Moving Beyond "Malingering": Reconceptualizing Feigned Symptoms as Motive-Based Phenomena

Malingering-traditionally defined as the intentional production of false or exaggerated symptoms for external gain-has long been treated as a unitary construct. Yet patients who feign illness do so for widely divergent reasons, from seeking material necessities to avoiding legal accountability. This paper critiques the limitations of "malingering" as a clinical category and proposes a motivation-based taxonomy of feigned symptoms: Resource-Driven Symptom Expression (RDSE), Accountability-Avoidant Symptom Expression (AASE), Care Access Symptom Expression (CASE), and Socially Motivated Symptom Expression (SMSE). By reframing feigned presentations through motive rather than symptomatology, clinicians can bring an individualized, ethical and just approach to a significant clinical challenge.