Factitious Disorder & Dissociative Disorder

Factitious Disorder

• Purposely faking physical symptoms
• May actually induce physical symptoms or just pretend to have them
• No obvious external gains
  • Only external gain may be benefit of “sick role” (e.g., sympathy)
  • Distinguished from malingering, in which physical symptoms are faked for the purpose of achieving a concrete objective (e.g., getting paid time off, avoiding military service)

DSM-5 Criteria: Factitious Disorder

• Falsification of physical or psychological signs or symptoms
• Individual presents self as ill or injured
• Deceptive behavior is evident in absence of external rewards
• Not otherwise explained

Factitious Disorder Imposed on Another

• More commonly known as Munchausen syndrome by proxy
• Inducing symptoms in another person
  • Typically a caregiver induces symptoms in a dependent (e.g. child)
• Purpose = receive attention or sympathy

Dissociative Disorder

• Severe alterations or detachments from reality
• Affect identity, memory, or consciousness
• Depersonalization – distortion in perception of one’s body or experience (e.g., feeling like your own body isn’t real)
• Derealization – losing a sense of the external world (e.g., sense of living in a dream)
• Types of DSM-5 dissociative disorders
  • Depersonalization/derealization disorder
  • Dissociative amnesia
  • Dissociative trance disorder
  • Dissociative identity disorder