Question

Jane works as a word processor for a large insurance company. Her job, which she detests, involves inputting hundreds of numbers into a computer. She has gone to her family physician because she feels a constant tingling in her fingers and a sharp pain in her fingers, wrist, and forearm but only at certain times. Her doctor is not a neurological specialist but can see nothing obviously wrong with Jane’s hands or wrists. Jane is depressed and anxious about this condition. She says, “Here I am only 29 and already I have pains that are worse than my 76-year-old grandmother has. What will I be like in twenty years? Already it is agony for me to do my work.”

List ways in which Jane’s condition could be evaluated. You cannot be expected to be experts in neurology, but you should think through ways of detecting malingering, voluntary inducement of symptoms, physical causes, and psychological causes.

What information would you need to decide whether Jane is malingering?

Answer 1

Malingering is that term applies to persons who deliberately pretend to have a illness or disability in order to avoid punishment or responsibility.

Here Jane is working on computer for a longer time so there is a physical and psychological cause for her ailment.

Physical cause : Here she makes her finger and hand movement over and over especially if the wrist bent down, It causes pressure on median nerve and several tendons run from fore arm to her hand through smal space in her wrist called carpal tunnel. The medial nerve controls movement and feelings in her hand, thumb etc. This pain and tingling is for short term and it will disappear once she relax.

Psychological cause: Due to the work load and external pressure she is undergoing nervousness, anxiety, fear and elevated stress. It will cause tingling on finger and pain in arms and wrist. It will disappear once she come out from the pressure.

After observing her symptoms it is a Genuine case and she has to consult Neurologist and Psychologist.