Psychology: Factitious Disorders Overview

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Questions and Answers

What distinguishes factitious disorders from malingering?

The presence of severe physical illnesses

The use of aliases to evade medical tracking

The psychological needs fulfilled by the sick role (correct)

The presence of external goals motivating the behavior

Which of the following is a common comorbidity associated with factitious disorder?

Cluster A personality disorders

Major depression (correct)

Anorexia nervosa

Obsessive-compulsive disorder

What is a characteristic behavior often exhibited by individuals with Munchausen syndrome?

Faking symptoms in a single location

Publicly disclosing their medical history

Refusing any medical treatment

Traveling widely using different aliases (correct)

Which statement best describes the treatment approach for factitious disorder?

Development of a separate treatment plan for each individual Signup and view all the answers

What makes the diagnosis of factitious disorders particularly challenging?

The presence of genuine physical diseases can complicate diagnosis Signup and view all the answers

How might someone with a genuine physical disease manipulate their condition to resemble factitious disorder?

By self-inducing symptoms or complications Signup and view all the answers

Which of the following best explains the impact of severe personality disorders on factitious behavior?

They can provoke splitting and manipulation in clinical settings Signup and view all the answers

What key element must be ruled out when diagnosing factitious disorders?

The presence of a genuine disease process Signup and view all the answers

What often indicates that a mother may be causing her child's illness in cases of factitious disorder imposed on another?

The child rapidly improves when the mother is absent. Signup and view all the answers

What psychological traits are commonly observed in patients with factitious disorder imposed on self?

Narcissistic or histrionic personality traits Signup and view all the answers

What is a notable laboratory finding in patients exhibiting factitious disorder behavior?

Hypokalemia from diuretic ingestion Signup and view all the answers

What consequence might arise from reasonable suspicion of factitious disorder imposed on another?

Mandatory reporting to child protective services Signup and view all the answers

Which of the following best describes a key characteristic of neuroimaging studies related to factitious disorder?

No neuroimaging studies have been reported specifically. Signup and view all the answers

What demographic commonly experiences high mortality rates due to factitious disorder imposed on another?

Children affected by factitious disorder Signup and view all the answers

In the context of diagnosing factitious disorder, what is a frequent challenge faced by healthcare providers?

Patients typically deny having any psychological issues. Signup and view all the answers

What is the hallmark of Munchausen syndrome by proxy?

Parent or caregiver intentionally causing illness in another. Signup and view all the answers

What is a primary characteristic of patients with common factitious disorder?

They frequently deny the true nature of their problems. Signup and view all the answers

Which of the following best describes Factitious Disorder Imposed on Another?

A situation where an individual deceives others by presenting someone else as ill. Signup and view all the answers

What motivates the behavior in Factitious Disorder Imposed on Another?

A desire to gain attention or sympathy. Signup and view all the answers

Which statements accurately describe Munchausen syndrome by proxy?

It involves the mother administering harmful substances to the child. Signup and view all the answers

What is a key diagnostic challenge in identifying factitious disorders?

The symptoms can be convincingly fabricated or induced. Signup and view all the answers

In which year was Factitious Disorder Imposed on Another first described?

1978 Signup and view all the answers

How do patients with factitious disorder typically react when confronted with evidence of their condition?

They react with hostility and disbelief. Signup and view all the answers

Which characteristics are often associated with patients diagnosed with common factitious disorder?

Borderline or histrionic personality traits. Signup and view all the answers

Study Notes

Factitious Disorder Imposed on Oneself

Patients with factitious disorder imposed on oneself often have severe characterological problems like sociopathy, narcissism, or histrionic personality traits.
Approximately 30% of patients with factitious disorder imposed on oneself have some form of cerebral dysfunction.
This dysfunction is often demonstrated by a significantly higher verbal IQ score compared to performance IQ score, possibly linked to pseudologia fantastica.
Test results of patients with factitious disorder imposed on oneself are consistent with histrionic or borderline personality traits, somatic preoccupation, and conflicts about sexuality.

Factitious Disorder Imposed on Another (Previously Factitious Disorder by Proxy)

This disorder involves a perpetrator (usually the mother) presenting another individual (the victim) as ill, impaired, or injured, with a clear intent to deceive.
The deceptive behavior is evident even without obvious external rewards.
The behavior is not explained by other mental disorders like delusional disorder or another psychotic disorder.
The diagnosis is given to the perpetrator, not the victim.
This disorder was first described in 1978 and has been widely reported since, with every major children's hospital seeing several cases per year.
The perpetrator usually presents the child with either simulated or factitiously produced diseases.
The perpetrator is often intensely involved in the child's care and with hospital staff, willingly signing consent forms for invasive procedures or treatment.

Symptoms and Behavioral Patterns

The child may inexplicably improve when the mother is out of the hospital for a period of time.
The child's father is usually uninvolved or absent.
When confronted with suspicions or proof, the mother often reacts with angry denial. Hospital staff may also express disbelief.

Diagnostic Considerations

Suspicion: Reasonable suspicion of factitious disorder imposed on another requires reporting to child protective services as a form of child abuse.
Mortality Rate: Children affected by this disorder have a high mortality rate, with almost 10% dying before reaching adulthood.
Sibling Implications: Studies show a similarly high mortality rate among the siblings due to the potential for perpetration on subsequent children.
Placement: Children may need to be placed outside the home, with relatives or in foster care.

Laboratory Findings

Laboratory testing may reveal inconsistent findings, not typical of known physical diseases (e.g., hypokalemia from surreptitious ingestion of diuretics).
The presence of toxins or medications denied by the patient can establish the diagnosis (e.g., phenolphthalein in the stool of a baby with diarrhea due to Munchausen Syndrome by Proxy).

Neuroimaging

There are no specific neuroimaging studies reported for factitious disorder.

Differential Diagnosis

Genuine Physical Disease: Factitious disorders must be ruled out from genuine physical disease processes.
Malingering: The key difference is motivation. In malingering, an external goal motivates the behavior (e.g., disability payments), while in factitious disorder, the goal is to fulfill psychological needs by assuming the "sick role."
Comorbidity: Patients often have comorbid somatic symptom disorder, major depression, or schizophrenia and are likely to have a Cluster B personality disorder (antisocial, borderline, histrionic, narcissistic).

Treatment

Therapeutic approaches for factitious disorder are distinct from those used for specific disease states.
Treatment plans must be individualized due to differing motivations and associated personality disorders.
The clinician must be cautious of manipulative behavior and hostility displayed by these patients, who often deny their problems despite clear evidence.

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Description

Explore the intricacies of factitious disorders imposed on oneself and others. This quiz highlights key characteristics, psychological challenges, and common traits associated with these disorders, including the role of deception. Test your knowledge on the differences and psychological implications surrounding these complex conditions.