Malingering has been described as intentional "pretending" to be sick, motivated by external incentives, such as financial gain or avoidance of work, school, or other negative situations. In these cases, the discrepancy between claimed distress and actual disability is often transparent, and the motivation is overt and obvious. Although malingering can become a chronic coping strategy used by the individual in a variety of situations, it does not involve im-posturing to meet self-serving psychological needs, as is the case in factitious disorder. Children may learn to malinger to avoid tasks or events they consider negative or threatening. These behaviors may be reinforced by parents for multiple reasons. Parents may use their children, claiming they are sick, to avoid situations that they view as negative in some way. Malingering by proxy tends to be transparent, and the secondary gain is tangible and straightforward.

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