Factitious and Malingered Dissociative Identity Disorder

Abstract

This paper compares the clinical features of 18 persons given a diagnosis of factitious or malingered Dissociative Identity Disorder with those of 18 matched persons who were given a diagnosis of genuine Dissociative Identity Disorder, taken from a sample of 129 second opinion consultations. Clinical features suggesting a factitious diagnosis or malingering included having a score above 60 on the Dissociative Experiences Scale (DES), reporting dissociative symptoms inconsistent with the reporting on the DES, being able to tell a chronological life story and to sequence temporal events, using the first person over a range of affect, being able to express strong negative affect, bringing “proof of a dissociative diagnosis to the consultation, having told persons other than close confidants about the alleged abuse or alleged dissociative diagnosis, reporting alleged abuse that was inconsistent with the medical or psychiatric history or volunteering allegations of cult or ritualized abuse, telling of alleged abuse without accompanying shame, guilt, or suffering, having been involved in community self-help groups, not having symptoms of co-morbid posttraumatic stress disorder, and having obvious secondary gain in having a dissociative diagnosis. Given the potential legal ramifications of making afalse positive diagnosis of Dissociative Identity Disorder and recognizing that the treatment for persons with valid dissociative psychopathology differs from the treatment of factitious illness, it is prudent to be able to separate the two groups.

Key Words:

• Factitious
• malingering
• diagnosis
• Multiple Personality Disorder
• Dissociative Identity Disorder