Malingering differs fundamentally from factitious disorders in that the malingerer simulates illness intending to obtain a material benefit or avoid an obligation or responsibility.
Somatic symptom disorders, though also diagnoses of exclusion, are characterized by physical complaints that are not produced intentionally.
[2] What causes factitious disorder is not well understood, however there is a handful of possible motives that drive this pattern of behavior.
[3] They may partake in this behavior in order to seek and maintain relationships or use the sick-patient role as a coping strategy in response to stressful life events.
[4] If an individual did not form a healthy attachment to a caregiver as a child, there is a possibility that the person may develop factitious disorder in order to fulfill the need of receiving care.
Attention from medical professionals may act as a replacement in satisfying important needs that the person never received as a child.
Individuals may also use invasive or painful tests or procedures as a way to punish oneself for past mistakes or to cope with guilt associated with abuse.
[3] Individuals diagnosed with this disorder are more likely to have a history of emotional or physical abuse, neglect, and/or turbulent childhoods.
Abuse may prompt a feeling of lack of control, and the person may use faked symptoms and a fabricated medical history to gain back a sense of autonomy.
However, there is an overarching belief that patients experience the uncontrollable urge to maintain the sick-patient role, acting as a type of behavioral addiction.
Criteria for diagnosis include intentionally fabricating to produce physical or psychological signs or symptoms and the absence of any other mental disorder.
When the individual applies this pretended sickness to a dependent, for example, a child, it is often referred to as "factitious disorder by proxy".
Factitious disorder symptoms may seem exaggerated; individuals undergo major surgery repeatedly, and they "hospital jump" or migrate to avoid detection.
Factitious disorder imposed on another, previously Munchausen syndrome by proxy, is the involuntary use of another individual to play the patient role.
Another hypothesis is that many times a factitious disorder individual is placed in a home, or experiences health issues that are not self-induced or feigned.
In this way, the problem with obtaining the "patient" status is resolved because symptoms arise without any effort on the part of the individual.