The implications eventually reduced to the potential for neurological dysfunction and cognitive abnormalities to be the root cause for the medical presentation. While there is ample amount of information presented supporting the premise of psychological responses at the root of particular illnesses, the review often becomes lost in itself. The discussion on the connection between stress and disease often appeared lost in the translation of prior research.
Brady, Scher, and Newman took a more humorous approach to assessing the issue of malingering in the emergency room. The information presented is easy to read, and is presented in an introductory textbook fashion. No new information identifying the specifics of malingering was indicated. However, there is discussion on potential differential diagnoses for consideration. Brady et al. (2003) do point out the resulting disposition of many of these cases of malingering "Even with the self-report by some individuals of "hollow" psychotic symptoms or bipolar disorder, many individuals were admitted for periods of 7 to 52 days to an inpatient unit for observation and assessment" (Brady, Scher, and Newman 2003, p. 38). There has not been one specific test or examination identified for use to clearly identify malingering. Relying upon admitting patients to a psychiatric floor appears to be the only available direction for emergency room doctors to follow. .
Further research by Calhoun, Earnst, Tucker, Kirby, and Beckham focused specifically on PTSD and combat related veterans. The focus of their study involved the use of the Personality Assessment Inventory (PAI), and the Negative Impression Management (NIM) scale to identify the presence of PTSD and malingering. The research referenced prior studies that indicated individuals that engage in malingering tend to score higher on PAI and NIM testing, but there were also noted negatives with this outcome.