a new, acute injury. During their hospital stay, nurses notice that the patient frequently reports pain levels of '10/10' even for minor discomforts, and often requests strong opioid medications. Family members report that the patient often exaggerates symptoms at home to gain attention. This behavior is most consistent with which of the following psychological concepts?
- AIllness anxiety disorder
- BMalingering
- CFactitious disorder
- DSomatic symptom disorder
Show answer & explanationAnswer & explanation
Correct answer: C. Factitious disorder
Factitious disorder is characterized by falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception. The motivation for the behavior is to assume the sick role, not for external incentives like financial gain, which distinguishes it from malingering.
Why the other options are wrong
- A. Illness anxiety disorder involves preoccupation with having or acquiring a serious illness, with somatic symptoms being absent or mild. The patient's exaggeration for attention doesn't fit this.
- B. Malingering involves intentionally faking or exaggerating symptoms for external incentives, such as financial compensation, avoiding work, or obtaining drugs. While drug-seeking is present, the family's report of exaggerating for 'attention' points more strongly to the sick role motivation of factitious disorder than a clear external incentive like avoiding legal action or obtaining specific drugs for sale.
- D. Somatic symptom disorder involves distressing somatic symptoms that result in significant disruption of daily life, with excessive thoughts, feelings, or behaviors related to the symptoms. While there are symptoms, the key here is the intentional exaggeration for attention, not just distress over symptoms.
Factitious Disorder
A mental disorder in which a person acts as if he or she has a physical or mental illness when he or she is not really sick. The primary motivation is to assume the sick role and gain attention/sympathy, not for external rewards.
- Intentional falsification or induction of symptoms.
- Motivation is to assume the sick role.
- Absence of obvious external incentives (distinguishing from malingering).
- Can be imposed on self or on another.
Memory trick: Somatic Symptoms: Sickness, Suspicion, or Simulation.