[Phenomenology of malingering, dissimulation and aspiration].

Malingering is a voluntary production and presentation of false or grossly exaggerated physical or psychological symptoms in an attempt to achieve secondary gain which otherwise is difficult to reach. Dissimulation means concealment of genuine psychiatric or other medical symptoms in an attempt to present a picture of psychiatric or organic health. Secondary gain is prominent, yet, primary gain exists as well. Aspiration is a higher degree of dissimulation, whereby the person not only denies having symptoms but pretends to be much healthier than he actually is and even more than all the healthy people surrounding him. Aspiration is mostly driven by primary gain. Secondary gain strengthens the primary one by the positive feedback the individual receives in considering him to be healthy and strong, deserving appropriate social, professional and financial attitudes. The article discusses these three phenomenological concepts with their possible medico-legal aspects, illustrating each by clinical vignettes.