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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 or as victims of violence, or whose deaths are announced to online forums.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.
Munchausen by Internet is a pattern of behavior akin to the 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).
For prolonged cases, he states the impetus for such behavior is the "longing for nurturing, sympathy, care and concern that they feel unable to get in appropriate ways," and that the admiration of forum members is a strong motivator to continue.
As manipulation is integral to most cases, the need to control others to feel as if the perpetrator is in control of his or her own life is apparent, as is the pre-existence of underlying personality disorders.
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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.