A factitious disorder is a condition in which a person, without a malingering motive, acts as if they have an illness by deliberately producing, feigning, or exaggerating symptoms, purely to attain (for themselves or for another) a patient's role. People with a factitious disorder may produce symptoms by contaminating urine samples, taking hallucinogens, injecting fecal material to produce abscesses, and similar behaviour. Factitious disorder imposed on self (also called Munchausen syndrome) was for some time the umbrella term for all such disorders. Factitious disorder imposed on another (also called Munchausen syndrome by proxy, Munchausen by proxy, or factitious disorder by proxy) is a condition in which a person deliberately produces, feigns, or exaggerates the symptoms of someone in their care. In either case, the perpetrator's motive is to perpetrate factitious disorders, either as a patient or by proxy as a caregiver, in order to attain (for themselves or for another) a patient's role. 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. Etiology What causes factitious disorder is not well understood, however there is a handful of possible motives that drive this pattern of behavior. Individuals may experience a heightened thrill from medical procedures, a desire for attention and care, or feelings of control or accomplishment when deceiving medical professionals. 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. 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. This is considered masochistic behavior. Individuals diagnosed with this disorder are more likely to have a history of emotional or physical abuse, neglect, and/or turbulent childhoods. This upbringing can cause an unstable sense of identity and low self-esteem. Abuse may prompt a feeling of lack of