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Munchausen by Internet
Munchausen by Internet is a pattern of behavior akin to Munchausen syndrome (a psychiatric factitious disorder wherein those affected feign disease, illness, or psychological trauma to draw attention, sympathy, or reassurance to themselves) in which Internet users seek attention by feigning illnesses in online venues such as chat rooms, message boards, and Internet Relay Chat (IRC). It has been described in medical literature as a manifestation of factitious disorder or factitious disorder by proxy.〔 Reports of users who deceive Internet forum participants by portraying themselves as gravely ill or as victims of violence first appeared in the 1990s due to the relative newness of Internet communications. The pattern was identified in 1998 by psychiatrist Marc Feldman, who created the term "Münchausen by Internet" in 2000. It is not included in the fifth revision of the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM-5).
The development of factitious disorders in online venues is made easier by the availability of medical literature on the Internet, the anonymous and malleable nature of online identities, and the existence of communication forums established for the sole purpose of giving support to members facing significant health or psychological problems. Several high-profile cases have demonstrated behavior patterns which are common among those who pose as gravely ill, victims of violence, or whose deaths are announced to online forums. The virtual communities that were created to give support, as well as general non-medical communities, often express genuine sympathy and grief for the purported victims. When fabrications are suspected or confirmed, the ensuing discussion can create schisms in online communities, destroying some and altering the trusting nature of individual members in others.
== Characteristics ==
The term "Munchausen by Internet" was first used in an article published in the ''Southern Medical Journal'' written by Marc Feldman in 2000. Feldman, a clinical professor of psychiatry at the University of Alabama at Birmingham, gave a name to the phenomenon in 2000, but he co-authored an article on the topic two years earlier in the ''Western Journal of Medicine'', using the description "virtual factitious disorder".〔 Factitious disorders are described in the ''Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR'' (DSM) as psychological disorders involving the production of non-existent physical or psychological ailments to earn sympathy. These illnesses are feigned not for monetary gain or to avoid inconvenient situations, but to attract compassion or to control others.〔(Factitious disorders ), Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR (Psychiatry Online). Retrieved on July 28, 2009.〕 Chronic manifestation of factitious disorder is often called Munchausen syndrome, after a book about the exaggerated accounts of the adventures of Baron Munchausen, a German cavalry officer in the Russian Army, that was written by Rudolf Erich Raspe.〔McDermott, Barbara E.; Leamon, Martin H.; Feldman, Marc D.; Scott, Charles L. (Chapter 14. Factitious Disorder and Malingering: Factitious disorder ), ''Textbook of Psychiatry'' (Psychiatry Online). Retrieved on August 18, 2009.〕 When another person's symptoms are caused, such as a child or an elderly parent's, it is called factitious disorder by proxy, or Munchausen syndrome by proxy.〔(Appendix B: Criteria Sets and Axes Provided for Further Study: Factitious disorder by proxy ), Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR (Psychiatry Online). Retrieved on August 18, 2009.〕
Feldman noted that the advent of online support groups, combined with access to vast stores of medical information, were being abused by individuals seeking to gain sympathy by relating a series of harrowing medical or psychological problems that defy comprehension. Communication forums specializing in medical or psychological recovery were established to give lay users support in navigating often confusing and frustrating medical processes and bureaucracy. Communities often formed on those forums, with the goal of sharing information to help other members. Medical websites also became common, giving lay users access to literature in a way that was accessible to those without specific medical training. As Internet communication grew in popularity, users began to forgo the doctors and hospitals often consulted for medical advice. Frequenting virtual communities that have experience with a medical problem, Feldman notes, is easier than going through the physical pain or illness that would be necessary before visiting a doctor to get the attention sought. By pretending to be gravely ill, Internet users can gain sympathy from a group whose sole reason for existence is support. Health care professionals, with their limited time, greater medical knowledge, and tendency to be more skeptical in their diagnoses, may be less likely to provide that support.〔〔Shreve, Jenn (June 6, 2001). ("They Think They Feel Your Pain" ), Wired.com. Retrieved on July 28, 2009.〕〔 〕
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