Simulation, when the lie wants to be true

We have a friend named Alberto who has been given the medical loss by Lumbago.  Keep charging while at home recovering. The day of the medical review arrives and the doctor asks him to make certain movements. He also asks about the degree of pain. Alberto cannot correctly perform all movements and ensures that it hurts a lot. The doctor issues another medical part for Alberto to continue. Our friend, through simulation, has managed to be loudly.

Alberto's first casual. He took advantage of a real situation and dramatized it to obtain an external benefit: do not work and collect at the same time. Simulation, as we will see throughout the article, still encompasses a long debate about whether or not it can be a disorder. Let's deepen!

Content

• Simulation, what is it? Is it a disorder?
• Differences and categories
• Simulation evaluation
  • Suspicion indicators
  • Factors in psychosis simulation and other disorders
  • Conclusion
  • Bibliography

Simulation, what is it? Is it a disorder?

According to the DSM-V, the simulation consists of the "intentional production of disproportionate or false physical or psychological symptoms, motivated by external incentives Like: avoiding a job, obtaining financial compensation, escape from a criminal conviction, obtain drugs, not perform military service, etc. ". In the simulation, there is supposedly the knowledge that it is lying on the condition of the symptoms, so the disorder or pathology would be ruled out. However, there are authors who defend that it could be an indicator of some kind of mental disorder.

The Mercedes Inda (2000) team from the University of Oviedo, puts on the table the question of whether the simulation could be the reflection of some mental disorder. The authors claim that "This can be quite clear in the so -called 'factitio' or fictional disorder, where the person pretends physical or psychological symptoms intentionally, in order to assume the role of patient".

The authors point out that it could be a sign of a Histrionic personality disorder Due to the lack of control over manipulative behavior. They also suggest that conscious exaggeration could be part of neurotic behavior since, as Mercedes Inda's team states, "No person in their balances usually reaches those extremes, nor would they choose such tortuous and painful routes, to obtain possible profits,".

The Inda team lists The most simulated disorders:

• Post-traumatic stress disorder.
• Post-traumatic brain damage syndrome.
• Amnesia.
• Psychosis.

Differences and categories

Resnick (1997), establishes Differences between simulations:

• Pure simulation or pretending of a non -existent disorder.
• Partial simulation or conscious exaggeration of symptoms present or a disorder that has already been overcome.
• False amputation. It consists of the erroneous attribution of real symptoms to a certain cause. All this, due to an incorrect interpretation of the situation or a conscious deception.

Yudofsky (1985) divided the simulation into four categories:

1. Staged events. It consists of preparing an episode in detail, for example, preparing an outrage or a fall in the workplace.
2. Data manipulation. Modification, alteration or pollution of medical tests with the purpose of simulating abnormal findings.
3. Opportunistic simulation. Through a wound or accident, the person exaggerates the symptoms to maximize economic compensation.
4. Invention of symptoms. It consists of the invention of symptoms without previous evidence of wounds or disease. It can range from neurological aspects such as seizures or headaches, to psychological aspects such as psychosis or post -traumatic stress disorder. For example, children usually simulate belly pain so as not to have to go to school.

Stoudemire (1989), added a fifth form of simulation, the self -destructive behavior. It is a self -destruction and/or mutilation behavior. The objective is to avoid any obligation. For example, you can find cases of soldiers who trigger themselves to avoid entering the prisoners to get out of their cells.

Simulation evaluation

Lezak (1995), advises the following neuropsychological tests to detect possible simulations:

• Bender test.
• Benton visual retention test.
• Halstead-Ready battery.
• MMPI.
• Pica (Porch Index of Communicative Ability).

On the other hand, It is important to perform a complete medical and psychological examination. It is convenient to rule out any real and psychological real pathology. Some authors such as Dualba and Scott (1993), point out the Importance of cultural differences when assessing simulation.

Suspicion indicators

Yudofsky listed a series of clinical indicators through which it can be suspected that simulation is taking place. However, the author assures that These indicators lack a diagnostic nature because they can occur in more situations. The following points would facilitate if someone is simulating:

• History data, examination and diagnosis are incongruous with symptomatic complaints.
• The symptoms are poorly defined and vague.
• There is excessive dramatization of complaints.
• The patient is not cooperative in the diagnosis.
• Favorable diagnoses are received with some resistance from the patient.
• Wounds seem self -induced.
• In case of analysis, unsuspected drugs or toxins usually appear.
• Medical records have been altered.
• Existence of a story of accidents or recurring wounds.
• Antisocial personality traits can be seen.
• Through the symptoms or disorder, some legal procedure or a possible entry into jail can be avoided, as well as avoiding unpleasant activities, situations or living conditions.
• The patient has requested addictive drugs.

Factors in psychosis simulation and other disorders

Resnick offers some Key points to detect psychosis simulation and other disorders:

• Avoid being guided by subjective trust In diagnostic acuity itself.
• Consider the importance of the reason that the subject has to deceive.
• To exclude simulation, Avoid based only on the results of the interview and on physical examination.
• Contemplate the use of evidence aimed at detecting simulation.
• Collect Collateral and confirmatory information.

Conclusion

Simulation is an issue that continues to be investigated in psychology. The difficulty in detecting cases of deception is still high, even so, little by little methods are being obtained for this. Because of the other side, Some authors emphasize the adaptive aspect of simulation.

Although throughout the article it has been drawn as a picaresca -dyed phenomenon whose intention seems to be malevolent, there are also cases where it could be justified. If we know they will send us to a war where we may die, Wouldn't we self -injured to get rid of an almost safe death? Thus, simulation is a topic as interesting as controversial.

Bibliography

• Inda, m., Lemos, s., López, a. And Alonso, J. (2005). The simulation of physical illness or mental disorder. Psychologist's papers, 26, 99-108.
• Dualba, l., And Scott, R. (1993). Somatization and Mallingering for Workers' Compensation Applicants: A Cross-Cultural MMPI Study. Journal of Clinical Psychology, 49 (6), 913-917.
• Lezak, m. (nineteen ninety five). Neuropsychological Assessment (Third Edition). New York: Oxford University Press.
• Resnick, p. (1997). Posttraumatic Disorders Malling. In r. Rogers (editor), Clinical Assessment of Mallingering and Disance (pp. 130-152). New York: Guilford Press
• Yudofsky s. (1985). Conditions not attribibitable to mental disorder. In "Comprehensive Textbook of Psychiatry (Fourth Edition)". Edited by James, B., Alcott, v. and Ruíz, P. Evansville: Wolters Kluver.