Which statement best distinguishes Factitious Disorder from Malingering?

• A. Factitious Disorder is driven by external incentives; Malingering by internal need to assume the sick role.
• B. Both are primarily unconscious.
• C. Factitious Disorder is external incentives; Malingering internal.
• D. Factitious Disorder is driven by an internal psychological need to assume the sick role; Malingering is driven by external incentives.

Answer: (D)

The main idea this item tests is motivation behind feigned illness. The best statement captures that Factitious Disorder involves an internal psychological drive to assume the sick role—people fake symptoms to be cared for and to obtain medical attention, not for external rewards. In contrast, Malingering is driven by external incentives—there are tangible benefits like avoiding work, getting drugs, or securing financial compensation, so the deception is aimed at a concrete outside goal. Keeping the distinction clear between internal, need-for-care motives and external, payoff motives is what distinguishes the two disorders.