Table 1: Feldman’s Clues to Factitious Illness Behaviour on the Internet and Diana’s Online Behaviour.
FIBI CLUES Diana’s Behaviour (including verbatim quotes)
The posts consistently duplicate material in other posts, in textbooks, or online health-related websites Posted the same or similar information with the same username to three BC support sites. 1. “a mother of daughter Michaela 8 years old with breast cancer stage 2 grade2.”
2.” im a mum with breast cancer stage 2 grade 2
The length, frequency, and duration of the posts do not match the claimed severity of the illness e.g. a detailed post from someone claiming to be in septic shock). Chatted with the SBCN at length, from hospital, shortly after a miscarriage and hysterectomy then after surgery for a brain tumour only on this occasion used her sister as a ‘sock puppet’.
The characteristics of the supposed illness and its treatment emerge as caricatures based on the individual’s preconceptions. Changes her BC stage and grade from one chat to the next Refers to oral chemotherapy that is given at the hospital and that she has to stay in hospital for so that ‘… they can keep watch on me” and “i am bedridden still for another week or so” “daily tablets hospital said spoke to oncology” frequently refers to feeling tired and nauseated and food “….tasting funny…”
Near-fatal exacerbations of illness alternate with miraculous recoveries. Recovers from brain and other major surgeries almost overnight yet continues to chat.
“Meningitis under control now but had total hysterectomy last night 2.30 am long needle in arm and 6 drips!”
Personal claims are fantastic, contradicted by later posts, or disproved. Claims to have a learning disability so her child was taken away at birth to live with her mother.
States she is in one location then another, in a timeframe that is impossible.
Claims to have lost her hair due to chemotherapy timeframes prove this to be unlikely.
Claims her mother was killed and her daughter seriously injured in a car accident
There are continual dramatic events in the person’s life especially when other group members have become the focus of attention. As more people joined the Click and made claims on the SBCN’s time Diana introduced more health conditions and underwent several surgeries while coping with the treatment for diabetes, asthma, breast infection due to cut from a mammogram, meningitis, breast cancer and cervical cancer, coeliac disease and a urinary tract infection plus the death of her mother and the serious injury of her daughter in a car accident.
The individual complains that other group members are not sufficiently supportive and warns that this insensitivity is undermining his/her health Diana she did ensure that a major part of any Click Chat session was taken up by her comments by pretending to leave the session, then staying in the chat room and interrupting other members discussions with her claims to feeling nauseated and upset.
The individual resists telephone contact, sometimes offering odd justifications One telephone contact is known to have occurred therefore the behaviour does not comply with this clue.
There is feigned blitheness about crises (e.g. a cardiac arrest) that will predictably attract immediate attention. Reports that her father had a stroke then when asked for further information about his condition, comments on a sporting event. Turns the conversation back to herself with “oh i had to get another scan for my cevical check as bleeding strated again” but then asks “what’s for dinner”
Others ostensibly posting on behalf of the individual have identical patterns of writing, such as grammatical errors, misspellings, and stylistic idiosyncrasies SBCN Comment: “Pauline [Diana’s sister] speaks in exactly the same fashion as Diana, and is in [A] one moment and with Diana in [B] the next! I am now doubtful 'Pauline' is sending any messages…she mayexist but I am not convinced she is 'sending' messages!). I have also had a nurse, social worker & specialist breast care nurse all 'send' me messages - they all speak in same fashion as Diana and many things do not add up - I suspect it is all just Diana …”