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Types of Factitious Disorders

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  • 0:07 Factitious Disorders
  • 1:22 Factitious Disorder
  • 3:36 By Proxy
  • 4:34 Ganser Syndrome
  • 7:15 Lesson Summary
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Instructor: Natalie Boyd

Natalie is a teacher and holds an MA in English Education and is in progress on her PhD in psychology.

Some people make themselves or others sick in order to get attention. In this lesson, we'll look at three types of factitious disorders, including their symptoms and the differences among them.

Factitious Disorders

When Jane was a little girl, she was very sick. She spent a lot of time in the hospital, and her mother and doctors all worked to make her feel safe and cared for. Now, as a college student, Jane sometimes makes up severe pain in her chest or abdomen. When she pretends to be in pain, her roommate takes her to the campus infirmary, where the doctors and nurses take care of her.

Callie doesn't make herself sick, but like Jane, she misses the attention she got when she was sick as a kid, so sometimes Callie gives her daughter a homemade concoction that induces vomiting. When her daughter begins to get sick, Callie rushes her to the hospital, where the doctors and nurses tell Callie what a good mother she is for bringing her daughter in.

Both Jane and Callie are suffering from factitious disorders, psychological disorders that involve faking or making yourself or someone else ill. There is not an external gain, like money or time off of work. Instead, most people with factitious disorders seek attention or other emotional fulfillment. Let's look closer at three types of factitious disorders: factitious disorder, factitious disorder by proxy, and Ganser syndrome.

Factitious Disorder

Remember Jane? She pretends to have severe pain in her abdomen or chest. In this way, she gets attention and care-taking from her roommate and the doctors and nurses at her school infirmary. Jane is suffering from factitious disorder. As we mentioned before, factitious disorder involves faking illness or making yourself sick without any external gain. There are three criteria that distinguish factitious disorder from other disorders:

  1. Intentional production or feigning of symptoms - These can be psychological or physical symptoms. Jane is faking pain; she isn't actually in pain, but she pretends to feel it. She's feigning physical symptoms.
  2. The motivation is to assume the sick role - In Jane's case, she's feigning her symptoms so that she can end up in the infirmary. She wants the attention that she gets by being the person with an illness.
  3. External incentives are absent - Some people pretend to have a psychological disorder to avoid jail time as part of an insanity defense. Others pretend to have something wrong with them so they don't have to serve in the military or so they can collect a disability check. These are all examples of external incentives.

But, in Jane's case, she has no external incentive. She's not trying to make money or get out of doing her coursework by pretending to be sick, so she has no external incentive. Because Jane meets all three criteria, we know that she has factitious disorder. But, there are three different subtypes of this disorder: factitious disorder with predominantly physical symptoms, factitious disorder with predominantly psychological symptoms, and factitious disorder with combined physical and psychological symptoms.

Jane has factitious disorder with predominantly physical symptoms because she complains of physical pain. If she was pretending to suffer from a mental illness, she would have factitious disorder with predominantly psychological symptoms. And, if she pretended to have both physical and psychological issues, she'd be diagnosed with factitious disorder with combined symptoms.

By Proxy

Jane has factitious disorder because she's pretending to be sick so that she can get attention, but what about Callie? What's wrong with her? Remember that Callie makes her daughter sick so that she can get attention herself. When a person produces or fabricates symptoms in someone else, it is called factitious disorder by proxy or factitious disorder imposed on another.

Patients who suffer from factitious disorder by proxy are usually caretakers. Parents, particularly mothers, are the most common group to have factitious disorder by proxy. Other types of caretakers include those taking care of elderly relatives, disabled persons, or even pets. Like Jane's factitious disorder, Callie must meet the criteria of faked or produced symptoms and no external motivators. In addition, Callie must want to play the role of caretaker of someone ill in order to be diagnosed with factitious disorder by proxy.

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