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Malingering by Proxy:: A Literature Review and Current Perspectives

    1. [1] University of British Columbia

      University of British Columbia

      Canadá

    2. [2] University of Alabama, Tuscaloosa

      University of Alabama, Tuscaloosa

      Estados Unidos

  • Localización: Journal of forensic sciences, ISSN-e 1556-4029, ISSN 0022-1198, Vol. 61, Nº. Extra 1, 2016, págs. 171-176
  • Idioma: inglés
  • Texto completo no disponible (Saber más ...)
  • Resumen
    • Malingering by proxy (MAL-BP) is a form of maltreatment that involves a caregiver who fabricates or induces signs or symptoms in a child, dependent adult, or pet in pursuit of external, tangible incentives. Rarely studied, MAL-BP has an unknown prevalence, and is a challenging diagnosis for healthcare professionals. Therefore, a comprehensive computer literature search and review was conducted. The review uncovered a total of sixteen case reports of MAL-BP (eleven human, five veterinary). The motive for malingering was financial in all human cases and medication-seeking in all veterinary cases. Although the strategies employed differed among the identified cases, common themes regarding the best approach to identification of MAL-BP cases became evident. A comprehensive workup including a thorough history, physical examination, appropriate neuropsychological testing, and relevant collateral information forms the basis of an effective identification strategy. The optimal method of management is currently unclear due to a relative paucity of data and guidelines. However, management of these cases would likely include a team-based approach with a prudent assessment of safety for the proxy and a low threshold for referral to appropriate services. Long-term follow-up is essential and should be approached from a biopsychosocial perspective. Attention, research, and guidance on this topic are needed to develop further evidence-based guidelines for the identification and management of MAL-BP.


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