Question
What is Factitious Disorder Imposed on Another (FDIA)?
Answer
Factitious Disorder Imposed on Another, or FDIA was formerly known as Munchausen Syndrome by proxy. It falls under the umbrella of physical abuse. We had a recent case of this in the Dallas-Fort Worth area that really grabbed my attention. I know this is rare, but I still want to call your attention to it because it is frightening behavior, usually committed by the mother. FDIA is, as I mentioned, very rare, but it is a diagnosable mental illness that's characterized by a mother who acts as if her child is physically or psychologically ill when the child is really not ill. Generally, this is a young child, under the age of six. The mother is craving attention and enjoys being in the spotlight for trying to care for this “ill” child because she wants people to think that she's such a caring and devoted mother. A mother with this disorder may create or exaggerate her child's symptoms in the following ways. She may flat out lie about the symptoms, or alter some type of diagnostic test. If no one else is in the room, she can contaminate a urine sample, for example. She might doctor shop and find a doctor who will listen to her and treat her child in the way she thinks the child needs to be treated. She may even falsify medical records. Then sadly, she may induce the symptoms herself by either poisoning, suffocating, starving the child, or causing infection. (Cleveland Clinic, n.d.)
Some warning signs for FDIA are that the child has a history of multiple hospitalizations, there is a worsening of the child's symptoms reported by the mother yet not witnessed by hospital staff, or the child's condition improves in the hospital but symptoms recur once the child is back home. The blood in lab samples might not match the child's blood, or there might be signs of chemicals in the child's blood, stool, or urine.
This Ask the Expert is an edited excerpt from the course, Child Abuse and Neglect: An Overview, by Marilyn Massey-Stokes, EdD.
