Factitious and Malingered Dissociative Identity Disorder

Area of Science:

• Psychiatry
• Psychology
• Forensic Psychology

Background:

• Dissociative Identity Disorder (DID) is a complex psychiatric condition.
• Differentiating genuine DID from factitious or malingered presentations is challenging but critical for appropriate treatment and legal considerations.

Purpose of the Study:

• To compare the clinical features of individuals diagnosed with factitious/malingered DID versus genuine DID.
• To identify specific indicators that differentiate between genuine and feigned DID.

Main Methods:

• A comparative study of 36 individuals (18 factitious/malingered DID, 18 genuine DID) from a larger sample (129) undergoing second opinion consultations.
• Analysis of clinical features associated with each diagnostic group.

Main Results:

• Features suggesting factitious/malingered DID include high Dissociative Experiences Scale (DES) scores (>60), inconsistent symptom reporting, ability to provide chronological life narratives, use of "I" statements across affect ranges, expressing strong negative affect, presenting "proof" of diagnosis, discussing abuse with non-confidants, inconsistent abuse histories, lack of shame/guilt regarding abuse, involvement in self-help groups, absence of co-morbid PTSD, and obvious secondary gain.
• Genuine DID presentations often lack these specific indicators.

Conclusions:

• Several clinical features can help distinguish between genuine Dissociative Identity Disorder and factitious or malingered presentations.
• Accurate differentiation is essential due to the significant legal and treatment implications of misdiagnosis.