Causes of fabricated or induced illness 

The causes of fabricated or induced illness (FII), also known as Munchausen's syndrome by proxy, are not fully understood, and more research is needed.

However, previous traumatic experiences in the life of the parent or carer responsible seem to play an important role.

Recent studies have shown that mothers who carry out the abuse have abnormal "attachment" experiences with their own mothers, which may affect their parenting and ability to secure bonds with their children. An example of this is repeatedly seeing a doctor to satisfy an emotional need to get attention for the child.

Child abuse

One study found that almost half of mothers who were known to have fabricated or induced illness in their child were victims of physical and sexual abuse during their own childhood.

However, it's worth noting that most people who were abused as children do not go on to abuse their own children.

Previous medical history

One or both parents may have a history of self-harm or drug or alcohol abuse.

Some case studies also revealed that the mother may have experienced the death of another child, or a difficult pregnancy.

Personality disorder

A high proportion of mothers involved in FII have been found to have a personality disorder and, in particular, a borderline personality disorder.

Personality disorders are a type of mental health problem, where an individual has a distorted pattern of thoughts and beliefs about themselves and others. These distorted thoughts and beliefs may cause them to behave in ways that most people would regard as disturbed and abnormal.

A borderline personality disorder is characterised by emotional instability, disturbed thinking, impulsive behaviour, and intense but unstable relationships with others. However, it's important to note that not all mothers with borderline personality disorder go on to abuse their children.

Read more about borderline personality disorder.

Sometimes, people with personality disorders find reward in behaviour or situations that other people would find intensely distressing. It's thought that some mothers who carry out FII find the situation of their child being under medical care rewarding.

Other mothers who have been involved in FII have reported feeling a sense of resentment towards their child because they have a happy childhood, unlike their own.

Role playing

A further theory is that FII is a kind of role playing.

It allows a mother to adopt the role of a caring and concerned mother, while at the same time allowing her to pass the responsibility of caring for a child onto medical staff.


Another theory is that FII is a way for the mother to escape her own negative feelings and unpleasant emotions.

By creating a permanent crisis situation surrounding her child, she is able to focus her thoughts on the treatment of her child, while keeping her own negative feelings and emotions at bay.

Page last reviewed: 06/10/2014

Next review due: 06/10/2016