Malingering, Factitious or Functional Disorder? Clinical Neuropsychology and the Perennial Issue of Symptom Validity - Dr Linda Monaci, Consultant Clinical Neuropsychologist and Chartered Clinical Psychologist
02/04/16. Many practitioners appear to privately offer medico-legal services involving the assessment of cognitive and emotional functioning after a road traffic accident. What can be challenging is to distinguish between clinicians who have completed all the relevant training, those who are qualified as a Clinical Psychologist and those who instead even lack the basic compulsory registration to practise. It is relatively common to come across practitioners who believe assessing someone’s cognitive functioning just consists of “administering some tests”. However, even graduate psychologists (employed in the NHS as Assistant Psychologists) can administer tests under supervision. The challenge and the aspect requiring clinical skill, is how to interpret data generated from testing.
Medico-legal assessments involve interpreting potentially complex clinical situations, but also additional litigation factors. Practitioners must be mindful that human behaviour can be influenced by a range of internal as well as external factors. Historical records show that human beings have long engaged in deceptive behaviour to avoid duties or bring them advantages. For instance, the Hebrew Bible reports that David feigned insanity to escape from a king who viewed him as an enemy (Sam 21: 10-15, cited in Stone & Boone, 2007). As early as Roman times, Galen reported two cases involving feigned illness to avoid performance of duties (Lund, 1941)...
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