Rosh Psychiatry Board Practice Exam

For a DSM-5 diagnosis of factitious disorder imposed on another, the presence of deceptive behavior is crucial. Factitious disorder imposed on another, previously known as Munchausen syndrome by proxy, involves an individual intentionally producing or feigning symptoms in another person (typically a child or dependent) to assume the role of caregiver and gain the attention or sympathy associated with that role. Deceptive behavior is central to the diagnosis because individuals exhibiting this disorder manipulate medical settings or provide false information to create the appearance of illness in another. The intent is to mislead healthcare professionals, which distinguishes this disorder from other types of malingering, where a person would seek external rewards or benefits. While the other options pertain to various aspects of psychiatric diagnosis, they do not fulfill the specific criteria for this disorder. Recurrent episodes may be indicative of patterns observed in some disorders but are not a necessary component for the diagnosis of factitious disorder imposed on another. The sick role motive, which refers to the motivation for the behavior, implies a psychological need for attention or care, but it is not explicitly required for the diagnosis. Lastly, external gains, such as financial compensation, are characteristic of malingering but are not consistent with factitious disorder, where the primary motivation is